Action Needed: Senate to Vote to Save Hospitals!

Over the past several months, I have diaried attempts by the Bush administration to gut our public health safety net through a proposed set of arcane rules changes. If implemented May 25 as planned, the rules changes will limit federal subsidies to public hospitals, indigent hospital care, emergency rooms, outpatient clinics, school-based health care, graduate medical education, case management, rehabilitation services, and children'a Medicaid enrollment. I have also diaried the efforts of health care activists to prevent these rules from going into effect. It is coming down to the wire now. The moratorium on the rules goes before the full Senate this week, probably as an attachment to the Iraq spending bill. Mitch McConnell (R-KY), Charles Grassley (R-IA), and administration officials have vowed to kill the moratorium. Find out how you can help below the break.

Potential impacts of the propsed combined rules changes include: leaving huge swaths of rural America and low income urban communities without trauma coverage; failing to train our next generation of physicians by forcing teaching hospitals to close their doors; severly limiting case management for the most vulnerable clients; limiting children's access to primary care through the closure of school-based clinics; cessation of new Medicaid enrollment efforts for children; and restrictions on access to rehabilitation services to victims of trauma, stroke and brain injury including vets.

According to a report by the House Oversight and Government Reform Committee Chaired by Henry Waxman (D-CA), the proposed cuts in Medicaid payments to hospitals will reduce America's ability to respond to a disaster or terrorist attack.

The report projects increasing strain to urban trauma centers most capable of responding to mass casualties in cities at highest risk for attack. Hospitals with Level 1 trauma centers could on average lose $27 million per year, or 5 percent of their budget, as a result of the three regulations targetting hospitals, according to the report. The Oversight and Government Reform report surveyed hospitals with Level 1 trauma centers in New York, Los Angeles, Washington, Chicago, and Houston. It found that as of late March, hospitals with Level 1 trauma centers in the five cities were operating above capacity.

Washington was the most overburdened. Its two Level 1 trauma centers were 214 percent over capacity. The report also looked at Level 1 trauma centers at the sites of the upcoming Democratic and Republican national conventions in Denver and Minneapolis. These cities' facilities were near capacity at 92 percent and 91 percent, respectively.

After an energetic and highly successful campaign by activists to draw public attention to the impact of these rules changes on communities across America, Representative John Dingell (D-MI) Sponsored HR 5613, the "Protect Our Medicaid Safety Net Act" which CLEARED THE HOUSE FLOOR WITH A VETO-PROOF MAJORITY 349-62! Despite blustery veto threats, one hundred-twenty eight Republicans and all voting Democrats voted for the bill. Only 20 representatives abstained. CongressDaily reports:

Sen. Olympia Snowe, R-Maine, who supports the moratorium, said the strong House vote will make it difficult for some senators to vote against it. “It is going to have major consequences for so many groups, special [education], disabled children, seniors. I mean, you go on, people who are just in desperate circumstances,” she said. “It would be interesting what the dynamics would be over here.”

The administration responded to Waxman's report, and to the possibility that their threats to veto the Senate version of the moratorium might be ignored, by offering a compromise. The administration would withold a veto if the Senate agreed to pass a temporary two or three month moratorium on those rules directly impacting hospitals, while allowing rules targeting school-based clinics, case management and rehabilitation to go into effect.

Senators Mitch McConnell (R-KY) and Charles Grassley (R-IA), have taken up the charge to block the bill in the Senate. "It is an absolute farce for anyone to argue that all of those [Medicaid] dollars are being appropriately spent and that Congress ought to just walk away from these issues," he said in a recent speech. He said the Finance Committee should fix the problems "instead of just making the regulations go away." Senate Majority Leader, Harry Reid (D-NV) initially attempted to fast track the bill, bypassing the Senate Finance Committee and bringing the bill directly to the Senate floor. However, many Senators received a memo from Republican Leadership urging them to oppose the legislation.

Senate Democrats are now working to attach wording about a moratorium to the Iraq Funding Bill which is likely to be taken up by the Senate on Thursday of this week. Please call your Senator today, and express your support for efforts to impose a one year moratorium on new Medicaid Rules changes.

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