WASHINGTON – Now that Barack Obama has been elected President of the United States and the Democrats have strengthened their control of Congress, what can hospitals expect from the federal government in 2009?
Blair Childs, senior vice president of public affairs at the Premier healthcare alliance, says hospitals are well positioned in the short term. One of the first things President Obama and Congress will address is the expansion of the State Children's Health Insurance Program, something that was not supported by the Bush administration.
“We’ll see the expansion of SCHIP early, probably in February 2009,” Childs said. “Because Obama has indicated that SCHIP will be one of the first things that will happen, that’s going to be good news for hospitals, as there will be less uncompensated care. But after SCHIP, the broader question of access to care will take more time to be resolved.”
Thomas Green, CEO of the investment banking and financial advising firm Lancaster Pollard, says reimbursement for critical access hospitals looks to be on solid footing with a Democratic Congress. He even predicts that more hospitals may be able to win CAH designation in 2009.
Still, Green indicated that some Democratic concerns could have negative effects on hospitals.
“You can probably expect some sort of patients’ bill of rights to pass under the new administration,” Green said. “That could be a problem for hospitals in that it would ultimately lead to greater legal liability and cost increases.”
While the Democrats now control both the executive and legislative branches of government, they do not have a filibuster-proof majority of 60 seats in the U.S. Senate, which could be critical, said Richard Umbdenstock, president and CEO of the American Hospital Association.
“Bipartisanship will be more important than ever,” he said. “President-elect Obama showed pragmatism on the campaign trail and that’s good, because the most likely successful path to healthcare reform will be a phased approach. You don’t easily or lightly alter major parts of a $2.1 trillion sector of the economy.”
The great unknown with regard to healthcare reform are the long-term plans of the Obama administration, Childs said. He expects the administration will continue with value-based purchasing and support the increased use of transparency, payment differentials and comparative effectiveness research when determining hospital payments.
“There is going to be huge pressure to cut payments to hospitals in 2009, but Congress is going to be cautious for fear of hurting the economy,” Childs said. “In the long term, things are going to be tougher for hospitals at the federal – and perhaps especially at the state – level.”