Obamacare has saved N.J. a huge amount of money for hospital charity care

With more than 800,000 fewer uninsured people in the state, the amount of charity care New Jersey hospitals provided to patients who are unable to pay their bills has declined by $550 million since Obamacare took effect in 2014, according to a new state health department analysis.

Health Commissioner Cathleen Bennett late Thursday disclosed how much the state's 72 nonprofit and for-profit hospitals would be getting to offset some of their costs treating lower-income people who qualify for charity care.

But the annual announcement -- always a source of consternation for many hospital executives who rely on the funds to make ends meet -- was met with added apprehension.

The bill repealing and replacing the Affordable Care Act cleared two congressional committees after contentious, marathon hearings Thursday. The legislation calls for halting enrollment in the expanded Medicaid program after 2019 and cap the federal funds that now pay more than 90 percent of the tab for the roughly 550,000 working poor people in New Jersey who qualified for coverage under the landmark, bitterly contested health care law.

Gov. Chris Christie has been able to cut state and federal charity care payments to hospitals by $373 million in charity care as the number of uninsured people plummeted, New Jersey Hospital Association President and CEO Betsy Ryan said.

The new budget cuts $50 million more, she said.

"For the most part, they've been able to absorb those cuts because they were caring for more insured patients. Now we have the added threat of an ACA replacement proposal that would erode coverage and change the Medicaid program as we know it," Ryan said.

"If this becomes our new reality, we could be back to the pre-ACA days when greater than one in every 10 New Jersey residents lacked health insurance," Ryan said. "Our hospitals would be facing an even deeper unfunded obligation in caring for the uninsured. The erosion of coverage combined with years of funding cuts would be a staggering one-two punch for hospitals."

In 2013, the year before Obamacare took effect, hospitals documented $1,023,668,000 in charity care payments; by 2015, the amount was $479,634,777, according to the state report.

Using a formula based on charity care billings, 44 hospitals will see their charity care payments dip and 28 will see them rise, according to the report.

When taken into account the increase the Christie administration is providing to train medical residents to become doctors, 32 of the 72 hospitals will receive an increase in financial assistance, while the remaining 40 will get less.

State spending on graduate medial school programs has increased $158 million since Christie took office in 2010, Bennett said.

"This proposed funding furthers the state's investment in a strong healthcare workforce and healthcare quality and reflects the governor's ongoing commitment to the growth of New Jersey's medical schools and the expansion of hospital-based teaching programs," Bennett said in a statement.

"This budget also recognizes that documented charity care to the uninsured at our hospitals declined by 53 percent over a two-year period, but continues to provide support for this care," Bennett's statement said.

University Hospital in Newark, a quasi-state supported facility, provided the most documented chair care, at $50 million, and will receive $48.2 million in payments to offset it, according to the report.

Christie's budget also contains $43.8 million to support University Hospital, which has historically been dependent on the state for financial assistance. It is the main teaching hospital for the medical and dental schools at Rutgers University, and operates the only level one trauma center in north Jersey.

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