Some of the larger hospitals in New York state are worried about one aspect of the Affordable Care Act: academic medical centers are slated to lose millions of dollars in a particular kind of Medicaid payment over the next few years.
The concern is about what's called Disproportional Share Funding, says SUNY Upstate President David Smith. The funding goes mostly to big hospitals that also provide regional emergency services. Many of the hospitals at risk are large teaching hospitals, like Upstate.
"Those are extra Medicaid payments that are provided to cover the fact that we see a lot of poor individuals without insurance," Smith said. "But also because we are the safety-net provider for burn, trauma and things like poison control; and even some of our high risk issues with children with health care needs."
If nothing is done to change the formula, Smith says the effect on Upstate would be traumatic.
"They're aware there's a problem. They don't have a fix because it's a method of finance," Smith said.
He says Gov. Andrew Cuomo and New York's federal lawmakers know about it and are joining forces to lobby President Barack Obama's administration to make a change.
"They now have to look at an offset in the budget, and that's going to cause some interesting dialogue, but New York is galvanized around the issue and we have to fix it," he said.
Smith says a similar situation happened in Massachusetts when their health care program went into effect. New York hospitals are lobbying for change because the loss could jeopardize some of the hospitals programs, he explains.
"In our case it's a $100 million shift and without a replacement it could put in jeopardy some of those safety net programs," Smith said. "We're just trying to work in advance. We have a four-year lag; the initial cuts begin in 2014 and progress to 2017."