The U.S. Senate is immersed in work on reforming healthcare, and at the same time dismantling the Affordable Care Act. And the chamber faces a long road ahead.
Florida’s two senators voted on either side of the measure, as expected. Republican Marco Rubio has been a longtime opponent of ACA.
“I ran for election in 2010 on the promise of repealing and replacing Obamacare; I was reelected in 2016 on the same promise,” Rubio told Fox News Channel. “I’m going to keep that promise. I’m prepared to vote for a bill to repeal; I’m prepared to vote for a bill to repeal and replace.”
Florida’s senior Senator, Bill Nelson, voted “no” with all other Democrats. He wants to go in another direction, instead of repeal and/or replace.
“If our brothers and sisters on the other side of the aisle are not successful, and then if we’re serious about it,” said Nelson. “Take what’s left which is the existing law – the Affordable Care Act – and fix it.”
Two of the Pensacola area’s major hospitals, Baptist and Sacred Heart, are non-profits. Officials at both, and at hospitals across Florida, are watching the back-and-forth in Washington, hoping for the best, and preparing for the worst.
“Right now, they’re looking at a bill that’s referred to ‘skinny repeal.’ That bill, at least as I understand it, does not include deep Medicaid cuts,” said Bruce Rueben, President of the Florida Hospital Association.
The FHA’s main concern, for now, lies with the roughly 1.8 million Floridians who have received coverage through the Obamacare exchanges.
“How many of those people would be from Florida I can’t say,” claims Rueben. “That uncompensated care that results when people get sick and they don’t have coverage that impacts everybody who has insurance, and who pays anything out-of-pocket.”
Florida is one of 19 states that refused to expand their Medicaid rolls when Obamacare became the law of the land. That decision came from Republican Governor Rick Scott.
“This is going to be devastating for patients; devastating for taxpayers, it’s going to be the biggest job-killer ever,” said Scott. “Every government program in the world, they say ‘I’m going to cover everything.’ They run out of money and then there’s no one to take care of you.”
The impact of reducing Medicaid payments on hospitals, says FHA’s Bruce Rueben, would have less to do with whether a hospital is for-profit or non-profit, and more to do with the makeup of the communities they serve.
“The more low-income folks they serve, the more are covered by Medicaid or are uninsured would be hurt the most,” Rueben said.
Depending on the final version of the bill, hospitals also could see less money in other areas, because they couldn’t just cut services for Medicaid patients.
“If a hospital has to cut services, then those services are eliminated for everybody,” said Rueben. “To the extent the federal government – if they did cut funding for Medicaid – it’s going to have an impact and the extent to which it impacts them, has everything to do with how many Medicaid patients they serve."
Both sides concede there’s a long way to go working on health care reform. And as in many cases with the legislative sausage grinder, any resemblance between the original bill and the finished product, can be strictly coincidental.