If House Bill 350 Passes, We All Lose

By Ric Cuming, Ed.D., MSN, RN, NEA-BC, FAAN

Supporters of House Bill 350 say the proposed legislation will impact cost and accessibility of health care in Delaware.

On that point, we agree.

House Bill 350 will result in sweeping, nearly instantaneous changes to the health care system in Delaware – only not in the way its proponents want.

Instead, House Bill 350 will reduce access to needed health care services, particularly in vulnerable communities that have been historically underserved. It will force hospitals to cut services and programs – not because they are ineffective, but because they don’t make money.

As a registered nurse for four decades and a member of the LGBTQ+ community, I have seen firsthand how a reduction in health care resources in a community can negatively impact underserved populations, and I am deeply worried about this.

House Bill 350 will also turn back the clock on innovation and investment in health care in Delaware, which has been critical in recent years as we look for ways to ease the ongoing health care workforce shortages while delivering high-quality, safe care at lower costs.

The bill includes a price cap that will slash health care resources across Delaware by $360 million, as well as a provision in the bill that says if hospitals earn more than the politician-run board allows, the state can take the extra revenue.

Yes, you read that right – the state keeps the money.

That money today is what Delaware’s nonprofit hospitals use to invest in our communities, including new services and technologies to meet the growing demands for care. If the state cuts off that ability to invest, the future of health care in Delaware starts to look extremely bleak.

The loss of this ability to invest and innovate will undoubtedly hurt patients and health care employees, both of whom are benefitting today from new ways of delivering care that are the result of investments our state’s hospitals made in past years. I’ve seen the difference it can make through examples like our hospital care at home program, which offers a safe, effective inpatient care experience in the comfort of a patient’s own home. Today, Delaware is a national leader in this innovative new model of care because of investments in technology and workforce that we’ve made over decades.

Importantly, these investments and innovation have been gradually moving people from higher-cost to lower-cost settings of care, while creating a better experience and without sacrificing quality and safety.

As a result of House Bill 350, Delaware could wind up with the opposite of what anyone wants — less access to care, poorer outcomes, increasing health disparities and rising costs. These are the very real unintended consequences that this legislation will have.

Perhaps the most unfortunate result of House Bill 350 is that it will do nothing to reduce health care costs. This legislation, written without any input from Delaware’s health care industry, only focuses on one thing – hospital costs. But it does nothing to lower the cost of health insurance or prescription drugs — and these are key drivers of health care costs today.

For example, prices for prescribed medication climbed 8.4% in 2023 and 6.4% the year before that. While hospitals have been working to maximize efficiency and cut down on costs, the insurance and pharma industries have been raking in record profits. How does legislation that singles out hospitals without addressing the overall drivers of health care costs make any sense?

Simply put, HB350 will be ineffective and destructive with long-lasting impact.

Despite what some legislators have suggested, there is no turning back if this law is enacted. Once these political appointees make the choice to slash budgets and reduce programs, those budgets and programs will be gone.

For my employer, ChristianaCare, that means being forced to cut $180 million in programs and services that help people get healthy and stay healthy.

Is this the legacy our legislators want for themselves? As a nurse, I know better than to support legislation that destroys good jobs and negatively impacts people’s health.

I’m not the only one. Other health care leaders from across the state have come forward to legislators to suggest alternatives that support price transparency without sacrificing access to care.

Business leaders have told the General Assembly this law is bad for Delaware. Nonprofit leaders have told them.

But so far, they are choosing not to see what’s coming.

This week is National Nurses Week, in which we celebrate the health care workers who serve with selflessness and compassion in our hospitals and on the front lines of care. I urge our legislators — and everyone in Delaware — to pause and reflect on the sacrifices nurses make every day in service to their neighbors. They deserve our community’s support. House Bill 350 would do the opposite, by eliminating resources and jobs, and rolling back progress we have made in increasing access to high-quality care for people in Delaware. We must vote no on this legislation.

Ric Cuming, Ed.D., MSN, RN, NEA-BC, FAAN, is chief operating officer of ChristianaCare.