Mayor Fischer Responds to Courier-Journal Editorial

In a letter to the editor today, Louisville Mayor Greg Fischer responds to a Sunday editorial in the newspaper that criticized cuts to city funding for the University of Louisville Hospital's indigent care.The mayor's next budget cuts indigent care funding from $9.7 million to $7 million. On Sunday, the CJ criticized the cut, pointing out that it will trigger a similar reduction in state funding, since the General Assembly's budget ties state funding to city funding. Instead of cutting, the council should try to preserve funding for another year while local officials take time to truly analyze indigent care needs. Mayor Fischer should gather civic and health care leaders together over the next year to decide what health care the community wants to provide for the poor and uninsured, how much it is willing to pay and how to do so.But Fischer's letter says "For the past five years, the city has contributed $7 million toward that fund annually, and the budget I proposed for the new fiscal year starting July 1 keeps that funding at the exact same level."That's technically true. Years ago, with concerns that the entire contribution to indigent care would be cut, the city struck a deal to allocate $9.7 million with the stipulation that a refund would be made to keep the city's funding at $7 million. In the end, that means the city's contribution to the hospital is the same. What has changed is the state funding. Fischer goes on to ask a number of questions about the hospital and the indigent care trust:

• How will the university respond to concerns raised by the state auditor, who discovered inadequate oversight of the trust?
• How will health care reform — and the pending decision from the U.S. Supreme Court — affect University Hospital?
• Will the hospital find another merger partner? What role will that play in indigent care in our city?
• How will the state’s decision regarding the status of Passport Health Plan, the Medicaid provider for Jefferson County, impact indigent care services?
• Does the flow of funds from the city to the QCCT through University Hospital and then to the medical school impact indigent care?
• Why is Louisville the only city government in the state that pays into an indigent care trust fund?

Some of those questions may be answered soon, as the SCOTUS ruling on the ACA is expected this month, the debate of privatized Medicaid continues and U of L Hospital continues to search for a new business partner.