And then there is the "rural floor" issue and the Massachusetts Hospital Association’s exploitation of a loophole in the byzantine ACA bill that would give Bay State hospitals an additional $367 million in annual Medicare funding. That funding, only for Massachusetts acute care facilities, would be taken from Medicare funding for hospitals in the 49 other states, and those states are not happy about it.
The issue first came to light in August, and many state hospital associations are still quite incensed. Last week, the leaders of 19 state hospital associations complained in a letter to President Obama that Massachusetts' "manipulation" of the ACA would come at the expense of every other state. They asked the president to remove the loophole from his 2013 budget.
MHA defended the windfall and said in a statement that it "followed all the rules regarding the rural floor regulations."
So, state hospital associations that are supposed to wage the home front battles to preserve funding are instead fighting amongst themselves.
At the same time, the AHA's support for ACA has placed hospitals in the crosshairs for more funding cuts from an avenging Republican majority with an axe to grind.
At a time when hospitals need to project a united and bipartisan front as funding comes under attack, neither of these developments is healthy.