This might be one more sign that Republicans are easing their repeal-and-repeal-only stance on Obamacare—four senators including two Republicans—are
working on an Obamacare fix to help safety-net hospitals. Granted, Sens. Roger Wicker (R-MS) and Mark Kirk (R-IL) aren't really among the firebrands among Republicans, and they're working with Joe Manchin (D-WV) and Bill Nelson (D-FL) who aren't the vanguard of the left, but it's still progress.
Here's the problem they're addressing: The law penalizes hospitals for readmitting patients within a month of their discharge. That's done in an effort to reduce errors in hospitals that require the follow-up admission, and ultimately to save money. The problem this creates is a greater burden on the hospitals that serve low-income populations.
Medicare does have some ways of adjusting penalties to take into account the sickness (or health) of a hospital's patients. But there are still things happening outside the hospital—a lack of primary care providers, for example, or difficulty following discharge instructions—that can send lower-income patients back for a second visit.
As a result, safety net hospitals are about twice as likely to get slammed with big readmissions fines compared to other providers. Medicare is asking safety-net hospitals to work much harder—then penalizes them when they don't perform as well as everyone else.
The legislation these senators are offering would require that Medicare consider the socioeconomic status of patients at these hospitals when they review their performance and dole out penalties, essentially giving safety-net hospitals a break. That's the kind of thing that some bipartisan cooperation might have taken care of in the law when it was written, but better late than never, I guess.
It's going to provide a good test case for where Republicans are at nowadays with Obamcare, something they haven't seemed to be able to work out for themselves. The law has a lot of support outside of Congress, "endorsed by the American Medical Association, the American Hospital Association, and a bevy of other provider groups." Senate Democratic leadership should put this one on the fast track, to put their Republican colleagues on the spot.