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ACA Repeal and Replace


Message from Andy Carter on AHCA

The U.S. Senate’s Better Care Reconciliation Act of 2017 includes deep cuts to the Medicaid program, which serves nearly 2.8 million of Pennsylvania’s children, pregnant women, seniors, and individuals with disabilities. Please click here to contact our U.S. Senators and tell them how Medicaid has helped your hospital.


Pennsylvania hospitals have been committed to and engaged in health care reform efforts that have reduced the ranks of the uninsured and advanced the Triple Aim—improving overall health and the safety and quality of health care while reducing per capita U.S. health care spending. 

Federal policymakers are in the process of reconsidering the Affordable Care Act (ACA).

 

HAP has produced an interactive state map to help the public and policymakers understand the Affordable Care Act’s health care coverage impact in the state’s Congressional districts.

 

The hospital community has stood firm in its commitment to coverage and transformation. As such, any alternative to the ACA must:

  • Ensure continuity of coverage and care through access to a robust, competitive delivery system
  • Ensure stable and sufficient funding for hospitals
  • Maintain momentum in delivery system transformation and innovation

Leading into the 115th Congress, the Republican-controlled Congress and the incoming Trump Administration pledged to take swift action to repeal the ACA. Those advocating for repeal have cited key areas of concern with the law including federally imposed mandates, instability and rising prices under the health insurance marketplaces, and a greater role and financial responsibility of the federal government in health insurance coverage.

Congress is grappling with how to approach repealing the law, and what alternative health care reform policies to pursue.

Policy concepts to address coverage and Medicaid reform that have been contemplated by Republican policymakers include:

  • Market-oriented, consumer-driven mechanisms to expand coverage such as health savings accounts and refundable tax credits
  • Insurance Market Reforms—retaining some of the consumer protections of the ACA, or attempting to achieve similar means through alternative policies
  • High-risk pools and default options for the uninsured
  • Tax Treatment of Employer-Sponsored Coverage—replacing the current Cadillac tax with a cap on the exclusion for employer-sponsored insurance
  • Medicaid Reform—proposals to block grant or provide a per-capita allocation, and reform through waivers

Pennsylvania hospitals face significant implications if repeal is not coupled with adequate replacement policies:

  • Coverage: 1.1 million Pennsylvanians have benefit from health care coverage through the health insurance marketplace, Medicaid expansion, and dependent coverage. More than 412,000 Pennsylvanians have gained health insurance coverage through the marketplace, with 78 percent relying on subsidies, and from 2013 to 2016, 685,000 Pennsylvanians have secured coverage through Medicaid or the Children’s Health Insurance Program (CHIP). Millions of Pennsylvanians have also benefited from consumer protections secured as a result of the ACA—coverage for patients with pre-existing conditions, no lifetime limits, a minimum essential benefits package.
  • Funding to support care: A report, issued by the American Hospital Association (AHA) and Federation of American Hospitals, details the impact ACA repeal would have on hospitals and health systems nationwide. ACA-mandated hospital cuts will amount to $14.9 billion for Pennsylvania hospitals for the period of 2018 to 2026. Hospitals will need that funding to address the additional uncompensated care that will result from growing numbers of uninsured patients.

ACA IMPACT – INFORMATION AND RESOURCES

HAP President and CEO Andy Carter Letter to Pennsylvania Delegation (Download PDF) -3/22/17

SUMMARY: The American Health Care Act (Download PDF) - 3/1/17

PA Health Care Providers Letter to Pennsylvania Congressional Delegation (Download PDF) - 5/2/17

PRESENTATION: The American Health Care Act: Policy and Implications (Download PDF) - 3/28/17

Analysis of the CBO Report and Implications for Pennsylvania (News Article) - 3/13/17

AHA Letter to Members of Congress on AHCA (Download PDF) - 2/16/17

Report Card Health Care Transformation in PA (Download PDF) - 2/14/17

PRESENTATION | Fundamentals of Medicaid (MS PowerPoint) - 3/2/17

INFOGRAPHIC | Repealing the ACA: Coverage Consequences (Download PDF) - 3/17

Regional Economic Impact of Pennsylvania Hospitals and Health Systems (Download PDF | MS PowerPoint)    - 2/17

POSITION PAPER: Coverage Consequences (Download PDF) - 3/2/17

POSITION PAPER: Eliminating Medicaid Expansion (Download PDF) - 2/17/17

POSITION PAPER: Medicaid Financing Reform (Download PDF) - 2/17/17

POSITION PAPER: Health Care Transformation (Download PDF) - 3/1/17

NEW HAP POSITION: Medicaid DSH Payments (Download PDF) - 9/14/17

NEW POSITION PAPER: Repealing the ACA: Addressing Insurance Rate Increases (Download PDF) - 9/6/17

NEW POSITION PAPER: Repealing the ACA: Stabilizing the Insurance Market (Download PDF) - 9/6/17

NEW RESEARCH BRIEF: Extend Funding for S-CHIP (Download PDF) - 9/8/17

Health Care Transformation

By the Numbers: Health Care Transformation in PA (Download PDF) - 2/17/17

Health Care Transformation in Pennsylvania Before and During the Affordable Care Act (ACA) (Download PDF) - 2/17

Economic Impact

MAP | Projected Regional Economic Impact of Medicaid Expansion in 2016 (Download PDF | MS PowerPoint) - 2/17

Related News

Uninsured in PA Drops 45% Since Affordable Care Act Began by admin

The latest data from the U.S. Census calculates that since passage of the Affordable Care Act  in 2010, Pennsylvania’s uninsured rate has declined from 10.2 percent in 2010 to 5.6 percent in 2016, a 45 percent decrease in our state’s uninsured population and the lowest number on record.

HAP Urges Pennsylvania Delegation to Oppose Disruptive Graham-Cassidy-Heller-Johnson Proposal by admin

HAP urged Pennsylvania’s federal lawmakers to reject the complex, sweeping proposal put forth by U.S. Senators Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV), and Ron Johnson (R-WI) that would jeopardize health care coverage and protections relied upon by millions of Pennsylvanians. HAP called upon lawmakers to instead leverage bipartisan support for stabilizing the health insurance markets and promoting access to affordable health insurance and high quality care.

Report Quantifies Burden of Multiple Chronic Conditions by admin

A new report, seeking to outline and quantify the key challenges of multiple chronic conditions found that with each additional chronic condition, health care costs more than double, so that treating a patient with four chronic conditions could cost as much as 16 times more than a patient with only one condition could.

Governor Wolf Joins Bipartisan Group of Governors to Oppose Graham-Cassidy-Heller-Johnson Amendment by admin

Governor Tom Wolf has joined a group of ten bipartisan governors from across the country to send a letter to U.S. Senate Majority Leader Mitch McConnell (R-KY) and Minority Leader Chuck Schumer (D-NY) to express their opposition to the Graham-Cassidy-Heller-Johnson amendment, the Senate’s last-ditch proposal to repeal and replace the Affordable Care Act (ACA) before budget reconciliation rules expire on September 30. Under current reconciliation rules, the Graham-Cassidy-Heller-Johnson amendment would only require a simple majority of senators vote to approve the measure.

HAP, Providers Urge Delegation to Preserve Key Health Care and Insurance Programs by admin

Ahead of looming Congressional deadlines regarding vital health care issues and the potential for action by the U.S. Senate on legislation to repeal the Affordable Care Act (ACA), HAP joined 26 Pennsylvania health care provider and advocacy groups to send a joint letter to Pennsylvania’s Congressional delegation, stressing the importance of preserving access to health care and health insurance coverage for the commonwealth’s families.

CHIP Funding Deadline Ahead; Five-Year Extension Discussed by Rmoore@haponline.org

Facing a September 30 deadline, U.S. Senate leaders have reached a bipartisan agreement to extend funding for the Children’s Health Insurance Program (CHIP) for five years. In Pennsylvania, more than 176,000 children rely on CHIP for affordable, comprehensive health care coverage. 

Graham-Cassidy-Heller-Johnson ACA Block Grant Proposal Introduced by cglessner@haponline.org

Four U.S. Senators have attempted to revive the effort to repeal and replace the Affordable Care Act (ACA) through the introduction of a new bill that would repeal much of the ACA and provide a block grant of health care funding to states.

Funding for ACA 2018 Open Enrollment Outreach Reduced; Hospitals and Community Partners Urged to Engage in Outreach Efforts by jshellenberger@haponline.org

The Centers for Medicare & Medicaid Services (CMS) announced that it only plans to spend $10 million on education and outreach for the 2018 Affordable Care Act (ACA) open enrollment. Previously $100 million was spent each year for advertising.

CMS updates transparency tool on hospices; HAP’s Care in PA continues to support transparency efforts for PA by jshellenberger@haponline.org

The Centers for Medicare & Medicaid Services (CMS) recently updated Hospice Compare, an informational website that allows consumers to learn more about hospice care in their area.

Governors Offer Blueprint for Insurance Market Stabilization; Senate Prepares for September Action by jshellenberger@haponline.org

In a letter to Congressional leaders, a bipartisan group of governors, including Pennsylvania Governor Tom Wolf, encouraged Congress and the Administration to take immediate steps to stabilize the individual health insurance marketplaces, and presented a policy blueprint.

Related Blogs

Uninsured in PA Drops 45% Since Affordable Care Act Began by admin

The latest data from the U.S. Census calculates that since passage of the Affordable Care Act  in 2010, Pennsylvania’s uninsured rate has declined from 10.2 percent in 2010 to 5.6 percent in 2016, a 45 percent decrease in our state’s uninsured population and the lowest number on record.

HAP Urges Pennsylvania Delegation to Oppose Disruptive Graham-Cassidy-Heller-Johnson Proposal by admin

HAP urged Pennsylvania’s federal lawmakers to reject the complex, sweeping proposal put forth by U.S. Senators Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV), and Ron Johnson (R-WI) that would jeopardize health care coverage and protections relied upon by millions of Pennsylvanians. HAP called upon lawmakers to instead leverage bipartisan support for stabilizing the health insurance markets and promoting access to affordable health insurance and high quality care.

Report Quantifies Burden of Multiple Chronic Conditions by admin

A new report, seeking to outline and quantify the key challenges of multiple chronic conditions found that with each additional chronic condition, health care costs more than double, so that treating a patient with four chronic conditions could cost as much as 16 times more than a patient with only one condition could.

Governor Wolf Joins Bipartisan Group of Governors to Oppose Graham-Cassidy-Heller-Johnson Amendment by admin

Governor Tom Wolf has joined a group of ten bipartisan governors from across the country to send a letter to U.S. Senate Majority Leader Mitch McConnell (R-KY) and Minority Leader Chuck Schumer (D-NY) to express their opposition to the Graham-Cassidy-Heller-Johnson amendment, the Senate’s last-ditch proposal to repeal and replace the Affordable Care Act (ACA) before budget reconciliation rules expire on September 30. Under current reconciliation rules, the Graham-Cassidy-Heller-Johnson amendment would only require a simple majority of senators vote to approve the measure.

HAP, Providers Urge Delegation to Preserve Key Health Care and Insurance Programs by admin

Ahead of looming Congressional deadlines regarding vital health care issues and the potential for action by the U.S. Senate on legislation to repeal the Affordable Care Act (ACA), HAP joined 26 Pennsylvania health care provider and advocacy groups to send a joint letter to Pennsylvania’s Congressional delegation, stressing the importance of preserving access to health care and health insurance coverage for the commonwealth’s families.

CHIP Funding Deadline Ahead; Five-Year Extension Discussed by Rmoore@haponline.org

Facing a September 30 deadline, U.S. Senate leaders have reached a bipartisan agreement to extend funding for the Children’s Health Insurance Program (CHIP) for five years. In Pennsylvania, more than 176,000 children rely on CHIP for affordable, comprehensive health care coverage. 

Graham-Cassidy-Heller-Johnson ACA Block Grant Proposal Introduced by cglessner@haponline.org

Four U.S. Senators have attempted to revive the effort to repeal and replace the Affordable Care Act (ACA) through the introduction of a new bill that would repeal much of the ACA and provide a block grant of health care funding to states.

Funding for ACA 2018 Open Enrollment Outreach Reduced; Hospitals and Community Partners Urged to Engage in Outreach Efforts by jshellenberger@haponline.org

The Centers for Medicare & Medicaid Services (CMS) announced that it only plans to spend $10 million on education and outreach for the 2018 Affordable Care Act (ACA) open enrollment. Previously $100 million was spent each year for advertising.

CMS updates transparency tool on hospices; HAP’s Care in PA continues to support transparency efforts for PA by jshellenberger@haponline.org

The Centers for Medicare & Medicaid Services (CMS) recently updated Hospice Compare, an informational website that allows consumers to learn more about hospice care in their area.

Governors Offer Blueprint for Insurance Market Stabilization; Senate Prepares for September Action by jshellenberger@haponline.org

In a letter to Congressional leaders, a bipartisan group of governors, including Pennsylvania Governor Tom Wolf, encouraged Congress and the Administration to take immediate steps to stabilize the individual health insurance marketplaces, and presented a policy blueprint.

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