ICYMI: Wisconsinites & Health Care Centers Would Be Hit By Trump-Backed Medicaid Cuts

That would mean less money available for federally qualified health centers in Wisconsin like Community Health Systems, which has locations in Beloit and Darlington.

CEO Stephen Smith said around 60 percent of the patients they see rely on Medicaid, and reducing their access to health care can have negative ripple effects on local communities.

Smith joined WPR’s “Wisconsin Today” to discuss the impacts that Medicaid cuts would have and how the resulting financial burden could be shifted back onto the taxpayers.

The following was edited for clarity and brevity.

Kate Archer Kent: What does it mean for Community Health Systems to be a federally qualified health center?

Stephen Smith: Federally qualified health center means that we are there to provide medical, dental, behavioral health care to those on Medicaid and those that are uninsured. We can also serve those on Medicare and commercial insurance, and we’ll see anybody, regardless of ability to pay.

KAK: If these proposed cuts to Medicaid happen, what happens to your clinics? 

SS: It depends on what type of cuts they make, but no matter what, the likely result is cutting back in services. We can’t afford to sustain off of no funding. More people are likely to lose their coverage. It is just something we have to look at from a sustainability standpoint to make sure we can continue to provide coverage longer term, but likely it means, unfortunately, longer waits.

With health centers really being driven towards helping individuals manage long-term chronic illnesses, that means they may not be able to get into services in a timely manner. Likely, those problems are going to escalate, and you’re going to see emergency rooms start to get flooded again for folks because they’re not able to access routine, ongoing primary care.

KAK: What are some of the ripple effects for the communities you serve if access to health care becomes less available, less reliable or too costly?

SS: If you can’t afford [care], you tend to wait. Sometimes you’re waiting too long, and you end up in the emergency room. With health centers being integrated with medical, dental, behavioral health, we have that ability now to see a dental patient, and maybe there’s an anxiety issue or a depression issue, and we can connect them immediately with a therapist. 

And the other piece is like looking at work requirements [for Medicaid], which sound good on their face, but there’s a huge administrative burden to that for our patients. Work requirements tend to be very costly to implement, costly to manage, and the burden tends to fall to the patient to try to justify that they need their Medicaid and that they are actively looking for work. 

It just takes what is a good thing, which is that ongoing, preventative-based care, and makes it more reactive. So you’re going to end up with people going to emergency rooms or just needing more costly surgeries and procedures. On its face, it sounds good to cut some of the expenses, but there’s a downstream effect on other agencies that are going to start to absorb these burdens, when the routine primary care starts to go away.

KAK: When someone who lacks insurance goes to the emergency room instead of Community Health Systems, who pays for that instead?

SS: It depends. In some cases, hospital systems do have some charity care. But ultimately it tends to be the taxpayers who are absorbing it, because those expenses are going to build up. And so [cuts to Medicaid] are not sometimes the savings that people think it is, because no matter what, taxes tend to go up, and there are going to be out of pocket expenses that tend to have to be absorbed by the communities.

KAK: Have you been in contact with any of Wisconsin’s Congressional leaders? WHat has your message been?

SS: Yes. Representative [Bryan] Steil and Representative [Mark] Pocan have been very receptive to taking feedback and understanding our perspective. The biggest message is, please play the tape all the way through. Sometimes when you’re looking to cut something, you see something that looks easy, or you think it’s a simple switch, but there is a downstream effect.