Inquirer Editorial: Hospitals put at risk

CLEM MURRAY / Staff Photographer
CLEM MURRAY / Staff Photographer
Posted: March 22, 2011

After scrapping the state health-insurance plan for 41,000 working poor Pennsylvanians, Gov. Corbett has shown a more gentle bedside manner with other safety-net programs. Yet, his budget proposal still has public-health officials and health-care providers scrambling to blunt the expected impact of some cuts - while understandably bracing for possibly worse fiscal news yet to come.

Nothing in Corbett's proposed spending for human services matches the troubling decision to toss thousands of low-income adults off the health-insurance rolls by ending the adultBasic plan after funding ran out. In addition, spending on some social-welfare programs actually would rise if the governor's proposed budget is enacted.

But in Philadelphia and across the state, there is reason for concern at hospitals and among other health providers who care for the sick and are also major employers. When the dust settles in Harrisburg, the struggle to close a $4 billion deficit in the state's $27.3 billion budget could rely far too heavily on sacrifices by the state's neediest residents.

A big question mark is whether state legislators will cut funding for human services even more, as they try to offset the governor's meat-cleaver cuts to school and higher-education funding. That would make the present outlook even more grim.

The roster of those already likely to be impacted by cuts in this region includes people with little recourse: those with HIV and lead poisoning, the homeless, children in after-school programs, and poor families provided with nutrition education.

If hospitals that serve as major economic engines also get hit with cuts to what they expect in reimbursements for low-income patients' care, that would generate shock waves for this region's all-important health-care economy.

Indeed, hospital trade-group officials contend that the state - by trimming some hospital reimbursements - will lose $183 million in federal matching funds. Beyond that, the hospitals say the plan reneges on a three-year deal made last year in which they agreed to pay a special assessment so the state could draw down more federal funds.

Such funding is key to the bottom line of a regional anchor like Temple University Hospital, which fulfills the role of a public hospital in the only major U.S. city without one. That makes it a priority to resolve this funding dispute in a way that maximizes federal aid for care for the poor.

As such, it's unfortunate that Corbett's safety-net spending plan is creating uncertainty for health-care providers and public-health policymakers at a time when major change looms due to federal health reform. With the newly unemployed losing their health insurance due to the recession, the central focus should be on setting up health-insurance exchanges that will afford the uninsured greater access to care - not on fighting budget battles.

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