The Congressional Budget Office predicts 14 million Americans who currently have insurance would be without it next year if the Senate Republican version of the health care overhaul bill is adopted.
That's leaving officials behind some rural health systems worried.
Washington Health System, or WHS, CEO Gary Weinstein calls the bill “very unfortunate."
The Health system has a 260-bed facility in Washington, Pa. and a 49-bed hospital in Waynesburg. Waynesburg is in Greene County, which ranks 60th out of 67 Pennsylvania counties in per capita income.
“It means a return to the time before the Affordable Care Act where people didn’t have insurance, so they waited until things got really bad and then their only alternative was the emergency room. And of course that’s a problem for hospitals,” Weinstein said.
Weinstein said the hospital system collects about 5 percent of what it bills uninsured patients.
“We don’t make money when somebody is insured by Medicaid but at least we get something,” Weinstein said. “But when somebody has no insurance at all, a lot of times they just aren’t able to pay any part of the bill.”
A vote on the bill was originally scheduled for last week, but it has been delayed as Republican leadership in the Senate looks to shore up support. Weinstein said he has spoken to Republican Senator Pat Toomey asking him to work to change the legislation before it comes up for a vote.
Toomey was among the group of 13 Senators who helped to craft the legislation. He said it is not perfect, but it is a step in the right direction and he will work to make it even better before the final vote is taken. He did not elaborate as to what changes he would like to see.
Weinstein said all hospitals have a certain base level of expenses for things such as information technology and compliance and with an average census of just 27 patients at the WHS facility in Waynesburg it becomes extremely hard to cover costs when any one of them is unable to pay their bills. Making maters worse, people who come into the system through the emergency room after neglecting their chronic conditions often rack up the largest bills.
"The Affordable Care Act was not perfect,” Weinstein said. “But it did increase coverage for millions of Americans. That has helped people to properly use the system and improve their health.”
If the system’s Waynesburg hospital closed, the nearest hospital for many of its users is at least 30 minutes away.
“We believe local community control is important,” said Weinstein.