In the Spring 2017 issue of Source, Huntsville Hospital's community magazine, I hesitated to predict what Congress might do regarding the repeal and replacement of ObamaCare. The Republican controlled Congress has tried to come up with a plan that is acceptable to all segments of the party, but as of early August, the nation’s health care law remains unchanged. The rub for some is the impact that repealing the current law will have on state Medicaid programs, which serve the indigent. In Alabama, the Medicaid program remains in a state of uncertainty following the recent announcement that the proposed model to use regional care organizations (RCO) would no longer move forward. There were many reasons for the decision but the primary factor was the changing environment in Washington that no longer points to RCOs as the best solution.
Huntsville Hospital has been very involved in helping to develop workable solutions for Medicaid over the past several years. We will continue to do so with the goal of improving the health of our citizens and helping to stabilize our Medicaid program. In Alabama, we have the some of the strictest Medicaid criteria in the nation, primarily covering children, pregnant mothers and disabled elderly. There are few adult males covered by Medicaid in our state. Unfortunately, we also have some of the lowest Medicaid reimbursement rates paid to physicians and hospitals in the nation.
Regardless of your politics, the impact of some of the proposals being discussed in Washington would be disastrous for many people in Alabama and would probably cause some hospitals in the state to cease doing business. Physicians who are paid very little to treat Medicaid patients would simply choose to no longer do so. We realize that this is a very complex and emotional issue. What we are watching in Washington, however, is proof that politics cannot solve the problem. Partisanship and protecting the home front are inherent in the constant concern for re-election. What is the answer? That depends on who you ask.
What is clear is that we need an approach that makes sense, one that brings a variety of people into the development of the solution. We used a process like this when our nation was tasked with closing and consolidating our military bases. The Base Realignment and Closure Commission was non-partisan, data driven, and was charged with recommending the plan to Congress for an up or down vote with no changes to the recommendation. The commission was tasked with finding a solution, not worrying about getting re-elected. It worked well. I happen to think that is an approach that should be considered for our nation’s health care system.