Five things to track: Health care programs facing cuts in Georgia

Deadlines expired to renew several crucial federal health care programs, Congress has still not renewed them. Now workers for the programs, such as at clinics, say they can’t plan and budget. But some lawmakers have said they’re not too worried because there’s still enough money in the bank to keep checks from bouncing for a while. A U.S. Senate committee passed a bill to renew one of the programs, but there’s argument over it and no standard renewal law has yet passed. So these are some of the programs still waiting for stability:

CHIP. The Children’s Health Insurance Program, known in Georgia as PeachCare for Kids. This has the best chance of the programs of remaining open. It’s popular across party lines and in Georgia it has enough money in the bank to last until early spring. A version of CHIP renewal — co-sponsored by Republican Sen. Johnny Isakson of Georgia — easily passed a Senate committee, but it’s hitting some snags. Lawmakers are arguing over how to pay for it and whether the other health program should pass along with CHIP. In Congress these are conversations that might be resolved overnight in the blink of an eye, or could take weeks or months of negotiations. Although Georgia’s CHIP is estimated to have money in the bank through early spring, other states could run out of funding in January. The cut to Georgia would be $427 million this year.

Community Health Centers. These were established under President Lyndon B. Johnson’s War on Poverty. Their funding also expired Oct. 1, but they currently have a funding extension until Dec. 8, according to their national association. This past week the association surveyed its members and found that regardless of having postponed insolvency, about a quarter of the clinics were already facing concrete consequences. They were having trouble hiring or keeping staff because nobody knows for sure how long the money for paychecks will be there. The cut to Georgia next year is undefined but could be about $60 million.

“Rural extenders” such as Low-Volume Adjustments and Medicare-Dependent hospital grants. These go to rural hospitals that take a hit on reimbursement for patients who generally aren’t privately insured. The dollar amounts are smaller than those for some of the other programs, but the small hospitals that get the grants say they make a big difference. The cut to Georgia for these two programs is estimated to be $11.7 million annually.

DSH, or Disproportionate Share Hospital grants. Subsidies for hospitals that treat a disproportionate share of indigent patients, such as Grady Memorial Hospital, are cut by about $49 million in Georgia for the coming year, expanding to well over $100 million by 2025. The idea was that DSH would be cut as Medicaid expansion would take up that slack, but states like Georgia didn’t expand Medicaid. Hospitals want to postpone the DSH cuts.

CSR’s, or Cost-Sharing Reductions. These are subsidies that help lower-income customers of Obamacare exchange plans afford the out-of-pocket costs. Republican Sen. Lamar Alexander was working on a bipartisan fix, but it also got waylaid by the discussion of Obamacare repeal and replace. This is one where the funding stream is there, but some lawmakers want to divert it to the other program renewals.


By Ariel Hart – The Atlanta Journal-Constitution

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