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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

NEW 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

POSITION PAPER: Repealing the ACA: Addressing Insurance Rate Increases (Download PDF) - 3/17/17

NEW POSITION PAPER: Repealing the ACA: Stabilizing the Insurance Market (Download PDF) - 4/28/17

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

Telemedicine Legislation Introduced in Pennsylvania by Rmoore@haponline.org

Today, Senator Elder Vogel (R-Beaver) introduced a top priority for the hospital community, telemedicine legislation.

Coverage is Critical in Fighting Opioid Epidemic by admin

The impact of the American Health Care Act (AHCA)—legislation would partially repeal and replace the Affordable Care Act (ACA)—on progress in addressing the opioid epidemic remains a key issue as Republican leadership in the U.S. Senate drive for a vote before the July 4 district work period.

HAP and Pennsylvania Children’s Hospitals Stress Concerns with AHCA and Impact on Children by admin

In a letter to U.S. Senators Bob Casey (D-PA) and Pat Toomey (R-PA), HAP and six children’s hospitals serving Pennsylvania stressed serious concerns for the potential loss of health care coverage for 1.1 million Pennsylvanians if the American Health Care Act (AHCA) is enacted into law, and pointed to particular impacts on children.

New Report Analyzes Possible State Response to Proposed Medicaid Changes by admin

A new report by the Urban Institute considers three scenarios states may pursue if the Medicaid financing policies included in the American Health Care Act (AHCA) are enacted. 

Pennsylvania Hospitals are Working to Reduce “Super-Utilizers” in the Commonwealth; New PHC4 Research Brief Released Today by admin

Today the Pennsylvania Health Care Cost Containment Council (PHC4) released its research brief for super-utilizers of inpatient care services.

Governor Wolf, Bipartisan Group of Governors: AHCA Not a Solution to Health Care Challenges by admin

Pennsylvania Governor Tom Wolf joined six other governors from across the country to urge Senate Majority Leader Mitch McConnell and Minority Leader Chuck Schumer to amend the American Health Care Act (AHCA) to make a fairer system for America’s consumers.

CMS Report Finds Marketplace Enrollment Down, Emphasizes Need for Continued Outreach by admin

This week, the Centers for Medicare & Medicaid Services (CMS) released its health insurance marketplace enrollment snapshot report, which found a decrease in marketplace enrollment from the prior reporting period.

Pennsylvania’s Critical Access Hospitals are Key to Rural Health Care by admin

As the Pennsylvania General Assembly continues its work on the 2017–2018 state budget, it is clear that the commonwealth faces a projected revenue shortfall for the current fiscal year of $1.2 billion and a growing structural deficit for next year. This places some important supplemental hospital payments at risk for reduction, including payments that support critical access hospitals.

PA will See Major Employment and Economic Strains under Proposed American Health Care Act by admin

Today, The Commonwealth Fund released its economic and employment assessment of the American Health Care Act (AHCA) on the United States. According to the study, enactment of the AHCA would lead to nearly 85,000 jobs lost in Pennsylvania by 2026 and more than $14 billion lost in business output.

The Importance of Trauma Centers in Pennsylvania by admin

The Pennsylvania General Assembly returned this week to continue work on the 2017–2018 state budget. The commonwealth faces a projected revenue shortfall for the current fiscal year of $1.2 billion and a growing structural deficit for next year, placing some supplemental hospital payments at risk for reduction, including payments that support life-saving trauma care.

Related Blogs

Telemedicine Legislation Introduced in Pennsylvania by Rmoore@haponline.org

Today, Senator Elder Vogel (R-Beaver) introduced a top priority for the hospital community, telemedicine legislation.

Coverage is Critical in Fighting Opioid Epidemic by admin

The impact of the American Health Care Act (AHCA)—legislation would partially repeal and replace the Affordable Care Act (ACA)—on progress in addressing the opioid epidemic remains a key issue as Republican leadership in the U.S. Senate drive for a vote before the July 4 district work period.

HAP and Pennsylvania Children’s Hospitals Stress Concerns with AHCA and Impact on Children by admin

In a letter to U.S. Senators Bob Casey (D-PA) and Pat Toomey (R-PA), HAP and six children’s hospitals serving Pennsylvania stressed serious concerns for the potential loss of health care coverage for 1.1 million Pennsylvanians if the American Health Care Act (AHCA) is enacted into law, and pointed to particular impacts on children.

New Report Analyzes Possible State Response to Proposed Medicaid Changes by admin

A new report by the Urban Institute considers three scenarios states may pursue if the Medicaid financing policies included in the American Health Care Act (AHCA) are enacted. 

Pennsylvania Hospitals are Working to Reduce “Super-Utilizers” in the Commonwealth; New PHC4 Research Brief Released Today by admin

Today the Pennsylvania Health Care Cost Containment Council (PHC4) released its research brief for super-utilizers of inpatient care services.

Governor Wolf, Bipartisan Group of Governors: AHCA Not a Solution to Health Care Challenges by admin

Pennsylvania Governor Tom Wolf joined six other governors from across the country to urge Senate Majority Leader Mitch McConnell and Minority Leader Chuck Schumer to amend the American Health Care Act (AHCA) to make a fairer system for America’s consumers.

CMS Report Finds Marketplace Enrollment Down, Emphasizes Need for Continued Outreach by admin

This week, the Centers for Medicare & Medicaid Services (CMS) released its health insurance marketplace enrollment snapshot report, which found a decrease in marketplace enrollment from the prior reporting period.

Pennsylvania’s Critical Access Hospitals are Key to Rural Health Care by admin

As the Pennsylvania General Assembly continues its work on the 2017–2018 state budget, it is clear that the commonwealth faces a projected revenue shortfall for the current fiscal year of $1.2 billion and a growing structural deficit for next year. This places some important supplemental hospital payments at risk for reduction, including payments that support critical access hospitals.

PA will See Major Employment and Economic Strains under Proposed American Health Care Act by admin

Today, The Commonwealth Fund released its economic and employment assessment of the American Health Care Act (AHCA) on the United States. According to the study, enactment of the AHCA would lead to nearly 85,000 jobs lost in Pennsylvania by 2026 and more than $14 billion lost in business output.

The Importance of Trauma Centers in Pennsylvania by admin

The Pennsylvania General Assembly returned this week to continue work on the 2017–2018 state budget. The commonwealth faces a projected revenue shortfall for the current fiscal year of $1.2 billion and a growing structural deficit for next year, placing some supplemental hospital payments at risk for reduction, including payments that support life-saving trauma care.

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