Nurses warn tax bill’s Medicaid cuts will hurt patients and hospitals
Millions could lose Medicaid coverage and hospitals face the loss of billions. Jennifer Mensik Kennedy, president of the American Nurses Association, says everyone will be affected.
America’s nurses are on the front line of the nation’s healthcare system, and they’re warning that the tax and spending bill could harm virtually everyone in the country.
Jennifer Mensik Kennedy, president of the American Nurses Association, says the package will leave millions without Medicaid coverage and could lead to hospitals cutting services or closing for good.
The House of Representatives approved the bill Thursday, after the Senate narrowly passed it Tuesday. It now goes to President Trump, who is anxious to sign it.
Jennifer Mensik Kennedy, president of the American Nurses Association, says the package hurts patients, nurses and hospitals. She spoke with Chief Healthcare Executive® Wednesday about her concerns about the legislation.
Millions are projected to lose Medicaid coverage, and hospitals face the prospect of treating more uninsured people with fewer resources, she says. Mensik Kennedy worries about the millions that are likely to lose Medicaid coverage, but she says Americans across the country will be affected.
“Absolutely everyone is going to pay more and be impacted by this,” Mensik Kennedy says. “Because it's not like, magically, these people don't have healthcare needs anymore. They're still going to come to the emergency room. They're still going to deliver babies. Now there's no one paying the bill.”
With more people packing emergency rooms, she says, “People will have longer waits in the emergency room. They're not going to get to the services that they need.”
Nurses could lose jobs
Some hospitals could close, while others could face tough choices about cutting services and staff, she says. Hospitals could be looking at the loss of 500,000 jobs, she says.
“This will be nurses’ jobs lost, and healthcare providers’ jobs lost,” Mensik Kennedy says.
With hospitals expecting to face more financial pressures, Mensik Kennedy worries about the prospect of nurses working longer hours and having less help. Some hospitals are already putting the brakes on hiring due to uncertainty in federal funding, she says.
“We're already seeing that now. We're seeing hospitals who are unsure of what's really going to happen, having to take preemptive measures to protect what money they might have now. So they're not replacing people. They're not filling positions,” Mensik Kennedy says.
She cited projections by the Congressional Budget Office of nearly 12 million people losing Medicaid coverage over the next decade. Another five million could lose coverage under the Affordable Care Act, with subsidies supporting additional coverage slated to lapse at the year’s end.
“This is really looking at upwards of 17 million people,” Mensik Kennedy says.
Hospitals are expected to see less support from Medicaid, as the package puts in new restrictions on how states can finance Medicaid programs. The CBO has estimated that $1 trillion in healthcare spending will be cut in the next decade.
‘Trickle-down effect’
Americans who don’t rely on Medicaid are still going to be affected, as they see longer waits for care. And others who have commercial insurance can expect to see higher healthcare costs, she says.
“We’ll have all these people who go bankrupt because they can't pay for their health care, treatments and cancer and everything else,” Mensik Kennedy says. “They're still going to come to the emergency room. They're still going to need care, and they're not going to be able to pay.”
“So that cost is going to get put back on all of the other people who can pay and who have health insurance,” she adds. “So everyone's going to see their insurance costs rise … it will have a bad trickle-down effect.”
Hospitals are expected to see less support from Medicaid, as the package puts in new restrictions on how states can finance Medicaid programs.
Rural hospitals are likely to be at greatest risk, says Mensik Kennedy, whose first job as a nurse was at a critical access hospital. The package includes a $50 billion fund to help rural hospitals; the money will be distributed over five years. But Mensik Kennedy says that funding will have little impact, especially as other losses are factored into the equation.
“They’re going to use it for capital and operations expenses,” she says. “And then we're going to see closures.”
Rural communities can’t afford to lose hospitals. She says some Americans in rural areas already may travel 50 miles to their nearest hospital.
“If you have a heart attack or stroke, you're going to miss the windows for treatment that are going to help ensure that you can survive,” Mensik Kennedy says.
“So this is so unfair to those wonderful people who live in our rural communities,” she says. “They're asking for their local hospitals to stay open.”
Ryan Oglesby, president of the Emergency Nurses Association, has also said that the tax package is going to make it harder for hospitals to deliver emergency care, and that will take a toll on nurses.
“Medicaid cuts of this magnitude will hurt Americans in need of medical coverage and hinder the ability of dedicated emergency nurses and other health care workers to provide the best care possible while further straining their well-being and morale to continue doing their vital work,” Oglesby said in a statement this week.
