The Wrong Prescription for Rural Nebraska

Senator Mike Johanns

My August travels throughout the state included meetings with doctors and hospital administrators who are bracing for major changes in the way they operate as a result of President Obama’s health care law. Unfortunately, the facts tell us rural Nebraska health care is likely to take a very hard hit from the law.

In our rural communities, access to health services is already limited. Every cut slices deeper and every regulation weighs heavier, hurting health care providers and the patients they serve. That’s why the law’s cuts to Medicare reimbursement rates is of great concern in rural Nebraska.

A report by Medicare’s chief actuary states that because of cuts in the law, “Medicare and Medicaid payment rates for inpatient hospital services would both represent roughly 39 percent of the average level for private insurance.” That means a hospital treating someone on Medicare or Medicaid will be reimbursed less than half the amount they’ll receive when treating someone with private insurance. The report also predicts that under these rates, 40 percent of providers would become unprofitable in the years ahead. The alternative will be to limit or stop accepting Medicare and Medicaid patients.

The law also cuts Medicare Advantage by $308 billion. This could prompt plan providers to move out of rural areas, limiting options for nearly 30,000 Nebraskans enrolled in this program, many of whom will not be able to keep their current coverage.

Medicare home health programs are facing $66 billion in reductions—another setback for rural Nebraska, where serving patients in the comfort of their own home is a monumental task. Health care providers often travel many miles to treat patients, requiring added time and resources in transportation alone. As these services become less available, patients may have to seek care in nursing homes, which are already facing $39 billion in cuts as a result of the law.

Overall, the Medicare cuts in the health care law total more than $700 billion, which is spent on new entitlements. You simply cannot claim the law protects seniors’ benefits when it threatens the very care they rely upon.

While the law cuts funding for major health care programs, it brings in millions more new patients, asking doctors to do much more with much less. Rural areas are already facing doctor shortages. Twenty percent of the nation’s population lives in rural America, but only nine percent of physicians practice here. Our rural health care providers are already stretched thin. If you think you have trouble finding a doctor today, just wait until the law is in full effect.

Rural America is facing less funding and fewer doctors who must travel more miles to serve more patients. The math doesn’t add up to better outcomes for patients and providers. To top it off, families, farms, ranches and other small businesses that serve as the engine of job creation will face a sharp tax increase under the health care law. The nonpartisan Congressional Budget Office projects $1 trillion in new taxes from 2013 to 2022. Employers who cannot afford their workers’ health premiums will face penalty taxes of up to $2,000 per full-time employee.

These looming realities are causing great concern across the country – especially in rural communities. Clearly, President Obama’s health care law is not the right prescription for rural Nebraska.