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Health Care

Representative Dwight Evans

Representing the 2nd District of Pennsylvania

Republicans’ failure on health care is unacceptable

October 27, 2017
In The News

This year, Washington has wasted months in an often-misguided debate over repealing the Affordable Care Act (ACA). And, while this debate has raged within one political party, two important programs have been forgotten: the Children’s Health Insurance Program (CHIP) has expired and the Medicaid disproportionate share hospital (DSH) program was left to be slashed at the beginning of this month.

Both programs have traditionally enjoyed very broad bipartisan support. I partnered with a Republican colleague in our legislature to fund Pennsylvania’s first-in-the-nation CHIP program. And, in 2015, the CHIP program was reauthorized with language that prevented cuts to DSH payments by a decisive margin of 92-8 in the Senate and 392-37 in the House.  

The DSH program supports safety net hospitals that serve a high proportion of low-income patients whose care is not entirely covered by third-party payers (such as Medicaid, Medicare, and CHIP). The DSH program provides payments to those hospitals to offset the uncovered costs. It’s a critical safety net program for hospitals that provide an invaluable service to people who need it the most.

The architects of the ACA included provisions in the law that cut DSH payments over time to compensate for what they expected to be reduced demand as more people were insured. Those cuts were also intended to help pay for the law’s coverage expansion.

The reality, though, is that the proposed coverage expansions and projected reduction in the number of un- or under-insured patients did not happen the way Congress originally intended. The Supreme Court gave states the option to refuse to participate in expansion of Medicaid and the Trump administration has threatened to withhold health care coverage payments, and in fact has already cut the CSR payments, which undergird the ACA.

The result is that DSH program cuts were still on track despite the ongoing need for DSH resources. And, Congress has failed to reauthorize CHIP over squabbles about how to pay for it and the distraction of the failed efforts to repeal the ACA.

That puts us in a tough spot in Philadelphia and something must be done.

As I have noted, the deadline has already come and gone. According to the most recent Kaiser Family Foundation’s State Health Facts, Pennsylvania’s current DSH allotment is $616.27 million. Cuts to the program will reduce payments by $121.03 million, a 19.6 percent reduction. And, we have 300,000 kids enrolled in CHIP which will soon run out of money to pay for their care.

As we speak, Congress is frantically trying to find a solution to this problem by delaying the cuts even though the deadline has passed.

The hospitals that rely on DSH payments and the kids who rely on CHIP are among the most vulnerable in our state and frankly, they need action now.

The solution doesn’t have to be partisan. Protecting low-income kids and the hospitals that serve them isn’t a Democratic or Republican issue; it’s a commonsense issue.

Republicans’ failure to act is unacceptable. Please join me in urging all of my colleagues in Washington back to the table to get back to work. Health care is far too critical to let it get caught up in partisan bickering.

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