Medicaid provider fee could be 
headed over the ‘fiscal cliff’

By Mark Francis, Mike McBride and Chris Thomas

In Mesa County, 23 percent of parents who are eligible for Medicaid are not yet enrolled, according to the Colorado Health Institute’s most recent figures. Among children eligible for Medicaid or Child Health Plan Plus, known as CHP+, 24 percent are not enrolled.

Unfortunately, these 4,500 relatives, friends and neighbors of ours may never be able to gain this health coverage if some policy makers in Washington get their way in the negotiations over the so-called “fiscal cliff.”

There is discussion in Washington of scaling back or eliminating the Medicaid provider assessment program, also known as the provider fee, in which Colorado has participated since passing bipartisan legislation in 2009.

The program assesses Colorado hospitals, and the resulting funds receive a federal match that has enabled 66,000 more Coloradans to enroll in Medicaid without costing Colorado taxpayers or the state’s General Fund a penny.

The program has also made it more financially sustainable for hospitals to continue to provide cost-effective care to our most vulnerable citizens at a time when providers nationwide have begun refusing to accept Medicaid patients due to chronic underpayment.

In Mesa County, the provider fee has helped us mitigate operating losses and continue to provide services to our community. Without our facilities, patients would have to travel many more miles to receive certain medical services.

Reducing the provider fee at the federal level would put even more pressure on Colorado’s fragile state budget and could jeopardize access to health care for many Coloradans. Additionally, a new analysis by the American Hospital Association finds that without the provider fee in place, those with private insurance will pick up even more of the tab. Private plan premiums would rise as much as 5.5 percent in Colorado, or as much as $822 in additional annual premiums for a family policy.

Burdening business owners and their employees with these increased costs would cause significant damage to our state’s economic recovery.

A recent national AHA poll found that 69 percent of Americans reject the idea of cutting reimbursements to hospitals for the services they provide Medicaid and Medicare patients. Yet that’s exactly what is being proposed as one way out of the fiscal mess in Washington. Provider fee cuts are just another name for Medicaid cuts, and such action would harm tens of thousands of Coloradans (especially children, the poor and the disabled) who rely upon this vital program. And it would cost us all more money in the long run.

At Community Hospital, Family Health West Hospital and St. Mary’s Hospital & Regional Medical Center, we take great pride in being able to provide vital health care services to our community. Scaling back or eliminating the provider fee program would put a substantial new financial burden on all of us — our hospitals, our physicians, our privately insured patients and our community.

The fiscal cliff in Washington should not be averted by creating new financial hardships here in Mesa County. We ask the Colorado congres-sional delegation and Sens. Mark Udall and Michael Bennet to continue to support the successful and important provider fee program.

Mark Francis is president and CEO of Family Health West Hospital in Fruita. Mike McBride is president and CEO of St. Mary’s Hospital and Regional Medical Center in Grand Junction. Chris Thomas is CEO of Community Hospital in Grand Junction.


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