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Pork For Nantucket Is The Latest Prescription

You don’t have to be a political scientist to know ObamaCare was passed with the help of payoffs to legislators including massive pork projects for Louisiana and Nebraska. The “Louisiana Purchase” and the “Cornhusker Kickback” are the more notorious scams that some Democrats demanded from the President as their price to secure votes needed to ensure the government takeover of our nation’s health care system. One other payoff, however, was particularly manipulative and cleverly gratuitous — Massachusetts Senator John Kerry’s pork barrel creation has already cost Americans billions of dollars just so one hospital on tony Nantucket can pilfer millions of tax dollars every year while more deserving hospitals in red and purple states see cuts to their funding.

The Kerry provision forces the Department of Health and Human Services’ Center for Medicaid Services to work from the budget priorities of the former Senator from Taxachusetts – not for the benefit of Americans across the entire country. Within CMS countless people tirelessly work to make certain that all States are able to provide insurance for our nation’s children. Another program within CMS works to ensure that medical professionals in the busier and more stressful inner cities get paid at least as much as their colleagues in the suburban and rural hospitals. A noble goal, but this program has been slowly twisted into a parody of its origin.

Then-Senator John Kerry was able to insert language into the bill which removed the ability of CMS to equitably distribute Federal funds across the country based on an understandable and fair equation. Rather than CMS transferring federal funds to each state and allowing the states to then disburse funds to each hospital as needed to maintain a common statewide “wage floor”, the Kerry provision forced CMS to create a national “pool” of all funds and disburse an unlimited amount of funds to whichever states’ hospitals faced the largest “wage difference” between rural and urban hospitals.

Because this change occurred by an Act of Congress, it should not come as a surprise that the state of the provision’s author, Massachusetts, is the state with the largest difference in salaries between the medical professionals of the urban and rural hospitals. A cursory review quickly reveals that Massachusetts is now receiving a massive annual increase due to this provision – more than $160 million every year since 2011 – and CMS does not anticipate this changing in the future.

It’s important to notice that Senator Kerry was very clever about this change to the regulatory program. During the then-Democratic Congress’ vote on ObamaCare this quiet provision did not trigger a negative reaction as CBO determined that technically this contains no “new spending”, it is simply “cost shifting” (otherwise known as “robbing Peter to pay Paul”).

But two things cause me to wonder about this.

1 – How could there be this much of a difference in wages between cities like Boston, Cambridge and Springfield and the wilds of rural Massachusetts? Is that state really that big?

2 – Where is this money coming from, who is losing medicine and care because of it?

The second question is actually the easier of the two to answer. Obama’s own Department of Health and Human Services provides the facts of the impact of Senator Kerry’s healthcare contributions.

In just 2014 alone, Georgia lost more than $12.7 million and Arkansas $5.2 million. Iowa had more than $12.3 million taken from their hospitals while Michigan watched helplessly as $22.4 million was taken. North Carolina was raided for $12.6 million and strangest of all Florida had nearly $30 million taken from their hospitals thanks to this policy shift alone.

Millions of dollars have been taken from the hospitals of more than 40 states every year. Rather then those funds being dedicated to pay for caregivers of the elderly and sick children in hospitals across the entire country, the vast majority of those funds are being given to the hospitals of a single private hospital chain in Massachusetts. It amounts to nearly $500 million since the Kerry Provision went into effect and there is no end in sight.

And there lies the complex answer to the first question. According to the Obama Administration, there isn’t a big difference between the cities and the rural areas of Massachusetts. In fact, there is no difference between downtown Boston and the middle of the bucolic Berkshire Mountains of Western Massachusetts. There is only ONE hospital in the entire state of Massachusetts that qualifies as “rural”. It is conveniently located on the ultra-rich enclave of Nantucket, summer home of now Secretary of State Kerry and just across the Nantucket Sound from the aristocratic summer vacation retreats of Presidents Obama and Clinton.

Shortly after the Nantucket “Cottage Hospital” merged into the mega-conglomerate Partners HealthCare in 2006, the Nantucket Cottage filed a change with the Center for Medicaid Services to switch to rural classification. The amendment was done specifically for the purpose of positioning all of the other hospitals in Massachusetts (the largest of which are part of Partners HealthCare) to receive funds from the Federal government.

It should be easy to achieve bipartisan support for this obvious waste of government funding in nearly any Congress – even one so split and contentious as the current one. With one small exception….. Senate Majority Leader Harry Reid opposes any change to any of the laws surrounding ObamaCare. And even this small provision has no chance of being repealed this Congress. And its easy to understand why… Nevada has received an increase of more than $11 million every year from this change to Federal funding.

It’s unfortunate that the Democratic Senators from Arkansas, Louisiana, Michigan, Georgia, Iowa and North Carolina seem to be unable to do anything to change this unfair policy. If only they had some actual pull with Leader Reid. There seems to be only one way to change this theft from the sick, injured and elderly of these and 36 more states. Take away Senator Reid’s ability to control the Senate Floor.


Daniel Horowitz

Daniel Horowitz

Daniel Horowitz is an independent consultant specializing in public policy strategy, coalition building and development. He previously has served as staff in the U.S. House and Senate and as the presidential appointee in charge of policy at the U.S. Small Business Administration.

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