‘A blunt force axe': Mass. Democrats warn of harm to hospitals, health care under Trump budget proposal

Boston Globe

5 days ago

Advertisement
About 2 million people statewide are enrolled in MassHealth, which covers almost half of the state's children and close to 70 percent of nursing home residents.
Democratic Senators Elizabeth Warren and Ed Markey joined Healey and said the news conference was just the start of their party's effort to derail the legislation.
'The cuts to Medicaid are Draconian, the cuts to SNAP are Draconian,' Markey said.
Republicans describe the legislation as 'rocket fuel' for the US economy and a response to the wishes of voters who gave them a majority in Congress.
The bill passed the House last week by just one vote. The state's US senators noted even some of their Republican colleagues expressed reservations about such significant cuts to the nation's safety net. Democrats hope the bill stalls in the Senate, forcing the House to come up with another proposal.
Advertisement
'Our job at this moment is to raise the stakes here, so everyone across this country can see exactly who's going to be hurt and exactly who's going to be helped by the Republican budget,' Warren said.
If the budget bill passes as written, estimates of the number of Americans who will be left without insurance over the next decade range from 8 million, the Congressional Budget Office reported, to about 14 million, according to estimates from left-leaning think tanks like the Center for American Progress.
For months, Congress has sought to offset trillions in tax cuts with reduced spending, and Medicaid, one of the federal government's most expensive mandatory programs, is a juicy target. The current bill would cut an estimated $698 billion from Medicaid over the next decade. That translates into a wealth transfer to the rich in several ways, Warren said.
The proposed Medicaid cuts would likely inhibit entrepreneurship in the country, she said, robbing small business owners of health care security as they attempt to start a new venture. Medicaid also gives stability to people working low-paying jobs. And it is a critical safety net that gives people with disabilities home health services and support that allows them to stay out of nursing homes.
Dennis Heaphy, an advocate with the Massachusetts Disability Policy Consortium, said he would likely be in a nursing home without MassHealth support. A quadriplegic, Heaphy said he doubts he would receive the care he needs if he had to move to a long-term care facility.
Advertisement
'If I go to a nursing home then I'll die,' he said at the press conference.
A concerned citizen shared his thoughts about what would happen if the Medicaid budget was cut during a visit to the Cambridge Health Alliance Revere Care Center on Tuesday, in Revere. During the visit, a panel discussed the impacts of President Trump's bill in Congress that would take away health care from Massachusetts children, families, seniors, veterans and people with disabilities.
Brett Phelps for The Boston Globe
Republicans frame the cuts as a money-saving attack on fraudulent claims and expensive loopholes. Among the most powerful provisions in the bill are new requirements that states confirm Medicaid recipients' eligibility more frequently, and that many adult Medicaid recipients work or put in time volunteering or taking classes in exchange for benefits.
Health policy experts note a work requirement solves a problem that largely doesn't exist. Most Medicaid recipients who are able to work do, either full time or part time. They just don't have jobs that offer health coverage and don't make enough to pay for insurance on their own.
Work requirements and eligibility checks make it more complicated, more time consuming, and more difficult to receive Medicaid coverage. Such policies save money, experts said, by making it harder for people eligible for Medicaid to receive it.
'And what's going to happen to all these people?' Healey asked at the news conference. 'Some will end up in the street. Many will end up in emergency rooms.'
Uninsured patients are likely to arrive at the state's emergency departments with more acute health problems, health care executives said. Massachusetts ER's already have among the
The cuts could create a nightmare scenario for hospitals that serve a large percentage of patients covered through MassHealth or Medicare. They'd lose revenue at the same time as demand on their emergency departments would increase, said Dr. Eric Dickson, chief executive at UMass Memorial Health, which operates five hospitals in central Massachusetts.
Advertisement
More than half the health system's patients rely on some form of government coverage, he said in an interview.
'Wait until you come to my emergency department and you're sitting there for an extra two hours because we failed to support the Medicaid system,' Dickson said.
Hospitals could have to choose between cutting services or raising costs. Typically obstetrics, pediatrics, psychiatric, and primary care departments don't make money, he said, and these departments could be most vulnerable if a hospital has to start cutting.
'Ultimately it all gets passed on to the patient,' Dickson said.
The state's 50 community health centers are a bulwark of primary care in Massachusetts and often have a significant population of Medicaid-covered patients. Places like Brockton Neighborhood Health Center, already struggling financially, would be severely hurt by a major cut to Medicaid, said Dr. Maria Celli, chief executive, in a recent interview. Hobbling community health centers undermines the Trump administration's stated goal of refocusing national health care priorities on chronic conditions.
'A fundamental purpose of primary care is to keep people well,' Celli said, 'to prevent . . . the development or the exacerbation of any chronic illness.'
An average 31 percent of community health centers' money comes through Medicaid, said Michael Curry, chief executive of the Massachusetts League of Community Health Centers, at the news conference.
Warren described the impact on hospitals and health centers, with the possibility of some closing, as another way Congress' proposal turns into a transfer of wealth from poor to rich.
'So that's how it starts to echo through the system,' she said.
Advertisement
Jason Laughlin can be reached at