Archive for June, 2012

TORCH Statement on Affordable Care Act Ruling

Saturday, June 30th, 2012

Judey Dozeto
Twitter: @torchnet

AUSTIN – Texas Organization of Rural & Community Hospitals (TORCH) released the following statement after the Supreme Court ruling on the Affordable Care Act:

Now that national health care reform through the Affordable Care Act has basically been upheld and the individual mandate is here to stay, TORCH will continue to monitor the ongoing analysis of yesterday’s Supreme Court ruling.

There are many phases of the health reform process yet to be implemented until it becomes fully effective in 2014. Therefore, we will also continue to watch for any possible negative impact on rural patients and providers.

The ruling yesterday does have one possible negative implication for hospitals. The law, as originally passed by Congress, required states to expand their Medicaid programs to cover all persons – men, women, and children – up to 133 percent of the national poverty level. This would mean a broad expansion of the number of persons in Texas being cover by Medicaid. In fact, the Texas Health and Human Services Commission had predicted that the level of uninsured in Texas could drop from 26 percent to less than 10 percent. Consequently, many more patients entering Texas hospitals would have insurance coverage.

At first blush, the ruling yesterday appears to remove the financial penalty for state’s that refuse to expand Medicaid. Given the Texas state budget situation and the general position of Governor Rick Perry and the Legislature, Texas could very well choose to decline an expansion of Medicaid.

If so, hospitals would be denied one of the real benefits of these reforms. The financial burden of dealing with high levels of uninsured patients would continue to fall upon small hospitals and local communities. Of course, some of the persons that would have been covered in a Texas Medicaid expansion might be picked up in other areas of the mandate, such as small employers of more than 50 people being required to provide coverage. The more likely scenario, however, is that many of the people that would have been covered by Medicaid expansion could remain uninsured.

As we move forward at the state level, TORCH will be watching to see how our state chooses to handle both the Medicaid expansion and insurance exchange issues.


About Texas Organization of Rural and Community Hospitals

Texas Organization of Rural and Community Hospitals (TORCH) is the voice and principal advocate for rural and community hospitals in Texas. We provide leadership in addressing the special needs and issues of these hospitals. We take aim at the struggle rural hospitals have to survive with the rigors of increasing costs, decreasing reimbursements, the added challenges of bringing new information technology into the rural landscape, dealing with a growing number of retirees and uninsured residents and functioning under a national health care system that many agree is broken. TORCH also takes a place on the national stage, serving both as a model of rural hospital organization and an effective voice in our nation’s capital for rural health care here and elsewhere. Learn more about TORCH on our web site or follow TORCH on Twitter.

HHSC Statement on Affordable Care Act Ruling

Thursday, June 28th, 2012

AUSTIN – Texas Health and Human Services Executive Commissioner Tom Suehs released the following statement after today’s Supreme Court ruling on the Affordable Care Act:

“We’ll work closely with Gov. Perry, state leaders and the Attorney to fully analyze the ruling, but I’m pleased that it gives states more ability to push back against a forced expansion of Medicaid. The court clearly recognized that the Affordable Care Act put states in the no-win situation of losing all their Medicaid funding or expanding their programs knowing that they would face billions of dollars in extra costs down the road.

I remain concerned that expanding Medicaid without reforming it only multiplies the tremendous budget pressure the program puts on states. Medicaid already consumes a quarter of the state budget in Texas, and enrollment and costs would mushroom under the Affordable Care Act.

We’ll continue to work with the Legislature to improve the Texas Medicaid program so that it delivers better results at a lower cost. The reforms we’re putting into place through our new transformation waiver will replace an archaic federal Medicaid funding system with one built around local solutions that rewards hospitals for patient care and innovation. This will lay the foundation for true Medicaid reform in Texas and allow us to use existing funding to improve access to care.  The best long-term solution is for Congress to grant states more flexibility to tailor solutions that best meet their needs.”

The Texas Medicaid program covers 3.4 million Texans today, including children, pregnant women, people with disabilities and those over age 65. The Affordable Care Act would have required states to expand Medicaid coverage to other low-income adults. The expansion was scheduled to take place in January 2014. The Supreme Court ruled that the federal government cannot deny Medicaid funds to states that opt not to expand their programs.
Source: HHSC press release

For more information please visit the HHSC web site.

Breaking News from TORCH – SCOTUS Decision

Thursday, June 28th, 2012

In Plain English:

The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn’t comply with the new requirements, rather than all of their funding.
Source: SCOTUSblog

Download a copy of the decision here

TORCH Representatives are on Capitol Hill Today and Tomorrow

Wednesday, June 27th, 2012

Four hospital CEOs are accompanying the TORCH staff on visits with the Texas Congressional delegation during the next two days. These meetings are intended to raise awareness on three issues. First, a recent MedPAC report surmised that rural access issues and payment inadequacies no longer exist. We intend to show that while rural providers deliver high quality, cost-effect care, that equal access and financial viability is a substantial and ongoing concern. Second, sequestration will hit on January 2013 and it will disproportionately hurt rural providers. We need Congress to consider alternatives for rural providers and to maintain their support for rural safety net programs. Lastly, we will be requesting their support for S. 2620 and HR 5943, which would extend the Medicare Dependent Hospital Program and low-volume hospital adjustment past this September when both are set to expire.

Yesterday, NRHA announced that more than 20 organizations – including TORCH – joined together to send a strong message to Congress on behalf of all the rural hospitals affected by the MDH/LVH issue, in order to prevent millions of dollars of critical federal funding cuts. These two rural hospital payments, the Medicare Dependent Hospital program and the low-volume hospital adjustment, are set to expire on Oct. 1 unless Congress intervenes.

Other supporting organizations include:
• Hospital associations of Arkansas, Florida, Illinois, Kansas, Kentucky, Missouri, North Carolina, Oklahoma, Ohio, Tennessee and Wisconsin
• American Association of Nurse Anesthetists
• Christus Health System
• Federation of American Hospitals
• LifePoint Hospitals
• Medicare Dependent Hospital Coalition
• Mississippi Rural Alliance
• Rural Hospital Coalition
• Rural Wisconsin Health Cooperative
• Southeast Kansas Rural Health Collaborative
• SSM Health Care

TORCH will be headed back to DC later this summer to continue these grassroots efforts. We strongly encourage all TORCH-member Hospitals to join us and NRHA July 30-31 for the March for Rural Hospitals. This event is free and we are hoping for a large crowd, so make plans to attend today. For more information, go to NRHA’s web site.

The joint letter to Congress is available here. More information on MedPAC’s findings can be found here.