Billions of dollars in aid not only guaranteed that uninsured Covid patients would not face medical bills during the pandemic but also offered a lifeline for financially stressed institutions that provide extensive uncompensated care for the poor, the New York Times reported. The infusion of aid is ending at a time when hospitalizations from Covid are receding, but as safety-net providers are facing tremendous unmet needs from patients who have delayed care for chronic conditions and other health problems even more than usual during the pandemic. “Their margins are slim to begin with,” Beth Feldpush, the senior vice president for policy and advocacy at America’s Essential Hospitals, which represents safety-net hospitals, said of the institutions. She added that some were already having a “more difficult time bouncing back operationally and financially.” Nashville General has seen an average of just one Covid patient a week recently. But its doctors and nurses say that a wide range of health problems that worsened during the pandemic are now overwhelming the hospital. Dr. Eric Neff, an orthopedic surgeon, said patients were afraid to visit the hospital during much of the pandemic and often had trouble finding transportation when they did. The consequences were dire: People waited six months to seek care for a broken wrist or ignored a torn rotator cuff, making it harder for him to fix their injuries. The crisis of the uninsured is especially acute in Tennessee, which has one of the highest rates of hospital closures in the country and is among a dozen states that have chosen not to expand Medicaid to cover more low-income adults under the Affordable Care Act. Roughly 300,000 people in the state fall in the so-called coverage gap, meaning they are ineligible for either Medicaid or discounted health insurance under the Affordable Care Act despite having little to no income.
