Latest news with #hospitalcuts
Yahoo
10 hours ago
- Health
- Yahoo
Senate Republicans propose deeper Medicaid cuts. Here's what that means.
Senate Republicans are preparing to slice deeper into Medicaid to finance President Donald Trump's agenda, proposing legislation that analysts say could deal a greater financial blow to hospitals and result in millions more uninsured Americans. The measure reflects Republicans' willingness to cut the nation's safety-net health insurance program, despite qualms expressed by some moderates and populists within their ranks. Subscribe to The Post Most newsletter for the most important and interesting stories from The Washington Post. Last month, House Republicans passed massive tax-and-spending legislation projected to result in 7.8 million fewer Medicaid enrollees. The Senate Finance Committee's revisions to the bill released Monday could prompt even steeper coverage losses, sharply reining in a Medicaid financing maneuver that hospital groups say would slash payments to their facilities. 'The Senate just made a bad bill worse,' Chip Kahn, CEO of the Federation of American Hospitals, said in a statement. 'Rural communities would take the hardest hit, with struggling hospitals compelled to face difficult decisions about what services to cut.' Rural areas disproportionately rely on Medicaid, and their hospitals are often the first backstop for patients without health coverage. Hospital networks said they might reduce pediatric, maternity or behavioral health services; end telehealth programs; close rural facilities; or enact layoffs if the Medicaid cuts become law, in a recent member survey by the American Medical Group Association before the Senate bill was released. These changes would partly be the result of caps on provider taxes, an unusual example of a tax many hospitals are happy to pay. States charge extra taxes to medical providers - mainly hospitals, nursing homes and facilities for people with intellectual disabilities - and in return give the providers higher Medicaid payments. That brings in more federal matching funds, which are pegged to state payments. The taxes, which some conservatives have dubbed a form of 'money laundering,' emerged in recent weeks as a top sticking point among Senate Republicans. The Senate legislation would throw a huge wet blanket over this practice. It says states must gradually reduce provider taxes on hospitals until they are no higher than 3.5 percent of a provider's net patient revenue. Right now, that threshold is roughly 6 percent - and the House bill caps it at that rate. At the same time, the Senate bill breaks with the House plan by exempting from the cap the two other main providers subject to the tax: nursing homes and facilities for people with disabilities. The proposed cap would affect 18 states, including New York, Virginia and Arizona. Six red states with high provider taxes would be exempt because they did not expand Medicaid to cover childless adults with low incomes: Texas, Kansas, Tennessee, Alabama, Mississippi and South Carolina. But three states with Republican senators - Missouri, Iowa and Indiana - would be affected. The cost of this move to hospitals isn't immediately clear. But they stand to lose $321 billion over the next 10 years under the House version and would face another $63 billion in costs from serving a larger uninsured population, according to an analysis by the Urban Institute and the Robert Wood Johnson Foundation. Hospitals collected $262 billion from Medicaid in 2022. Associations representing hospitals slammed the Senate legislation and called on senators to push back on the cuts. Ellen Kugler, executive director of the Alliance of Safety-Net Hospitals, said the Senate bill would 'bottom out resources that safety-net hospitals need to keep the doors open to serve their communities.' The Senate is aiming to pass its bill by July 4, a deadline set by Trump. It would then need to be reconciled with the House version and approved in both chambers before becoming law. But the path forward is far from clear, as Senate Republicans can lose only three GOP votes and still pass their bill. Americans have mixed feelings about the budget bill, with a plurality of 42 percent opposing 'changing tax, spending and Medicaid policies,' according to a recent Washington Post-Ipsos poll. Nearly two-thirds said the projected Medicaid enrollment drop from the House bill is unacceptable. It's not just the provider tax caps that have hospitals up in arms. The Senate bill also would pare back two other funding streams for hospitals caring for larger Medicaid populations and providing better-quality care. Sen. Josh Hawley (R-Missouri) said Tuesday that he is concerned the Senate proposal would hurt poor Missourians and lead rural hospitals to close, and he said it needs a lot of work before he could vote for it. 'I don't think they understand politically who our voters are,' Hawley told reporters, referring to Senate Republicans backing the funding cuts. 'But also, setting aside the politics of it, it's just not the right thing to do to shut down a bunch of rural hospitals to pay for tax cuts.' But other Republicans sounded open to the Medicaid cuts after a Tuesday lunch meeting with Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services. Oz told Republicans the Senate bill would merely slow Medicaid growth, not reverse it, said Sen. Shelley Moore Capito (R-West Virginia). 'I believe what Dr. Oz said,' Capito said when asked whether she will support the Senate legislation, adding that she needs to 'talk to my folks in West Virginia' before committing to vote for it. Capito and West Virginia's other senator, Jim Justice, are among the Republicans who had expressed resistance to cutting Medicaid. West Virginia, which would have to scale back its tax on ambulance services under the Senate bill, has one of the highest share of residents on Medicaid and relies more heavily on federal dollars than most states. Justice told reporters on Tuesday that the provider tax caps would 'hurt' but that 'it may very well be you've just got to hold your nose on part of it and get through it.' After the lunch, Oz brushed off concerns about the bill's changes to provider taxes after meeting with senators, telling reporters that he does not believe they would hurt rural hospitals. 'The framework of addressing the legalized money laundering with state-directed payments and provider taxes must be in this bill, it should be in this bill, and I believe it will be in the bill,' Oz said. Health care experts generally agree the funding maneuver isn't the ideal way to boost federal funding for hospitals and other Medicaid providers. Former CMS administrator Chiquita Brooks-LaSure, who served during the Biden administration, said there's 'an argument' against the provider tax. 'If it were up to me, I would change the way states can raise their state share,' she said. But there's little support in a Republican-controlled Congress for hiking Medicaid spending in lieu of provider taxes. Other Senate changes to the Medicaid proposal would expand requirements for some beneficiaries to work, train for a job or volunteer to include parents of older teenagers. Senate Majority Leader John Thune (R-South Dakota) acknowledged some members of his caucus are seeking changes to the Senate measure. 'We continue to hear from our members specifically on components or pieces of the bill that they would like to see modified or changed or have concerns about, and we're working through that,' Thune told reporters. - - - Daniel Gilbert, Theodoric Meyer and Liz Goodwin contributed to this report. Related Content Trump is as unpredictable as ever, even when faced with war Field notes from the end of life: My thoughts on living while dying He's dying. She's pregnant. His one last wish is to fight his cancer long enough to see his baby.
Washington Post
a day ago
- Health
- Washington Post
Senate Republicans propose deeper Medicaid cuts. Here's what that means.
Senate Republicans are preparing to slice deeper into Medicaid to finance President Donald Trump's agenda, proposing legislation that analysts say could deal a greater financial blow to hospitals and result in millions more uninsured Americans. The measure reflects Republicans' willingness to cut the nation's safety-net health insurance program, despite qualms expressed by some moderates and populists within their ranks. Last month, House Republicans passed massive tax-and-spending legislation projected to result in 7.8 million fewer Medicaid enrollees. The Senate Finance Committee's revisions to the bill released Monday could prompt even steeper coverage losses, sharply reining in a Medicaid financing maneuver that hospital groups say would slash payments to their facilities. 'The Senate just made a bad bill worse,' Chip Kahn, CEO of the Federation of American Hospitals, said in a statement. 'Rural communities would take the hardest hit, with struggling hospitals compelled to face difficult decisions about what services to cut.' Rural areas disproportionately rely on Medicaid, and their hospitals are often the first backstop for patients without health coverage. Hospital networks said they might reduce pediatric, maternity or behavioral health services; end telehealth programs; close rural facilities; or enact layoffs if the Medicaid cuts become law, in a recent member survey by the American Medical Group Association before the Senate bill was released. These changes would partly be the result of caps on provider taxes, an unusual example of a tax many hospitals are happy to pay. States charge extra taxes to medical providers — mainly hospitals, nursing homes and facilities for people with intellectual disabilities — and in return give the providers higher Medicaid payments. That brings in more federal matching funds, which are pegged to state payments. The taxes, which some conservatives have dubbed a form of 'money laundering,' emerged in recent weeks as a top sticking point among Senate Republicans. The Senate legislation would throw a huge wet blanket on this practice. It says states must gradually reduce provider taxes on hospitals until they're no higher than 3.5 percent of a provider's net patient revenue. Right now, that threshold is roughly 6 percent — and the House bill caps it at that rate. At the same time, the Senate bill breaks with the House plan by exempting the two other main providers subject to the tax, nursing homes and facilities for the disabled, from the cap. The proposed cap would affect 18 states, including New York, Virginia and Arizona. Six red states with high provider taxes would be exempt because they did not expand Medicaid to cover childless adults with low incomes: Texas, Kansas, Tennessee, Alabama, Mississippi and South Carolina. But three states with Republican senators — Missouri, Iowa and Indiana — would be affected. The cost to hospitals of this move isn't immediately clear. But they stand to lose $321 billion over the next 10 years under the House version, and would face another $63 billion in costs from serving a larger uninsured population, according to an analysis by the Urban Institute and the Robert Wood Johnson Foundation. Hospitals collected $262 billion from Medicaid in 2022. Associations representing hospitals slammed the Senate legislation and called on senators to push back on the cuts. Ellen Kugler, executive director of the Alliance of Safety-Net Hospitals, said the Senate bill would 'bottom out resources that safety-net hospitals need to keep the doors open to serve their communities.' The Senate is aiming to pass its bill by July 4, a deadline set by Trump. It would then need to be reconciled with the House version and approved in both chambers before becoming law. But the path forward is far from clear, as Senate Republicans can lose only three GOP votes and still pass their bill. Sen. Josh Hawley (R-Missouri) said Tuesday he's concerned the Senate proposal would hurt poor Missourians and lead rural hospitals to close, and he said it needed a lot of work before he could vote for it. 'I don't think they understand politically who our votes are,' Hawley told reporters, referring to Senate Republicans backing the funding cuts. 'But also, setting aside the politics of it, it's just not the right thing to do to shut down a bunch of rural hospitals to pay for tax cuts.' But other Republicans sounded open to the provider tax limits after a Tuesday lunch meeting with Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services. Oz brushed off concerns about the bill's changes to provide taxes after meeting with senators, telling reporters that he didn't believe they'd hurt rural hospitals. 'The framework of addressing the legalized money laundering with state-directed payments and provider taxes must be in this bill, it should be in this bill and I believe it will be in the bill,' Oz said. Health care experts generally agree the funding maneuver isn't the ideal way to boost federal funding for hospitals and other Medicaid providers. Former CMS administrator Chiquita Brooks-LaSure, who served during the Biden administration, said there's 'an argument' against the provider tax. 'If it were up to me, I would change the way states can raise their state share,' she said. But there's little support in a Republican-controlled Congress for hiking Medicaid spending in lieu of provider taxes. Other Senate changes to the Medicaid proposal would expand requirements for some beneficiaries to work, train for a job or volunteer to include parents of older teenagers. Senate Majority Leader John Thune (R-South Dakota) acknowledged some members of his caucus are seeking changes to the Senate measure. 'We continue to hear from our members specifically on components or pieces of the bill that they would like to see modified or changed or have concerns about, and we're working through that,' Thune told reporters. Daniel Gilbert, Theodoric Meyer and Liz Goodwin contributed to this report.
The Independent
18-05-2025
- Health
- The Independent
Warning NHS making same mistakes that led to Mid Staffs scandal as bosses ‘consider cutting hospital beds'
NHS leaders are being forced to consider cutting hospital beds, closing hospitals, and even reducing services for children and cancer patients, a new study has claimed. In a bid to meet savings targets from the government and reduce its £6.6 billion deficit, hospital leaders are now cutting or rationing patient care, according to think tank the King's Fund. A new study, published on Sunday, reveals NHS leaders said they have been forced to cut services thought of as not essential including hospital beds, community paediatric services, community phlebotomy, mental health support for cancer patients. Hospital leaders also claimed they may have to consolidate hospital beds for services such as stroke or critical care beds. The cuts come in a bid to meet government savings demands, called 'eyewatering' by NHS leaders, to reduce the £6.6 billion deficit facing the NHS. The government has been warned it could be repeating the mistakes made under a previous Labour government that led to the Mid Staffordshire scandal, in which between 400 and 1,200 patients, from January 2005 to March 2009, were estimated to have died as a result of poor care, by the Mid Staffordshire Hospitals trust. A public inquiry into the scandal, led by Sir Robert Francis, revealed in 2013 that the failures were in part a consequence of the trust's focus on achieving financial balance. The King's Fund report comes after hospital waiting lists in England rose for the first time in seven months to 7.42 treatments, 6.25 million patients, at the end of March. This is up from 7.40 million treatments and 6.24 million patients at the end of February. Meanwhile, waiting lists for community services in England jumped from 1,077,514 in April 2024 to 1,090,356. For community paediatric services, a service being cut by leaders according to the King's Fund, waiting lists have risen from 125,603 in March 2024 to 171,092 children waiting for community paediatric services. The King's Fund report said: 'Leaders also gave examples of non-core services they are reducing or cutting completely, such as community phlebotomy or community paediatrics, to maintain patient safety and focus on services that most impact clinical outcomes, often emergency or specialist treatments. 'An example of a non-core service, now seen as a 'nice to have', was clinical psychiatry to support people with cancer – a service that is key to patient experience but not considered core to clinical treatment.' Responding to the report, Royal College of Nursing general secretary and chief executive Professor Nicola Ranger said: 'It's an appalling state of affairs when trust leaders talk about cutting frontline roles and closing beds to make savings. Nursing staff already face an almost impossible job as they try to keep patients safe amidst a workforce crisis and rising demand. The prospect of this situation worsening will fill every nursing professional with dread. 'This problem starts with the government, and ministers must stop putting arbitrary financial targets ahead of patient safety. That's what happened at Mid Staffs, and I fear they could be set to repeat the mistakes of the past. 'This report shows there is no hope of delivering the government's reforms whilst the NHS is simultaneously being asked to cut staff and services.' As part of the drive, hospital leaders also told the think tank that services which are now being delivered by private providers at a cheaper rate than the NHS, could be cut altogether if the suppliers go bust or if the NHS cannot take these services back on. 'You cut fat, muscle, bone, and I think we're at the bone point for most services and clinicians,' one leader told the think tank. The report said hospital leaders are having to consider cutting hospital beds, or closing services, despite the UK having lower bed numbers compared to other high-income countries. Earlier this month a survey of NHS trust leaders by NHS Providers revealed chiefs have already begun cutting frontline clinical posts in a bid to save money. According to the King's Fund in order to limit staffing costs providers are freezing recruitment of new staff, reducing overtime payments, and limiting their use of bank and agency staff. A Department of Health and Social Care spokesperson said: 'This government invested an extra £26 billion through the Autumn Budget to fix the broken health and care system we inherited and make it fit for the future.' 'Through our Plan for Change, we are determined to tackle inefficiencies and drive-up productivity in the NHS. 'Investment must go hand in hand with reform, and the Secretary of State has told the NHS to go back to basics – halving the number of national targets and giving local leaders a clear direction to focus on the things that matter to patients.'
