National healthcare changes worry hospital leaders

WhidbeyHealth administrators are stuck in wait and worry mode as the Republican version of national health insurance moves to the U.S. Senate for a vote.

“There is great concern across all hospitals, all physicians, but it is particularly challenging for small rural hospitals that run on the thinnest of margins,” CEO Geri Forbes said.

Thursday’s repeal and replacement of the Affordable Care Act by the U.S. House of Representatives after years of failed attempts shook not only health care providers, but also the industry’s investors.

“When Congress passed repealing the Affordable Care Act, it sent a shock wave to the market,” Ron Telles, chief financial officer for WhidbeyHealth, said at a Monday meeting. “Healthcare may not be a good place to invest your money; that’s how this is being viewed.”

At the monthly meeting of the Whidbey Island Public Hospital District Board of Commissioners, Telles spoke about the reaction of investors at a national gathering of hospital executives he attended on Thursday. He said the plan will put financial pressure on the industry and that healthcare has “become a risk.”

Possible repercussions include making it more difficult for healthcare systems to secure loans and a downgrading of bond ratings.

“A lower rating means a higher interest rate,” he said, explaining that all health systems are vulnerable, whether they are for profit, nonprofit or a publicly-financed system, such as WhidbeyHealth.

The bad news comes on the heels of financial gains for WhidbeyHealth that’s about to open its new $50 million patient wing at its Coupeville medical center. Earlier this year, WhidbeyHealth’s bond rating was upgraded by Moody’s Investment Service. Additionally, March was “the biggest and best month the hospital has ever had,” in terms of net income, Telles told the board.

Department administrators also expressed concern for patients. Most worrisome, they said, are those with pre-existing conditions and patients relying on Medicaid, which provides medical care for low-income individuals. The Republican bill, known as the American Health Care Act, would roll back states that offer Medicaid expansion and eliminate penalties for those who forego being insured.

Washington state’s expanded Medicaid program, known as Apple Care, and its Children’s Health Insurance Program, enrolled more than 1.8 million residents — an increase of 62 percent — since October 2013, according to Medicaid data.

Last year, WhidbeyHealth successfully signed up hundreds of qualified patients into Medicaid, many whom had previously received treatment known as uncompensated care.

“We’ve enrolled so many people on Apple Insurance, many of them for the first time in their lives have insurance,” commented Linda Gipson, chief nursing officer. “When you have a health condition, uncertainty is not pleasant.”

The Senate is expected to pass a version of the bill in the next several weeks. Forbes urged people to “call, write, text, reach out to your senator.”

Jill Usher, a member of WhidbeyHealth Patient and Family Advisory Council, said she did just that.

“I have emailed both Senators Murray and Cantwell urging them to take an active role in developing the Senate Bill ensuring proper coverage for all, including a guaranteed coverage for those with pre-existing conditions,” Usher said.

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