Editorial: Hospitals feeling squeeze

May. 19, 2014 @ 11:01 PM

Should Gov. Pat McCrory’s budget plan be approved as is during the ongoing short session, count local hospitals among the latest to feel more negative impact from President Obama’s Affordable Care Act.

This time it is in decisions on Medicaid.

McCrory has proposed a $21 billion budget. Within that number are increases to the amount of money hospitals send back to the state, which is already at $135 million.

The budget writers found an extra $15 million through assessments on Medicaid receipts for the 130 hospitals.

A cut of what hospitals earn is given in exchange for providing Medicaid and receiving state and federal money to provide the care. Prior to the 2011 legislative session, hospitals had a fixed rate to pay to the state. Three years ago, it changed to 25.9 percent of hospital Medicaid revenue.

McCrory’s budget bumps the percentage another 2.95 percent.

When it comes to budgets, the fewer variables the better. The N.C. Hospital Association is in favor of the state getting a more predictable budget related to Medicaid.

But unpredicatable hospital budgets and less patient care shouldn’t be the costs.

Hospitals give care for patients unable to pay for services. And $5.6 billion of $7.8 billion in federal Medicare cuts related to the ACA in the next decade are already sharpening hospital accountants’ pencils.

When a hospital has financial loss, whether from a government cut or a patient’s inability to pay, choices have to be made to recoup the loss. The options are dwindling.

The state’s uninsured number 1.5 million, and more than 300,000 are uninsured and don’t earn enough to qualify for the ACA’s premium tax credits. That translates to many in emergency rooms with higher costs, and those costs will be passed along to the rest of us.

A Democrat from Richmond County in the N.C. House has called the $15 million a “sick tax.” That may be hyperbole, but the passage of costs to other patients is not.

Rural hospitals don’t need any more hurdles. While our state has major hospital facilities the envy of many along the East Coast, our borders are far apart and care in the communities is crucial for all North Carolinians.

Legislators should be careful of the cause and affect with this 2.95 percent.