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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

Pennsylvania Sees 100,000 Insurance Sign-ups During First Three Weeks; PA Hospitals Urge Consumers to Continue Signing Up for Health Care Coverage by jshellenberger@haponline.org

During the first three weeks of open enrollment (November 1–18), Pennsylvania has had 101,286 plan selections for health insurance enrollment. Nearly 800,000 people have selected health plans using the HealthCare.gov platform. This puts nationwide open enrollment selections near 2.3 million during the first three weeks of open enrollment, including more than 550,000 new consumers.

American College of Physicians Highlights the Need for Increased Transparency; HAP’s Care in PA Provides Quality and Price Transparency in Pennsylvania by jshellenberger@haponline.org

A recently released report from the American College of Physicians (ACP) recognizes transparency efforts to mend the fragmentation of health care. The report provides recommendations to improve transparency to address cost and quality challenges.

HAP Thanks State’s Veterans for Their Service, Highlights Health Systems’ Veterans Health Programs by jkissinger@haponline.org

HAP thanks Pennsylvania's veterans for their service and sacrifices to protect our freedom. The association and its members recognize that, as a result of these sacrifices, our veterans and their families sometimes need additional support, including help for health care challenges.

 

State Delays Phases 2 and 3 of Community HealthChoices Program, Allowing More Time to Learn from Initial Rollout in West by jkissinger@haponline.org

Today, the Pennsylvania Department of Human Services (DHS) announced that it is delaying the start dates for Phases 2 and 3 of Community HealthChoices (CHC), Pennsylvania’s new Managed Long-Term Services and Supports (MLTSS) program. DHS says it wants to learn from the Phase 1 rollout and allow time to make any necessary adjustments before implementing further phases.   

U.S. House Passes CHIP Bill; Includes Two-Year Delay to DSH Cuts by JCOLLINS@HAPONLINE.ORG

The U.S. House of Representatives passed legislation that would extend funding for the Children’s Health Insurance Program (CHIP) for five years and provide a two-year delay to Medicaid Disproportionate Share Hospital (DSH) payment cuts.

2.9 Million Pennsylvanians Insured through Medicaid and CHIP; New Data from CMS by JCOLLINS@HAPONLINE.ORG

The Centers for Medicare & Medicaid Services released a preliminary August 2017 report and supporting data on Medicaid and the Children’s Health Insurance Program (CHIP) enrollment stats earlier this week.

CMS Payment Rule Undercuts Key Program Supporting Access to Affordable Prescription Drugs by JCOLLINS@HAPONLINE.ORG

The Centers for Medicare & Medicaid Services (CMS) finalized a payment regulation that will undermine efforts to ensure access to affordable prescription drugs by dramatically cutting payments for drugs acquired under the 340B Drug Pricing Program.

Open Enrollment Starts Today; HAP, PA Hospitals Encourage Pennsylvanians to Get Covered, Stay Covered by JCOLLINS@HAPONLINE.ORG

Today, HAP president and CEO Andy Carter joined Philadelphia Mayor Kenney and Health Commissioner Dr. Farley at a press conference promoting the start of open enrollment for the Affordable Care Act (ACA) insurance marketplace. Carter underscored the importance of securing health insurance coverage as well as how Pennsylvania hospitals are helping consumers find the right plan for them.

Report Finds Drop in Uncompensated Care, Outpatient Growth for PA’s Non-Acute and Specialty Hospitals by JCOLLINS@HAPONLINE.ORG

Today, the Pennsylvania Health Care Cost Containment Council (PHC4) released its Annual Report on the Financial Health of Pennsylvania Non-General Acute Care Hospitals, finding that uncompensated care saw a decrease of 17 percent or $3.3 million in fiscal year 2016. Specialty hospitals saw the largest percent point decrease, followed by psychiatric and long-term acute care

Pennsylvania Health Care Providers Urge Congressional Action to Stabilize Marketplaces by Rmoore@haponline.org

Today, in a joint letter, health care providers and advocates serving Pennsylvania patients and families presented a unified voice that Congress should “take swift action to fund cost-sharing reduction (CSR) benefits for the thousands of Pennsylvanians who depend on this crucial support to make their health insurance coverage affordable.”

Related Blogs

Pennsylvania Sees 100,000 Insurance Sign-ups During First Three Weeks; PA Hospitals Urge Consumers to Continue Signing Up for Health Care Coverage by jshellenberger@haponline.org

During the first three weeks of open enrollment (November 1–18), Pennsylvania has had 101,286 plan selections for health insurance enrollment. Nearly 800,000 people have selected health plans using the HealthCare.gov platform. This puts nationwide open enrollment selections near 2.3 million during the first three weeks of open enrollment, including more than 550,000 new consumers.

American College of Physicians Highlights the Need for Increased Transparency; HAP’s Care in PA Provides Quality and Price Transparency in Pennsylvania by jshellenberger@haponline.org

A recently released report from the American College of Physicians (ACP) recognizes transparency efforts to mend the fragmentation of health care. The report provides recommendations to improve transparency to address cost and quality challenges.

HAP Thanks State’s Veterans for Their Service, Highlights Health Systems’ Veterans Health Programs by jkissinger@haponline.org

HAP thanks Pennsylvania's veterans for their service and sacrifices to protect our freedom. The association and its members recognize that, as a result of these sacrifices, our veterans and their families sometimes need additional support, including help for health care challenges.

 

State Delays Phases 2 and 3 of Community HealthChoices Program, Allowing More Time to Learn from Initial Rollout in West by jkissinger@haponline.org

Today, the Pennsylvania Department of Human Services (DHS) announced that it is delaying the start dates for Phases 2 and 3 of Community HealthChoices (CHC), Pennsylvania’s new Managed Long-Term Services and Supports (MLTSS) program. DHS says it wants to learn from the Phase 1 rollout and allow time to make any necessary adjustments before implementing further phases.   

U.S. House Passes CHIP Bill; Includes Two-Year Delay to DSH Cuts by JCOLLINS@HAPONLINE.ORG

The U.S. House of Representatives passed legislation that would extend funding for the Children’s Health Insurance Program (CHIP) for five years and provide a two-year delay to Medicaid Disproportionate Share Hospital (DSH) payment cuts.

2.9 Million Pennsylvanians Insured through Medicaid and CHIP; New Data from CMS by JCOLLINS@HAPONLINE.ORG

The Centers for Medicare & Medicaid Services released a preliminary August 2017 report and supporting data on Medicaid and the Children’s Health Insurance Program (CHIP) enrollment stats earlier this week.

CMS Payment Rule Undercuts Key Program Supporting Access to Affordable Prescription Drugs by JCOLLINS@HAPONLINE.ORG

The Centers for Medicare & Medicaid Services (CMS) finalized a payment regulation that will undermine efforts to ensure access to affordable prescription drugs by dramatically cutting payments for drugs acquired under the 340B Drug Pricing Program.

Open Enrollment Starts Today; HAP, PA Hospitals Encourage Pennsylvanians to Get Covered, Stay Covered by JCOLLINS@HAPONLINE.ORG

Today, HAP president and CEO Andy Carter joined Philadelphia Mayor Kenney and Health Commissioner Dr. Farley at a press conference promoting the start of open enrollment for the Affordable Care Act (ACA) insurance marketplace. Carter underscored the importance of securing health insurance coverage as well as how Pennsylvania hospitals are helping consumers find the right plan for them.

Report Finds Drop in Uncompensated Care, Outpatient Growth for PA’s Non-Acute and Specialty Hospitals by JCOLLINS@HAPONLINE.ORG

Today, the Pennsylvania Health Care Cost Containment Council (PHC4) released its Annual Report on the Financial Health of Pennsylvania Non-General Acute Care Hospitals, finding that uncompensated care saw a decrease of 17 percent or $3.3 million in fiscal year 2016. Specialty hospitals saw the largest percent point decrease, followed by psychiatric and long-term acute care

Pennsylvania Health Care Providers Urge Congressional Action to Stabilize Marketplaces by Rmoore@haponline.org

Today, in a joint letter, health care providers and advocates serving Pennsylvania patients and families presented a unified voice that Congress should “take swift action to fund cost-sharing reduction (CSR) benefits for the thousands of Pennsylvanians who depend on this crucial support to make their health insurance coverage affordable.”

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