Senate bill cuts more Medicaid funding

The U.S. House’s version of the Big, Beautiful Bill are slashes Medicaid funding. Now, the Senate is stepping up to slice health coverage for low-income Americans even more deeply.

The Senate’s evolving version of the bill would drastically diminish states’ ability to use what are called provider taxes to raise more Medicaid funding and more federal matching dollars. The revenues from provider taxes on hospitals and other health facilities allow states to raise Medicaid reimbursement rates.

Currently, provider taxes can be collected on up to 6 percent of a facility’s net patient revenues. The Senate version would cap the tax at 3.5%.

You might think hospitals would appreciate the tax cut. But in Iowa, hospitals are against the measure. It would reduce Medicaid payments to hospitals and could force rural hospitals and other providers to slash services or close. The Center for Healthcare Quality and Payment reform reports that 20 rural hospitals in Iowa are at risk of closure, including five facing an immediate risk of closure.

Forty-seven percent of rural births are paid for by Medicaid. And 65% of rural nursing home residents are covered by Medicaid.

The Senate provision will cut access to treatment, worsen health care shortages and increase wait times.

It’s a bad idea that will harm Iowans and their ability to get the health care they need. Senators should reject it, as well as deep Medicaid funding cuts approved by the House.

“So, ultimately, hospitals would have difficult decisions to make” Chris Mitchell, CEO of the Iowa Hospital Association, told The Gazette’s Tom Barton. “There’s not a lot of levers for them to pull with these kind of cuts. They either reduce labor (or) reduce services, and when those services go away, they don’t just go away for the Medicaid population,” but for the entire population served by that hospital.“

Ostensibly, Republican senators, including Sen. Chuck Grassley, argue a cap on provider taxes improves “transparency” to determine which states are using “schemes” to inflate Medicaid funding.

As with so many other harmful actions, the Trump administration is trying to cover up obvious consequences with ridiculous falsehoods. Of course, the Senate provision will harm rural hospitals. Who says so? People who run rural hospitals.

The House bill already is projected to grow the number of uninsured Americans by 10.9 million people. The Senate bill likely would add to that number.

Grassley and Sen. Joni Ernst should listen to rural hospital leaders and oppose the measure. The Senate version still is taking shape, making this a critical moment for Grassley and Ernst to make an impact on the final bill.

If this bill goes through, it’s not just hospitals that will suffer — it’s the Iowans who count on them: new moms, aging parents and families who are already struggling to get the care they need.

(319) 398-8262; editorial@thegazette. com