The One\u00a0Big Beautiful Bill\u00a0Act, which\u00a0extends the 2017 tax cuts and creates new ones, will have severe consequences for New York\u2019s health care system and everyone who needs it. To help finance the tax provisions, it included about $1 trillion in cuts to Medicaid, the Children\u2019s Health Insurance Program and the Affordable Care Act\u2019s insurance exchange plans. While the legislation\u2019s defenders have focused on the denial of coverage for most noncitizens, much less has been made of major provisions that cut straight to the heart of health care in New York. These cuts will impact every New Yorker, regardless of the kind of insurance they have or their immigration status.<\/p>\n
Nearly half the legislation\u2019s health care savings \u2014 $451 billion, according to the Congressional Budget Office \u2014 has nothing to do with coverage for immigrants or curbing fraud. It comes from cuts to the funding streams that New York and other states use to bolster their health care system.<\/p>\n
These funds allow the state to provide baseline support to safety net providers, such as the Nassau County Medical Center and others on LI,\u00a0so they can keep their doors open;\u00a0help close the troubling gap between what providers get reimbursed by Medicaid and what it actually costs to provide the care;\u00a0invest in modernization; and expand access to low-cost insurance.<\/p>\n
The state cannot absorb cuts of this magnitude without making hard choices about reimbursement and coverage.<\/p>\n
Another set of provisions in the legislation creates administrative hurdles that make it harder to get and keep coverage if you have a modest income.<\/p>\n
It\u2019s already complicated if you don\u2019t have stable housing or internet access to get enrollment notifications;\u00a0have a job with work hours and income that change\u00a0weekly;\u00a0have a complicated family situation;\u00a0are disabled or elderly; or suffer from mental illness.<\/p>\n
Most people are on Medicaid because they don\u2019t have access to employer-provided insurance and can\u2019t afford to pay out of pocket for care. The new law\u00a0offers no solutions for these folks.<\/p>\n
The bill\u2019s many provisions that deny or restrict access to insurance coverage for noncitizens does not mean that those without legal status won\u2019t need and get care. They\u2019ll seek care later, at greater cost from emergency rooms and with worse long-term health consequences. Congress has not tackled immigration reform for 35 years, nor did the president, after four and a half years in office.<\/p>\n
Rather, they made the consequences of a failed immigration policy the health care system\u2019s problem.<\/p>\n
As the number of uninsured spikes, hospitals will continue to care for every patient that comes through their doors. That\u2019s what they do. They just won\u2019t get paid for it.<\/p>\n
However, they will have to make up for the growing burden of charity care somehow. Additional costs will be shifted to private insurance premiums, making coverage more expensive for businesses and those purchasing plans on the insurance exchange. Wait times will be longer. Care will be harder to access. Health care jobs, long a bedrock of Long Island\u2019s economy even during economic downturns, will be at risk.<\/p>\n
Whom does this hurt? All of us, not just Medicaid beneficiaries or immigrants.<\/p>\n
Taking resources out of the health care system doesn\u2019t preserve it for some \u2014 it weakens it for all.<\/p>\n
But it\u2019s not too late to do better. Because many of the law’s\u00a0provisions phase in over several years, Congress still could act to reverse the most damaging measures\u00a0before they take effect. Doing so will benefit every patient.<\/p>\n
This guest essay reflects the views of Wendy D. Darwell, president of the Suburban Hospital Alliance of NYS and Nassau-Suffolk Hospital Council.<\/p>\n","protected":false},"excerpt":{"rendered":"The One\u00a0Big Beautiful Bill\u00a0Act, which\u00a0extends the 2017 tax cuts and creates new ones, will have severe consequences for…\n","protected":false},"author":3,"featured_media":158184,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[210,1141,91906,1142,39994,67,132,68],"class_list":{"0":"post-158183","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-health","9":"tag-health-care","10":"tag-health-opinion","11":"tag-healthcare","12":"tag-newsday","13":"tag-united-states","14":"tag-unitedstates","15":"tag-us"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@us\/115055021498119746","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/158183","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=158183"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/158183\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/158184"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=158183"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=158183"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=158183"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}