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CAMC CEO says ACA spells trouble for WV hospitals

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West Virginia has lost 18 hospitals since the 1980s, and the Affordable Care Act is putting more pressure on the remaining ones, the head of Charleston Area Medical Center says.

David L. Ramsey, president and CEO of CAMC Health System, told the 200 people attending the West Virginia Economic Outlook Conference on Oct. 1 that gridlock in the federal government is leaving health care providers vulnerable to the unaddressed financial problems the ACA is bringing upon them.

"There's no interest on the part of our policymakers to make it work, so we're going to be taking the brunt," Ramsey said, adding that by "we" he meant the state's health care providers.

Government-run health insurance programs such as Medicare on the federal level and PEIA on the state level do not pay the entire cost of services provided to patients, so those costs are shifted to people with private insurance, he said.

West Virginia's hospitals provide about $810 million in uncompensated care annually, Ramsey said. About 76 percent of patients in West Virginia hospitals are in a governmental health care plan such as Medicaid or PEIA, and hospitals shift more than $300 million of Medicaid and PEIA costs to the private sector because of underpayments, he said.

The PEIA has the worst reimbursements, Ramsey said.

"There's a hidden tax that everyone in this state pays, and that's called cost sharing," he said.

Ramsey said as many as 90,000 West Virginians could become eligible for Medicaid under the ACA. Enrollment began Oct. 1, and coverage becomes effective Jan. 1, 2014

Federal funding is scheduled at 100 percent for the first three years then phases down to 90 percent by 2020, Ramsey said.

Until people in Congress talk to each other, "the health care industry in this state and every other state will be in disarray and challenged financially," Ramsey said.

Under the Affordable Care Act, more people will have insurance, but they won't necessarily have access to health care because some doctors will not take their insurance, so those people will go to the hospital emergency room, he said.

Mark Muchow, deputy secretary of the West Virginia Department of Revenue, said West Virginia state government had problems paying for its health care obligations before the program was expanded. As it absorbs more costs in the future, something will have to be cut from the state budget, and that probably will be spending on higher education, he said.