“It’s horrible,” he said.
Dr. Philip Elizondo, his orthopedic colleague, said the hospital needed to cancel minor surgeries for health problems that subsequently ballooned. One uninsured woman he treated had torn her meniscus, lost her job and lost her house. Dr. Elizondo said he could have performed a 20-minute surgery if the patient had been in a position to seek care immediately, but as an alternative her injury went untreated and got worse.
Dr. Richard Fremont, a pulmonologist, said that he had treated dozens of Covid patients over the past two years, but that patients with other health conditions, comparable to chronic asthma, had more often needed oxygen. Because uninsured patients cannot get short-term home oxygen therapy, he sometimes keeps those that need it within the hospital for days or perhaps weeks.
The crisis of the uninsured is particularly acute in Tennessee, which has one in every of the best rates of hospital closures within the country and is amongst a dozen states which have chosen to not expand Medicaid to cover more low-income adults under the Reasonably priced Care Act. Roughly 300,000 people within the state fall within the so-called coverage gap, meaning they’re ineligible for either Medicaid or discounted medical health insurance under the Reasonably priced Care Act despite having little to no income.
John Graves, a health policy professor at Vanderbilt University School of Medicine, said the influx of relief funds in the course of the pandemic had allowed something akin to a “universal coverage system inside a system,” granting coverage to everyone who got Covid. Now, he said, hospitals and patients are back to facing prepandemic pressures — and can face much more once the federal government ends the general public health emergency, which has temporarily increased Medicaid and Medicare reimbursements.
The federal Provider Relief Fund offered hospitals an early lifeline within the pandemic by providing tens of billions in direct funding, although the cash was steered inequitably, said Jason Buxbaum, a Harvard doctoral student who has written in regards to the program.
Individually, the Covid-19 Uninsured Program provided greater than $20 billion in reimbursements to roughly 50,000 hospitals, clinics and other providers for testing, vaccinating and treating the uninsured, including nearly $8 million to Nashville General. A pandemic relief package that has stalled within the Senate will almost definitely not replenish the fund, leaving providers on the hook and making reimbursements during future Covid waves unlikely.
