Hospital official: Cut to Medicaid ‘almost unfathomable’

By Lynn Arditi
Journal staff writer

PROVIDENCE — President Trump’s proposal to slash more than $600 billion over 10 years from Medicaid would cut deep into the government health program for low-income people that insures nearly one-third of Rhode Island residents.

Hospital officials and health care analysts said Tuesday it’s too soon to quantify the impact of the proposed cuts on Rhode Island. But the direction of the latest plan, they say, is painfully clear.

The impact is “almost unfathomable,″ said Dr. James E. Fanale, chief clinical officer for Care New England, the state’s second-largest health system. It would mean “going backwards″ to a time when “the number of uninsured increases, the access to care decreases and the quality of care suffers.”

Medicaid insures close to 300,000 Rhode Islanders, including about 70,000 adults who gained coverage through an expansion option that state adopted under the Affordable Care Act, known as Obamacare. Rhode Island’s expansion of Medicaid, coupled with another 30,000 residents who purchased coverage on the state exchange, have helped reduced the state uninsured rate by nearly two-thirds, to about 4 percent from close to 12 percent prior to Obamacare.

The prospect of more uninsured patients worries hospital officials. Lifespan, the state’s largest health system, reports that its charity or so-called uncompensated care has fallen by more than half during the last five years. “Clearly, the sheer size of the proposed Medicaid cuts … would be detrimental to health care here and throughout the nation and in addition a hardship for hospitals and other health care providers,″ David Levesque, a spokesman for Lifespan, said in an e-mail.

The president’s budget would cut Medicaid by capping payments to states; governors would have more flexibility to manage their Medicaid rolls. The funding change is projected to cut $627 billion over 10 years.

Those cuts would impact Medicaid services for the 155,000 children, parents, pregnant women; 19,000 seniors; 32,000 adults with disabilities and 12,000 children with special health care needs, said Linda Katz, policy director for the nonprofit Economic Progress Institute.