Leader Blues

Tuesday, January 05, 2010

TOP STORY >> Reform to help hospitals

By GARRICK FELDMAN AND JOHN HOFHEIMER
Leader staff writers

Sen. Blanche Lincoln (D-Arkansas) says community hospitals in Arkansas will recover millions of dollars a year in losses after the health-reform bill becomes law.

Lincoln says hospitals like North Metro Medical Center in Jacksonville, which provides charity care to thousands of patients a year, will be paid for almost all the care they provide because virtually all Americans will be insured when the bill is enacted.

In one recent year, North Metro wrote off $10 million in uncompensated care, or more than 10 percent of its annual revenues of $46.8 million. By law, hospitals cannot turn away patients if they’re uninsured or cannot pay the bill.

This is the main reason North Metro has lost millions of dollars in the last decade.

In a wide-ranging interview Monday, the senator said the 10-year, $871 billion health bill will help insure most Arkansans and bring more Medicare and Medicaid funds to Arkansas without having to make backdoor deals like Sen. Ben Nelson (D-Neb.), who won concessions from the Democrats in return for his support of the health bill.

She said the bill will close the so-called donut hole in the Medicare drug program, which will eventually pay for all the drugs for middle-class seniors. They now pay several thousand dollars that Medicare doesn’t cover.

The senator said some 500,000 Arkansans are uninsured today. At least 250,000 will be insured under the new law. Others will be insured as other features of the law — such as multi-state compacts, ex-changes, cooperatives and other nonprofit groups, where more affordable insurance will be available — are phased in over the next decade.

The senator said the bill would steer people into insurance programs, including automatic enrollment for those available for public assistance, such as ARKids, the state Medicaid program for children.

These efforts, she said, will greatly reduce unreimbursed care and will put more paying patients in hospitals once the state gets the Medicaid rolls expanded to include adults up to 133 or 150 percent of the poverty line. Over time, that should restrain insurance premiums because hospitals won’t be passing along so many costs to insured customers.

“Hopefully, all Americans will be covered,” said Lincoln, who is running for re-election this year.

Amy Arnone, a spokeswoman for North Metro, said Tuesday the hospital “is still evaluating how (the bill) will affect us.”

She said charity care and other uncompensated care has cost the hospital tens of millions of dollars over the years.

Lincoln is one of 60 Democrats and independents supporting the health-care bill.

Sen. Olympia Snow (R-Maine) could be a 61st vote for the plan if it returns from the joint conference committee without significant changes from the bill the Senate approved, Lincoln said.

The bill from that committee must still be approved by both houses of Congress, and in the Senate it will take 60 votes again to avoid a filibuster, Lincoln said.

“If it’s close to what we’ve got, we can maintain the 60 votes we need,” she said.

Lincoln opposes a public option, which she believes would be more costly than its supporters want to admit.

“My concern is that it’s a risk to taxpayers and it it will hurt private insurers,” she said of the public option, which is not included in the Senate version, although it is in the House bill.

Asked how the system could accommodate the influx of 31 million currently uninsured Americans, Lincoln said the bill would expand medical-residency programs, which is pretty much the only way to increase the numbers of health professionals in Arkansas—most medical students are homegrown.

“The key is to make sure we get some residency slots,” she said, “and also an increase in reimbursement, more commensurate with that of other states.”

The senator said there was so much misinformation about the plan—that Medicare services would be cut and that the reforms are socialist.

She said there was $118 billion in subsidies to health-insurance companies paid by Medicare.

Lincoln said core Medicare benefits would be more generous than the current benefits.

“Just absurd,” she said of charges that implementation of the proposed new health-care bill would be another step along the path to socialism.

She said the senators were “painfully aware” of the needs of the private market place, but that it needed to be painfully aware of the health care needs of a nation.

Three out of five Arkansas voters picked John McCain over President Obama in November 2008, leading many pundits, particularly Republicans, to predict Republican upsets of Lincoln and of Cong. Vic Snyder in November.

But she said Sen. Mark Pryor didn’t have competition in the 2008 general election and it was an off-year for statewide elections, so Democrats didn’t have a lot of incentive to turn out.

“(Obama) didn’t create all the challenges and problems we face,” she said. “His plate is full, too.”

“Only by working together are we going to see the country grow strong,” she said, “To make people and the marketplace strong.”

In addition to health-care reform, Lincoln said Congress must provide some predictability to help put people back to work.

She said Congress needs to stop short-term extensions of the highway bill and approve the five-year highway reauthorization bill, to give predictability to state highway departments, which depend on the federal money, and create more jobs.