Developments in Washington D.C.

This week, two developments in Washington D.C. made a big impact on the proposed destruction of Prouty Garden. The first was the ongoing attempt to tear up the U.S. healthcare system, stripping hundreds of billions of dollars from providers such as Boston Children’s Hospital.

Under the Senate proposal, Medicaid, a major source of revenue for hospitals, would be drastically cut. By 2025, new funding caps for federal contribution to Medicaid will be instituted and states will be forced to reduce their Medicaid payments to hospitals, which have become reliant on the such payments. The Congressional Budget Office predicts Medicaid will be cut by $772 billion. Moody’s Investors Service says that Medicaid provides 52% of revenue for children’s hospitals and 14% for others. Hospitals will need to make tough decisions as their revenue begins to fall; this includes layoffs and cuts to services and closure for some hospitals and clinics.

As BCH President Sandra Fenwick put it in a column in The Hill: “Make no mistake, what is being considered isn’t a ‘fix‘— it’s a demolition and rejection of our commitment to children and their families.”

Whatever the outcome, it is hard to see how BCH can commit $1 billion to a new hospital project when finances are so uncertain.

Also, this week the United States Supreme Court temporarily allowed some of President Trump’s Travel Ban to take effect, until the Court hears the case this fall. The Court said that anyone with “a credible claim of a bona fide relationship with a person or entity in the United States” would be allowed to enter the US. That does not include medical tourists from the Middle East, which comprise a large part of the market for the proposed BCH facility.

Travel from the Middle East to the U.S. in the first quarter of 2017 has dropped 5 percent from 2016, according to the Airlines Reporting Corporation. Now that some of the ban has been upheld, we will watch with great interest the impact this decision has on the patient population at BCH from the targeted countries.