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Canton-Potsdam Hospital officials say changes to Affordable Care Act bring uncertainty

Posted 1/29/17

By MATT LINDSEY Proposed changes to the Affordable Care Act, also known as Obamacare, have Canton-Potsdam Hospital and Community Health Center of the North Country officials concerned that cuts could …

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Canton-Potsdam Hospital officials say changes to Affordable Care Act bring uncertainty

Posted

By MATT LINDSEY

Proposed changes to the Affordable Care Act, also known as Obamacare, have Canton-Potsdam Hospital and Community Health Center of the North Country officials concerned that cuts could have a negative effect on local healthcare.

In the November general election, the Republicans won majorities in the House of Representatives and the Senate, plus the presidency. The party has vehemently opposed the ACA since its 2010 inception and is prepared to unravel it, potentially cutting off insurance coverage to thousands of St. Lawrence County residents.

With many details still to be ironed out, CPH and Community Health Center representatives say they are waiting eagerly to find out the financial impact it might have on their organizations.

‘Destabilizing Impact’ at CPH

CPH CEO David B. Acker said that as part of the negotiation that occurred in the creation of the ACA, there was a fundamental agreement between Medicare and hospitals: cuts to Medicare reimbursement were passed.

“That has happened and those cuts are a reality we deal with now,” he said.

In exchange, having more people insured was presumably to offset these cuts, Acker said.

“No one is talking about rolling back the cuts to Medicare,” he said.

Disproportionate Share payments (also known as DSH payments), which are supposed to offset rural hospitals' disproportionate share of Medicaid patients, have been substantially reduced; they are still being reduced and will go away and there is nothing on the horizon to replace these payments, Acker said.

“Reimbursement from Medicaid does not cover the costs of care to begin with,” he said.

CPH is paid approximately 20 percent for an emergency room visit made by a patient covered under Medicaid, according to hospital spokesperson Rebecca Faber.

If the reimbursement that was taken away remains and there is no off-setting revenue which the ACA provides, then that hurts rural hospitals.

Why does all this matter more in rural America?

“Because rural hospitals have a heavier reliance on Medicare and Medicaid than in urban places,” Acker said.

Acker says rural America is where you find the smaller hospitals and smaller means fragile.

“Since 2010, 25 states have seen at least one rural hospital closure,” Faber said. “Rural hospital operating margins nationally are below three percent. Yet the need for care is greater in rural areas because of isolation and other factors. Rural Americans deserve the same high level of care as those who live in urban areas.”

“Now all you add to that is uncertainty -- small rural hospitals need predictability and now we have the polar opposite of that,” he said. “So the expected impact is destabilizing."

Uncertainty at CHCNC

CP of the North Country, which operates the Community Health Center of the North Country, a federally qualified health center that is available to all residents across communities in Northern New York regardless of income level, served 12,000 patients last year.

They have locations in Canton, Gouverneur and Malone. Depending on location, patients can receive medical, eye care, dental and behavioral therapy.

Ray Babowicz, director of marketing and communications at the health center, says there is “so much uncertainty” involved in the possibility of the Affordable Care Act (ACA) being replaced.

The center is reliant on federal grants and Babowicz says the ACA “certainly helped” the center when it was implemented in 2009.

“We’ve been concerned – but we’re trying not to panic,” he said.

He said healthcare has had strong support on both sides of the aisle in government providing access and cost savings to the region.

The center offers a sliding-scale fee for people that are uninsured and qualify based on income and household requirements. For example, a family of four with a household income of $25,000 would pay $15 for an office visit.

Babowicz did not have hard numbers to indicate if sliding-scale payments had gone up or down since the ACA as been implemented.

But should people lose insurance, he wanted them to know the center is there for them.

“At the end of the day, the community health system was here over 40 years ago and we will continue to provide quality healthcare to the North Country,” he said.

From a specific financial standpoint, he said it was impossible to gauge how it would affect the center.