MHA Today | July 7, 2017

July 7, 2017
MHA Today: News for Healthcare Leaders

twitter linkedin MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.


Herb Kuhn, MHA President & CEO
There was an amazing statistic in a St. Louis Post-Dispatch column this morning. Referring to the Affordable Care Act, columnist Chuck Raasch wrote, “less than half of today’s members of the U.S. House cast a vote on the bill. Half the Senate has turned over since the 2010 passage of Obamacare. Fourteen of them were in the House when the bill passed in 2010, including Sen. Roy Blunt, R-Mo.”

Although the derisive term “career politician” has been slung at members of Congress and Missouri’s state legislature, turnover in less than a decade has been significant. In Missouri, turnover is hard-wired. Term limits allow no more than eight years of service in the Missouri House and Senate, or a total of 16 years combined. Most serve far fewer.

The civics lesson is relevant to the nation’s health care discussion. Both the U.S. House’s American Health Care Act and the Senate’s Better Care Reconciliation Act were scored by the Congressional Budget Office for their impact throughout a decade. In the life of our state and national politics, that’s the long term. By 2026, both the AHCA and the BCRA would shift significant costs to states. Adopting them in the short term will lead to long-term risk, and financial pain for future lawmakers and chief executives.

On Thursday, MHA and several other states released new research on the Senate bill’s equity gap between Medicaid expansion and nonexpansion states. Between 2016 and 2026, the 19 nonexpansion states will have foregone an additional $737 billion in net federal outlays for Medicaid, compared to states that have opted to expand the program under the ACA. The report further projects that federal spending on Medicaid in expansion states by 2026 will be $1,987 per capita compared to $1,192 in nonexpansion states — a relative difference of 67 percent.

Missouri and the other 18 nonexpansion states have left significant ACA Medicaid funds on the table. Importantly, the Senate legislation acknowledges this fact and proposes ways to close that gap. But as this research shows, the effort comes up short. In effect, the House and Senate proposals double-down on the long-term Medicaid inequity, creating a structural disadvantage for nonexpansion states in the long term.

Today, MHA delivered a letter to Gov. Eric Greitens underscoring the problems the BCRA would create for Missouri and Missourians. The bill’s problems are not exclusive to Medicaid; they are manifold. Greitens has built his image around the idea of being responsible for hard choices. One of the most difficult choices any policymaker can make is to think long term.

Now is the time for Missouri’s leadership to voice concerns about the BCRA. The evidence is clear.

Let me know what you think.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
New Law Enhances Criminal Penalties For Assaulting Hospital Workers
Governor Signs Suicide Awareness Legislation

state and federal health policy developments

New Law Enhances Criminal Penalties For Assaulting Hospital Workers

Staff Contact: Daniel Landon or Rob Monsees

Gov. Eric Greitens has approved Senate Bill 34, enacted during the 2017 state legislative session. The bill makes a variety of changes related broadly to criminal offenses. One of its changes applies stiffer criminal penalties to those committing various types of assault against a hospital worker in the performance of his or her official duties. Previously, those enhanced criminal penalties applied in a hospital setting only to emergency and trauma center personnel, as well as emergency medical technicians. The change was made by an amendment offered by Rep. Shawn Rhoads (R-West Plains). 

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Governor Signs Suicide Awareness Legislation

Staff Contact: Daniel Landon or Rob Monsees

Gov. Eric Greitens has approved Senate Bill 52 from the 2017 state legislative session. It has several components concerning suicide awareness and prevention, including one focused on medical students. 

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Did You Miss An Issue Of MHA Today?

July 6, 2017
New MHA Research Finds Health Care Equity Gap Widens In Senate’s BCRA
Budget Documents Detail Gubernatorial Spending Restrictions
CMS Releases Updated Hospital Discharge Appeal Notices
MLN Connects Provider eNews Available
Federal Court Orders Illinois To Pay Medicaid Providers
CMS Issues Guidance Regarding IPFQR PY 2018 Reporting

July 5, 2017
Greitens Approves Tort Reform, Workers’ Comp Bills
Centene Plans To Fill Missouri’s Marketplace Deserts
CMS Updates Data Used To Determine Medicare DSH Adjustments
Trajectories — Opioid Use Disorder
CMS Releases OQR Specifications Manual

July 3, 2017
Greitens Announces Restrictions On FY 2018 Appropriations
Greitens Vetoes Fund Sweep Bill
CMS Releases IQR Specifications Manual

Consider This ...

Between 1975 and 2015, life expectancy at birth increased from 72.6 to 78.8 years for the total U.S. population. For males, life expectancy increased from 68.8 years in 1975 to 76.3 years in 2015, and for females, life expectancy increased from 76.6 years in 1975 to 81.2 years in 2015.

Source: Centers for Disease Control and Prevention