States, hospital systems puzzling over possible effects of health reform

The Los Angeles Times: "Over the next decade, many of [the new health law's] consequences will play out at places like St. Joe's, a 431-bed nonprofit hospital founded by the Sisters of Providence in 1943, and in surrounding community clinics."

"Its emergency room, bustling with nurses, doctors, clerks and paramedics, is often overloaded." And such pressure is likely to increase, "Because the government health program for the poor pays less than private insurers, hospitals will be pressured to treat more people at lower cost per case, said St. Joe's chief executive, Barry Wolfman. … That should accelerate some trends that are already underway in many hospitals, such as standardizing procedures, he said."

Meanwhile, some health care services will receive a boost in funding. "The new healthcare law will help the clinics by providing $11 billion in capital improvement funds nationally over five years ..." But, according to Wolfman, the future is still uncertain. "Despite the planning and projections inspired by the new law, much of its effect remains incalculable" (Girion, 4/5).

Chattanooga Times Free Press: Counties in Georgia and Tennessee are trying to determine how more people receiving Medicaid or subsidies to buy insurance  will affect the local health care system. Though the subsidies are designed to help low to middle income earners, "…some fear that larger businesses that already offer health coverage could decide to drop their health plans and send their workers to buy coverage on their own with the help of government subsidies. Some critics of the reform plan say that shifts the burden of paying for coverage to taxpayers, and from lower-wage workers to higher-wage workers. … However, Mr. Burgess said one shouldn't underestimate powerful market forces -- such as health benefits as an employee recruiting tool -- that could counterbalance any incentive for employers to drop health plans."

Under reform, "the homeless, people with mental illness and childless adults who previously couldn't afford private insurance will benefit enormously" but "the premium levels for coverage in the insurance exchange still remain to be seen," according to Tony Garr, president of the Tennessee Health Care Campaign in Nashville (Bregel, 4/5).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.