While some of the nation's richest hospital chains have received billions in coronavirus bailouts, many of the hospitals that have been bearing the worst of the crisis and need the support haven't gotten it. Some hospitals that the Trump Health and Human Services Department sent money returned it because they didn't need it or because they were closed, the Wall Street Journal reports. Months into this crisis, the Trump administration still hasn't figured out how to disburse the funding effectively.
"Our hospitals are on the front lines of the Covid-19 response and care for many Medicaid and low-income patients," Dr. Bruce Siegel, president and chief executive of America's Essential Hospitals told the WSJ. His organization represents hospitals in poor or underserved communities. He says the methodology HHS used for disbursing funds "tilted the playing field against our hospitals." In order to get the money out fast, HHS decided to send it to hospitals based on their Medicare reimbursements and patient revenue—patients covered by private insurance. So the hospitals heavily reliant on Medicaid for operating funds, among them the hospitals needing the most assistance, have gotten much less. Some of the hospitals treating the most coronavirus patients have gotten funding, as have rural hospitals HHS say, and they blame Congress for not giving them guidance on how to send the money out. As if they needed Congress to tell them not to send money to hospitals that are closed.
"A divided Congress failed to give the agency clear direction in law for how to spend the money, and now members are contacting HHS with their individual priorities and complaining the dollars are not spent to their wishes," HHS spokesman Michael Caputo whined. Their "individual priorities" like keeping hospitals open and operating in the middle of a pandemic. Frustration with HHS over this is bipartisan. The chairs and ranking members on both the key Senate and House committees overseeing HHS wrote to Secretary Alex Azar last week with their concerns. "Medicaid-dependent providers serve some of the frailest and most vulnerable Americans," Sens. Chuck Grassley, Ron Wyden, and Reps. Frank Pallone and Greg Walden wrote. "We must not let their financial insolvency due to the Covid-19 pandemic threaten access to essential care for these individuals." A bipartisan group of 90 House members, led by Democrat G.K. Butterfield and Republican Pete Olson, demanded that HHS allocate the funds to hospitals and providers disproportionately serving Medicaid and low-income patients.
The HHS Office of Inspector General, as long as it continues to exist under Trump, is auditing the initial fund disbursements, and HHS says it's trying to refocus the remaining funds as quickly and effectively as possible, "and will make targeted distributions to facilities and providers that have been disproportionately impacted by the coronavirus pandemic." HHS is aware, they say, that many hospitals are facing financial hardship.
That hardship is increasing for many of them, because they've lost so much revenue in both treating coronavirus patients who don't have insurance and from the loss of all the elective surgeries and procedures that have had to be postponed because of the epidemic. With millions of people losing their health insurance along with their jobs, hospitals are facing months more of treating uninsured people and many will require the expensive coronavirus treatment. The American Hospital Association estimates that hospitals have been losing about $50 billion per month since March, and is urging HHS to release another $52 billion to these hospitals as quickly as possible, saying that many are "in dire circumstances as they face the biggest financial crisis in history."
Meanwhile, some of the largest hospital chains, with billions in cash reserves, have been receiving billions in funding and have been laying off workers. That might be prudent for them from a financial standpoint, since we don't know how long this epidemic is going to last, but it's shitty for the primarily low-wage workers—custodial and janitorial staff and nursing assistants—who are losing their jobs now. And it's shitty for the hospitals that are on a knife's edge that are carrying debt and who don't pay their CEOs millions.