Officials say the combination of Obamacare with an increase in people using the emergency room as their primary doctors is putting Newton Medical Center in trouble.

Tuesday night, the hospital’s top officers asked the Newton County Board of Commissioners to restore their original request for 1.5 mills in this year’s operating budget. The commissioners at the beginning of the budget process agreed to keep the hospital’s millage at 1.2 mills, but the hospital officials asked that the remaining .3 of their request — about $600,000 — be returned to the budget to help pay for emergency room care.

“It’s getting dangerous,” hospital administrator and CEO Jim Weadick said.

Last year the hospital “wrote off” — simply didn’t receive — $22 million after caring for indigents (those who can’t pay) in the emergency room. Of that, the county contributed $2.4 million overall to offset the losses.

“It helps,” Weadick said. “But when you have $22 million worth of indigent care and you’re getting money to the tune of $2.4 million and you have the likelihood of $2.9 (million), we’re still out about 90 percent on indigent care and that’s not covered except by the hospital.”

The commission took no action on the hospital’s request during the hearing, nor during the adoption of the budget Thursday night.

An increase in the hospital’s millage would require three more hearings; essentially a do-over of that part of the budget.
One reason for the hospital’s losses is the “double whammy” of Obamacare, or the federal Affordable Healthcare Act, said hospital chief financial officer Troy Brooks. Obamacare as written calls for an increase in Medicaid payments and a decrease in Medicare, but gives states the right to opt out of the Medicaid expansion. Georgia is one of 26 states to do so. That means that money is “just lost,” Brooks said.

Commissioner Nancy Schulz suggested the hospital become the centerpiece of a “collaboration” of healthcare providers to treat the indigent, taking some of the burden from the hospital.

Commissioner JC Henderson said the poor economy has left many residents looking at the emergency room as their only hope. “We take care of our own,” he said. “What I like about our hospital … we all get the same things and sit in the same row and get help depending on how sick you are.”

Henderson spoke out against separating people based on income via a collaboration of providers.

The hospital’s emergency room is a “busy place,” Weadlick said — far busier than anyone planned for. When the ER was dedicated in 1993, there were 11,000 visits per year, with 28,000 projected as 100 percent capacity. The hospital passed that estimate by nine or 10 years ago, he said. Today, 45,000 visits are recorded annually.

A relatively new hospital regulation requires people to be pre-examined in the ER, with those not obviously in need of emergency care told they’d need to pay $150 up front, before care. “Word has spread around,” he said, somewhat slowing the increase.

Schulz asked what other steps the hospital is taking to collect money from patients going through the ER. Brooks broke it down: Collect at the ER, send bills, contact a collection agency and place liens on property. However, despite all these actions, the problem still persists.