Lawmakers ask Biden administration about hospital closures, service cuts

U.S. Senators Ed Markey and Elizabeth Warren, and eight Democratic House members, want to know what is being done to sustain struggling hospitals.

Members of Congress are asking President Biden’s administration questions about the number of hospitals closing their doors or reducing services due to financial difficulties.

Ten Massachusetts lawmakers, all Democrats, signed a joint letter just before the holidays raising concerns about the reduction in services seen at some hospitals. U.S. Sens. Ed Markey and Elizabeth Warren, along with eight House members, sent the letter to U.S. Health and Human Services Secretary Xavier Becerra.

“Despite health care systems operating over capacity and receiving substantial financial support from federal, state, and local government in recent years, hospitals across the country are closing their doors, reducing their services, or consolidating,” the letter begins.

“We are concerned that this pattern will result in communities facing increasingly significant barriers to health care, and seek your assistance in ensuring those communities have sufficient hospital resources to guarantee access to a full continuum of high-quality care.”

Pointing to their home state of Massachusetts, the lawmakers said there have been 20 reductions of services or closures by providers in 17 cities or towns. The service reductions include pediatric care, obstetric services, ambulatory care, outpatient birth centers, and cancer treatment, among others.

When systems reduce services or close facilities, patients end up traveling farther to obtain healthcare, and that poses a barrier for some in getting the care they need, the lawmakers said.

Lawmakers said they were particularly concerned that hospitals were reducing services that are utilized by a higher number of people with lower incomes.

The lawmakers also pointed to the struggles of rural hospitals. Since 2010, more than 130 rural hospitals have shut down, according to a report by the American Hospital Association.

“Hospital service reductions impact access to care and reduce health system resilience to emergencies,” the lawmakers wrote. “Indeed, fourteen of the hospital service reductions in Massachusetts were services that the Department of Public Health deemed ‘necessary for preserving access and health status within the hospital’s service area.’”

The Massachusetts lawmakers asked the health department to provide answers to a host of questions by Jan. 15, including data on service reductions and the impact of the closure of hospitals and other healthcare facilities on surrounding communities. The lawmakers asked the department what is being done to address the prospect of additional hospital closures and to ensure accessibility for communities that rely on safety net hospitals. And they asked what is being done to help hospitals avoid, or at least reduce, financial distress.

Hospitals endured serious financial difficulties in 2022, with many seeing expenses surpassing revenues. Industry analysts expect 2023 to be a challenging year as well.

Hospital leaders across the country have said they have been forced to reduce some services because they don’t have enough staff.

Mike Slubowksi, president and CEO of Trinity Health, said in a September conference call that the shortage of healthcare workers is like nothing ever seen before. “The crisis is real,” he said.

“Facilities in our system are closing patient services,” he said. “We’re closing beds, reducing OR capacity, reducing specialty care capacity like behavioral health, and closing some long-term care sites.”

The House members who signed the letter are U.S. Reps. Jake Auchincloss, Katherine Clark, William Keating, Stephen Lynch, James P. McGovern, Seth Moulton, Ayanna Pressley, Lori Trahan.