Erie County Comptroller Stefan Mychajliw says his office took on a report to look at how much the government is really paying to Erie County Medical Center under the Affordable Care Act.
He argues since the law’s passage there's been a significant upward trend. The chart the comptroller initially gave Spectrum News showed the county in 2017 gave more than $50 million to the hospital. Mychajliw said the majority of it is for losses ECMC incurs when uninsured patients don't pay their bills.
"This is a very good first step. This is putting in a neat package a report that says, ‘This is the cost, it's astronomical and it's going up.’ So I would love nothing more than to sit with our federal congress men and women and sit with state legislators and county legislators and say, ‘Here's the problem, let's fix it,’" Mychajliw said.
County Executive Mark Poloncarz says there are a lot of problems with the report. In a revised version he noted a $20 million error in 2011, which the comptroller's office has acknowledged — that's before the ACA went into effect, the county executive noted.
The graph suddenly shows much more fluctuation in costs. Poloncarz also noted in 2017, they changed what was in the budget line, so for a fair comparison the number should be closer to $43 million.
Finally he said the county is projecting roughly $36 million this year, but the comptroller didn't include this because it didn't fit the narrative.
"This report is the kind of thing that bothers me because he puts this out there. He makes it sound like, oh it's horrible," Poloncarz said. "The sky is falling when in effect it's a very complicated thing to discuss but moreover, there's errors in it and those errors immediately destroy his argument, which is the numbers have gone substantially up from when the Affordable Care Act was passed."
Furthermore, Poloncarz said Mychajliw essentially ignores another component of these statistics:
The costs the government pays to make up the difference for Medicare eligible patients paying their bills out of Medicaid. He said that's significant with the local population getting older and because ECMC has a long-term care nursing facility.
Mychajliw said bottom line the county is spending too much on a hospital business it's not technically supposed to be in anymore. It could be using that money on other services or even a tax cut.
Poloncarz said any budget expense is a burden but this is not a new or rising one.
ECMC said it gets similar reimbursement as other hospitals across the country and most if not all would take losses without them. As for any policy decision about who makes the payments, that's for the different levels of government to discuss.