NEW YORK Tenet Healthcare Corp (THC.N) sees its hospitals playing a role in signing up uninsured Americans for President Barack Obama's healthcare overhaul, particularly in states that are balking at implementing the reform.
Tenet runs hospitals mainly in Texas and other Southern states, which have high proportions of uninsured people. It expects improvements in its business next year as more Americans obtain coverage either through subsidized insurance exchanges in each state or an expansion of the Medicaid program for the poor.
But the enrollment effort has been threatened by opposition from Republican governors and lawmakers and delays to building the exchanges and launching outreach programs to explain how they will work. The exchanges are due to start enrolling new customers on October 1 for benefits that will take effect on January 1, 2014.
"We're taking matters into our own hands," Tenet Chief Executive Officer Trevor Fetter said on Tuesday at the Reuters Health Summit in New York.
Tenet is awaiting final word from the government on whether hospitals can act as approved guides, or navigators, for these exchanges. The company's hospitals already have extensive experience in helping uninsured patients who show up in its emergency rooms to check whether they are in fact eligible for Medicaid or other assistance programs.
Each year, Tenet enrolls 125,000 patients who walk through its hospital doors in Medicaid programs, Fetter said.
"We know who these people are, because they've been coming to us, many of them. So we are really excited about the opportunity to turn everything on its head and reach out to the currently uninsured and help them gain health insurance and enroll in these programs."
The new insurance marketplaces will offer coverage to individuals and families. Those with low-to-moderate incomes will receive subsidized rates. About 7 million people are expected to sign up for healthcare coverage in 2014 through the state-run and federal exchanges, with up to 24 million onboard by 2016.
About 20 percent of the nation's uninsured, estimated around 50 million people, are concentrated in 13 counties and Tenet has hospitals in five of the top seven counties, the company said. In Texas where it is based and has 11 hospitals, 30 percent of people do not have insurance.
Enrollment has become a hot-button issue for the health exchanges, and politicians have questioned whether the government is doing enough to ensure the success of the exchanges.
Tenet, the No. 3 U.S. for-profit hospital operator, and competitors have experienced a slowdown in use of medical services in the past few years as the weak economy, changes in health insurance plans and other factors have kept consumers from opting for elective services.
TEXAS WILL COME ALONG
Another possible boost for admission rates at hospitals is the expansion of Medicaid under Obama's health reform, which has been accepted by governors in about half of the 50 U.S. states.
The federal government pays for 100 percent of the Medicaid expansion in the first three years and then 90 percent after that under the 2010 Affordable Care Act.
Texas Governor Rick Perry has been firmly against expanding Medicaid coverage, but Fetter expects the state to come along one day.
"I do believe that eventually Texas will not let this federal support go to waste, and I believe that there is widespread acknowledgement in Texas that the current Medicaid safety net is inadequate," Fetter said.
There is still a possibility that Texas could expand Medicaid this year before the state legislative session closes in a few weeks, he said.
"We certainly hope that a sensible compromise is reached within that next three weeks, and if not, then they'll take up the idea some time later, recognizing they will have left quite a lot of money on the table."
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(Additional reporting by Susan Kelly and David Morgan in New York; editing by Michele Gershberg and Matthew Lewis)