The Jindal administration came to the rescue recently when Baton Rouge General Medical Center-Mid City decided to close its emergency room because of mounting red ink.
The General had long warned that the growing number of uninsured patients receiving emergency medical treatment — and not paying — threatened the hospital’s financial viability. Hospital officials reported $1 million a month in losses from providing medical care in the emergency room to patients who cannot afford adequate insurance and cannot afford to pay. The losses were projected to increase to $20 million next year.
Some financial relief came but not enough. So, the hospital’s board of directors made the tough decision to close the door through which most uninsured patients arrived: the emergency room. That decision would have left much of the city without close access to treatment of life-threatening medical problems.
The administration then announced it had identified $18 million in uncompensated care dollars to stop what many would have portrayed as a black eye to Gov. Bobby Jindal’s health care policy.
The General blamed its fiscal crisis on the uninsured. And Jindal has consistently and vigorously opposed Medicaid expansion to provide insurance to about 250,000 of Louisiana’s uninsured.
When Jindal talked about the General’s situation, not once did he mention the role uninsured patients played.
“I know that Baton Rouge General-Mid City for many years has had challenges financially with that particular location and especially with that emergency room,” Jindal told reporters.
He mentioned more than once that the General’s executives faced “challenges running that facility.”
The $18 million would allow the General “to continue to provide critical services in that particular part of Baton Rouge,” Jindal said.
The uninsured care dollars being used were funds unspent in the prior fiscal year that the health agency still had access to.
Jindal then followed up with comments on how public-private hospital partnerships in Baton Rouge, Lafayette and elsewhere have resulted in improved services at taxpayer savings.
But still the problem lingers.
The General’s crisis underscored a problem facing other hospitals operating in communities — hospitals without the partnership agreements and their guaranteed reimbursement for uninsured care.
“These nonpartnership hospitals in those communities are clearly getting slammed,” said state Sen. Sherri Buffington, a Keithville Republican who follows health care issues.
State Sen. Ronnie Johns, R-Sulphur, said uninsured patients are showing up in increasing numbers at two Lake Charles hospitals that are not part of a partnership arrangement since LSU closed W.O. Moss Medical Center there. “Those hospitals are not being compensated one penny for those coming in,” he said.
The General’s problem existed prior to the closure of LSU’s Earl K. Long Medical Center, the north Baton Rouge charity hospital. The closure of the Earl just exacerbated the situation as the General became the nearest location for emergency room care.
And the General isn’t alone. Lane Regional Medical Center in Zachary has felt the financial pinch, too.
But all these fiscal problems started before the Earl closed in April 2013, Lane Chief Executive Officer Randy Olson said. Area hospitals slowly began seeing more uninsured patients when the state started taking money from the north Baton Rouge charity hospital.
“We are not impacted as much as Mid City,” Olson said, adding, “A hospital like Lane, we are pretty fragile,” and an influx of indigent care and mental health patients hurts.
The hospital is now running $6 million in bad debts annually and “a lot of that is coming through the emergency room,” he said.
“What do we do so we don’t have to do what the General did?” Olson asked, referring to the emergency room closure decision that prompted Jindal’s action. “We are all trying to be reasonable, but sometimes being reasonable, you don’t get the attention you need.”
Olson said Medicaid expansion to cover more uninsured patients would relieve the pressure and get people the care they need.
“More people would be able to be Medicaid eligible. We were very much hoping that would happen. I think the Jindal administration has made it clear it won’t,” Olson said.
And so the hospitals continue to struggle.
Marsha Shuler covers health care policy for The Advocate Capitol news bureau. Her email address is firstname.lastname@example.org. Follow her on Twitter, @MarshaShulerCNB.