After the Supreme Court’s ruling that upholds the Affordable Care Act’s individual mandate— the requirement to have or buy health insurance beginning in 2014 or face a tax— Governor Bobby Jindal has been vocal about his plans to reject “Obamacare” outright, which includes rejecting federal funds to expand the states Medicaid program. The effects of this are being felt by many healthcare facilities throughout the state that rely on Medicaid dollars to operate.

The Affordable Care Act in a nutshell

The Affordable Care Act is expected to extend coverage to an estimated 32 million people who currently lack health insurance. To help people comply with the mandate, the ACA seeks to make insurance more affordable for small businesses and individuals, by establishing tax credits for companies with less than 50 on their payroll. The ACA also allots seed money to states so they can establish smaller health insurance co-ops and expand their Medicaid programs.

Additionally, the Affordable Care Act also establishes free or low-cost preventative care which includes cancer screenings. Many feel that some of the strongest merits of the ACA is that people with pre-existing conditions can no longer be denied coverage, women can’t be charged more than men for an insurance policy, and young adults under the age of 26 can stay on their parents’ policy.

According to the U.S. Census Bureau’s 2008 − 2010 survey, of the 32,570 living in St. Bernard Parish, 13 percent of the population is uninsured. The demographics with the largest number of uninsured include males between the ages of 25 – 34 and females between the ages of 45 − 54.

Jindal’s stance & how it affects SBPH

Governor Bobby Jindal has made national headlines as being one of the more vocal opponents to the law, and has stated that he plans to reject “Obamacare” and any federal dollars stemming from it. Jindal has criticized the legislation as being too expensive and an unnecessary expansion of government.

Hospital Service District Chairman, Wayne Landry says he is “gravely concerned” about the state’s Medicaid expansion rejection.

If Louisiana expanded Medicaid, the federal government would pay 100 percent of costs for the first three years, then 95 percent for the following three years and 90 percent after that, under the provisions of the ACA.

With more people covered by Medicaid, the state would be paying less for uninsured care through disproportionate share. Louisiana relies heavily on the disproportionate share funding to run its public hospitals and support rural and community hospitals, like the one to this August in St. Bernard Parish.

“The rejection of these federal funds has created a complex problem in terms of the reimbursement methodology for St. Bernard Parish,” said Landry. “It’s kind of a surreal moment for me–I kinda feel like they’re pulling the rug out from under us.”

Landry says that he does see the bigger picture Governor Jindal is trying to point out to Louisiana and the rest of the country by opting out of “Obamacare” but hopes that an alternative solution is reached through a special session of the legislature.

“I think Governor Jindal recognizes the financial burden of the expansion of Medicaid, and he’s trying to be frugal as a steward of the peoples’ money. Hopefully the state is going to work out plans for an alternative reimbursement methodology if he’s going to opt out.”

Landry says that if the state does opt out of “Obamacare” and doesn’t come up with an alternative way to make up for this large Medicaid shortfall, SBPH will have to work even harder to become profitable. Additionally, Landry says that any financial studies that have been done in the past year are “thrown out the window”.

“As we’re coming on line, we’re facing Draconian changes to the reimbursement methodology that couldn’t have been planned for 3 years ago. Financial data and studies were done before these changes,” Landry explained.

But Landry says overall, his major concern is that the deep Medicaid cuts, weeks before the hospital is to start admitting patients, will affect the hospitals time frame for “breaking even” financially.

“Essentially, I have less money that I have to make last longer,” Landry explained.

The importance of utilizing SBPH

Regardless of how things transpire in Baton Rouge and Washington, Landry says that the best way for people of St. Bernard to help the hospital is to use it.

That means that SBPH has to deliver on it’s promise to the community for top-notch healthcare.

“We can’t control the hospital’s location–it’s already built; we can’t do anything about how much we get from the government, but we can control the quality of our service,” Landry said.

Construction of the new St. Bernard Parish Hospital is set to be completed at the end of this month, and Landry says patients will start to be admitted in mid-August.