Undocumented immigrants, DSH cuts add pressure to Conn. hospitals

Undocumented immigrants will make up a greater proportion of the uninsured population in Connecticut next year, further straining the state's safety net hospitals, the Middletown Press reports.

Although the Affordable Care Act increases available coverage options for legal immigrants, undocumented immigrants do not have access to Medicaid or Connecticut's insurance marketplace. Experts say this means they must continue to use emergency departments, even as Connecticut hospitals stand to lose millions of dollars in state and federal subsidies meant to offset uncompensated care, according to the article.

"This is a global problem that isn't going away. This population [of undocumented residents] is not being addressed by any state or federal initiatives. It's operating under the radar screen," William Gedge, senior vice president for payor relations for Yale New Haven Health System, the state's largest provider of uncompensated care, told the Press.

Safety net hospitals in the Nutmeg State spent more than $200 million in uncompensated care last year, according to the article, and a further $868.3 million to offset Medicaid and Medicare reimbursement shortfalls. Deficits are expected to increase next year with the implementation of cuts to disproportionate share hospital (DSH) payments, as well as the loss of $550 million in state funds that previously covered Medicaid expenses, according to the Press.

"All of our five hospitals function as safety net hospitals. So sadly, we look at the elimination of DSH payments as another cut from the federal government because the additional revenues from some incremental bump in Medicaid enrollment will in no way [make up the deficit]," Rocco Orlando III, M.D., senior vice president and chief medical officer of Hartford HealthCare, told the Press.

Although the ACA aims to expand the insured population through the exchanges and Medicaid expansion, the Congressional Budget Office estimated that nearly 30 million people will remain uninsured by 2022, necessitating the continued existence of institutions like free clinics and safety net hospitals, Fierce Healthcare previously reported.

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