[Congressional Record Volume 154, Number 55 (Tuesday, April 8, 2008)]
[Extensions of Remarks]
[Page E544]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


[[Page E544]]
INTRODUCTION OF H.R. 5721, THE STRENGTHENING THE SAFETY NET ACT OF 2008

                                 ______
                                 

                           HON. JOHN SULLIVAN

                              of oklahoma

                    in the house of representatives

                         Tuesday, April 8, 2008

  Mr. SULLIVAN. Madam Speaker, today, I am pleased to introduce H.R. 
5721, the Strengthening the Safety Net Act of 2008. This important 
legislation will increase Medicaid Disproportionate Share Hospital 
(DSH) payments to Oklahoma and 19 other low DSH States and bring 
Oklahoma's hospitals on equal footing with other States who receive 
their fair share of DSH funds.
  With Oklahoma having the fourth highest rate of uninsured in the 
Nation, it is critical that Oklahoma hospitals receive a fair 
distribution of DSH funds we need to care for our indigent population. 
This legislation will increase the rate that unused DSH funds are 
reimbursed to these low DSH States from the current rate of 16 percent 
to 19.5 percent for the next 5 years. The Medicare Modernization Act of 
2003 statutorily defined low DSH States and provided these States with 
16 percent funding increases each year for the last 5 fiscal years. In 
total, there are 20 States that have lower DSH allotments, including: 
Alaska, Arizona, Arkansas, Delaware, Florida, Idaho, Iowa, Maine, 
Maryland, Minnesota, Montana, Nebraska, New Mexico, North Dakota, 
Oklahoma, Oregon, South Dakota, Utah, Wisconsin, and Wyoming. The 16 
percent rate expires at the end of this fiscal year, so it is critical 
that we increase this percentage so that our hospitals do not feel the 
financial strain of providing health care services to the indigent.
  Under the 19.5 percent increases, Oklahoma will receive an additional 
$49 million in Federal funds which, when matched by the State, could 
amount to $75 million over the 5-year period to allocate to Oklahoma 
hospitals to help offset the costs of uncompensated care. Oklahoma 
hospitals provided $325 million in uncompensated care costs in 2006. 
H.R. 5721 will help decrease uncompensated care costs for Oklahoma 
hospitals and ensure fairness among all 50 States by equitably 
distributing unused DSH Funds.
  Since this bill is being solely funded through unused Federal DSH 
allotments, the funding source of the bill merely utilizes funds that 
are currently being returned to the Federal Government by other States 
that do not use all of their DSH funds. These unused funds currently 
are not being used toward any other health care related programs.
  Another important issue which needs to be addressed is access to 
quality, affordable health care, especially within our Nation's 
indigent population. Indigent patients in Oklahoma and our Nation face 
a significant number of unmet health care needs. These patients have 
difficulty accessing primary, diagnostic and specialty care and rely on 
hospital emergency rooms as their primary entry into the health care 
system. The price of treating the indigent at hospital emergency rooms 
is astounding compared to care found in a primary care setting. H.R. 
5721 will help bring down these costs and save taxpayer dollars in the 
process.
  My legislation will create an innovative new grant program through 
the Department of Health and Human Services to help our Nation's health 
care providers fund health access networks, which will get low income 
and uninsured patients who need basic medical care out of emergency 
rooms and into primary care facilities. These networks would be 
required to provide high quality primary, outpatient, inpatient and 
specialty care to uninsured and other medically vulnerable populations 
in an effort to reduce the costs of treating these individuals for 
hospitals and taxpayers alike.
  According to a 2005 study by the Lewin Group on Strategic Planning 
for Safety-Net Services, Tulsa, like many communities, faces many 
challenges in its delivery, financing and organization that limit its 
ability to successfully meet the needs of safety-net populations. To 
give an example, the price of treating the indigent at our hospital 
emergency rooms is astounding compared to the cost of treating someone 
in a primary care setting. To give you an example: the Oklahoma Health 
Care Authority recently found that the cost of a claim for asthma 
treatment in a primary care setting was $34.12 per claim, while the 
average cost for the same asthma treatment in an emergency room setting 
was $61.20 per claim. While some of these claims may have been 
emergencies, it is clear that treatment in an outpatient setting is 
significantly less, almost two times less, than treatment in an 
emergency room. Without these networks in place, the majority of 
Oklahoma's uninsured will continue to go without a primary healthcare 
provider.
  Lastly, my bill also changes the grandfather clause for the mandatory 
requirement related to hospitals providing nonemergency obstetric 
services which are located in low DSH States. The new grandfather 
clause will be the date this law becomes enacted. The purpose of this 
change is to remove a constraint imposed on low DSH States whose rural 
hospitals stopped providing nonemergency obstetrics during the 1990s 
and early 2000s due to rising liability insurance costs. The change is 
intended to encourage low DSH States to change their approach to 
funding more hospitals through the DSH program. Should my legislation 
become law, 16 additional Oklahoma hospitals will be able to qualify 
for DSH funds.
  I am pleased to have the support of the Oklahoma Health Care 
Authority, the Oklahoma Hospital Association and advocates for Tulsa 
health-plexes for the Strengthening the Safety Net Act of 2008. As a 
member of the House Energy and Commerce Subcommittee on Health, I am 
looking forward to working with my colleagues on the committee to see 
this legislation become law.

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