How Have the Sequester Cuts Affected Nursing and Health Care

The sequester cuts, which took place on March 1, 2013, resulted in $85 billion dollars in government spending cuts and have impacted the entire medical field. It affects every aspect of the Department of Health and Human Services since Congress did not act. The only programs exempted from these cuts were Medicaid, the Children’s Health Insurance Program and Social Security.

The sequester was a provision of the Budget Control Act passed in 2012, but the cuts were delayed until March as a result of the fiscal cliff agreement reached in January. Healthcare lobbyists have spent the last year trying to persuade Congress to cancel the sequester, but due to no budgets being passed and no compromises being made, these dramatic sequester cuts have gone into effect.

The Food and Drug Administration (FDA), which encompasses many important healthcare functions such as food safety inspections and approving new medications faces an eight percent budget cut. Much of the FDA’s budget is spent on employees so the cuts have resulted in layoffs and reduced hours. Less manpower at the FDA affects the agency’s ability to perform its essential functions. The process by which new drugs are approved is slowing down dramatically. This has affected healthcare providers and particularly patients who have lost access to new medicines that may be better able to fight disease. Additionally, the FDA can not perform as many food safety inspections. It is estimated the number food safety inspections will decrease by 2,100, resulting in more food-borne illnesses and deaths. Healthcare providers are caring for more people with food-borne illnesses and disease.

Medicare has also been affected by the sequester cuts. An estimated $11 billion has been cut from the Medicare budget. Payments to physicians caring for patients with Medicare has been reduced by an estimated 3 to 4 percent, equating to a $2 to $3 billion decrease in the physician fee schedule. This is in addition to previous cuts that were made to Medicare reimbursements. Physicians now have to find ways to absorb the lost income, as the cost of caring for patients continues to rise. This has resulted in lower pay or loss of jobs for supportive health care staff such as nurses, certified nursing assistants and medical assistants.

Physicians aren’t the only ones that have been impacted by the sequester cuts. Hospitals have also lost a large amount of money due to reduction in payments. It is estimated the average reduction in payments per hospital ranges from $800,000 to $1.3 million. Hospitals have been forced to cut services and staff to accommodate the loss of reimbursement. Nursing care has been greatly impacted in the hospitals, with higher nurse-patient ratios, understaffed nursing units and higher nurse burn-out rates. Nurses are working harder, caring for more patients, and carrying more responsibility for less pay. According to the American Nurses Association and the American Hospital Association, over 500,000 healthcare jobs are expected to be lost in by the middle of 2014.

Community services faces steep cuts as well. Free and reduced-cost vaccination programs for children have bee cut. Lack of vaccinations will likely lead to higher disease rates, including increased incidence of measles, mumps, rubella and diphtheria. In Georgia alone, 4,180 fewer children will receive vaccines. The Meals on Wheels program that delivers meals to home-bound seniors has seen cuts, with approximately four million less meals provided. For many recipients of this service, the meals are 50 percent of their daily food intake, meaning these seniors have been impacted by malnutrition and decreased ability to ward off disease and illness. Treatment of the mentally ill will be impacted. The White House estimates up to 373,000 seriously mentally ill adults and seriously emotionally disturbed children have lost access to treatment. This loss of mental health treatment leads to increased rates of homelessness, involvement in the criminal justice systems and hospitalizations for this vulnerable population. Reductions in breast and cervical cancer screenings through the National Breast and Cervical Cancer Early Detection Program will result in 33,816 fewer screenings.

Research on health and disease has slowed due to the sequester. The National Institutes of Health have been forced to cut research grants, triggering a loss of over 20,000 jobs and a reduction of $3 billion in economic activity. Many grants are not being paid since the cuts have gone through on March 1. Some believe these cuts will be impacting medical research for an entire generation. Progress has been delayed on prevention of common chronic diseases and finding cures for common and rare diseases.

Sequester cuts to healthcare have affected every single American. The impact of the budget cuts have been felt in every healthcare sector. Federal agencies have been forced to cut services, lay off employees and find other ways to make up for the loss of money. Local physicians have been further squeezed to provide high quality care for less reimbursement. Hospitals have had to cut valuable community programs and lay off staff in order to account for lost reimbursements. It appears at this time that these sequester cuts have taken a toll on health care as a whole. In the wake of these cuts, the entire healthcare field has been challenged to provide needed services and care to Americans.