In reviewing the proposal by President Obama, there will be $320 billion reductions in Medicare and Medicaid. Approximately $268 billion in Medicare and $52 billion in Medicaid. The proposed cuts include reducing care for the elderly indigent by lowering the bad debt payments up to 25 percent from the current level of 70 percent. Indirect medical education, rural healthcare providers and post-acute care will also be negatively impacted. Medicaid payment formulas and Medicaid disproportionate share hospital payments will be adjusted and rebased.

Hospitals have already agreed to $155 billion in reductions over 10 years, face a 2 percent cut on January 1, 2013 due to sequestration (resulting from the Super Committee failing to reach agreement) and have had significant reductions to Medicaid over the past 18 months. We have done our fair share in working to be a part of the budget deficit solution. However ” enough is enough “ and the President’s budget proposal goes too far in additional cuts and could potentially negatively impact hospital staffing, access to cutting-edge treatment and longer wait times in the emergency care areas.