Chair Lee on H&H preparation for federal Medicaid cuts

And just in terms of the federal funding risks, obviously, you know, that are set to take effect this summer and fall, what steps are you taking to prepare for some of these changes to Medicaid eligibility?

Right, so the analogy I always think of with the government changes, and it's why it's so dangerous, it's the true scientific experiment that if you have boiling water and you drop a frog into it, the frog will jump out.

But if you put the frog in the water and you just slowly heat it, the frog will die.

And I feel this bill was really created with that in mind, that the changes are very incremental so that you never have

have that moment when you say, oh my God, but as they accumulate, right, and now we have the first people, for example, not getting food, right?

But so far everybody is still insured, right?

But then there's going to be the people who are falling off and they've arranged for there to be accommodation for the first shift, so they won't all fall off at once.

I mean, the most important thing that we do is to constantly remind people, we're here whatever insurance or no insurance you have.

Right, that that does not affect your care.

And we are the only provider who can do full range services for people who do not have insurance.

The FQHCs are great, but don't have the specialty services.

Right.

Right.

So, you know, when someone needs the MRI or they need the breast biopsy, they're going to come to us.

So beyond that, we just need to think about how, given that there will be less dollars, because more of the people that we care for will be uninsured.

Exactly.

So we have to figure out the model of how to do it.

You had already asked, John, we do think that in the coming months there are going to be opportunities for AI to help us to do certain administrative tasks more efficiently.

That may help a bit.

We're constantly looking to see how we can be, you know, what care models are the most efficient, deliver the greatest benefit.

We will work with you and share any information.

We're certainly working hard to re-enroll everybody we can and to help people learn that there are exemptions, including for volunteer work.

We welcome, I know, the public health department has a great initiative for volunteering to help other people to get benefits.

We're also always trying to get people to work in our skilled nursing facilities where the only skill you need is the willingness to sit next to somebody

next to a baseball game and talk to them about it or sit with someone and play cards.

They're always looking for a fourth hand, right?

And that would qualify as, you know, volunteer experience, right?

There's nothing wrong with work.

There's something wrong with taking away people's fundamental health care, right?

And we want to try to figure out as much as possible how we maintain people's benefits.

No, definitely.

And I think that was brought up in...

Quite a few of the hearings we've had so far, especially with HRA as well as DOHMH before this, when it comes to making sure that the health benefits and also just in general, like SNAP, food stamps, the resource navigator,

remain funded.

And do you have those staff that are going to be impacted by this within the hospital setting or within some of your other program areas?

So far, no.

I mean, nobody is affected yet.

Right.

Again, that's this very slow moving thing.

Right.

I mean, again, even to the end of this year, we're fiscally okay.

I know 22 days of cash on hand is very great.

Yeah, it's only as you get into the outer years when you start adding up all the incremental things.

But again, we have reason to hope that there is an election before there are the final cuts and that maybe there is some opportunity to protect the benefits that people need.

And then in terms of that and the subsidy amount that could potentially increase as the eligibility gets stricter in the long term, do you have any sort of,

I know you're saying this year it should be okay, but in the out years, have you done calculations of how much extra funding you would need?

Well, in a sense, the shortfall is the loss.

The question is how much can we make up without harming services?

Right, so whatever that delta is.

Right, and if it all happens, we will need to come up with alternative models, but maybe sometimes bad times cause you to have creative thoughts.

Come up with new ways, right?

city learned a whole new set of things through COVID that we never knew before, right?

We never used before.

You know, I hope it's not going to come to that, but we will certainly look for other opportunities to figure out how to protect services.

That will be our bottom line.

Yes, definitely.