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ACA Repeal and Replace


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

New Report Looks at Correlation Between Disabilities, Health Care Disparities, and Population Health Efforts by jshellenberger@haponline.org

According to a report in the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report, one in four U.S. adults (61 million) have a disability that impacts major life activities. CDC specialists say that if we can learn more about this population, we can better meet their health needs.

Low-Cost Health Insurance Options Get Mixed Reviews by cglessner@haponline.org

Discussions around health insurance options that were previously prohibited or limited under the Affordable Care Act (ACA) continue to draw mixed reactions from industry experts, consumer advocates, and state and federal officials.

Pennsylvanians That Didn’t Receive New Medicare Cards Urged to Follow-up by jshellenberger@haponline.org

The Centers for Medicare & Medicaid Services (CMS), in conjunction with its distribution timeline, has completed mailing new Medicare cards to beneficiaries in Pennsylvania. Federal officials have provided instructions for residents who haven’t received their new card.

Employers are Adopting Value Innovations to Manage Health Care Costs and Improve Health by jkissinger@haponline.org

The Duke Margolis Center for Health Policy recently released a brief which highlights new initiatives that employers are adopting to manage rising health care costs and improve employee health.

PA Hospital Perspective, Economic Impact Shared During Federal Opioid Policy Roundtable by JCOLLINS@HAPONLINE.ORG

Federal and state policymakers received input from business leaders, local officials and hospital and health care providers during a roundtable policy discussion this week in Somerset exploring the impact of the opioid crisis on economic development in Appalachia counties.

PA Insurance Commissioner Issues Letter to HHS on State’s Plan to Implement Association Health Plans Rule by JCOLLINS@HAPONLINE.ORG

Today, Pennsylvania Insurance Commissioner Jessica Altman sent a letter to the U.S. departments of Labor and Health and Human Services outlining the state Insurance Department’s position on the implementation of a federal rule aiming to expand association health plans (AHP).

Trump Administration Continues to Promote Less-Costly, Less-Generous Coverage by JCOLLINS@HAPONLINE.ORG

A newly finalized federal policy significantly extends the amount of time individuals may remain enrolled in short-term health insurance plans from three months to up to three years. The stated intent of the policy is to expand access to less expensive alternative insurance options; however, these plans are not subject to the full patient protections and benefits assured under the Affordable Care Act (ACA).

Surgeon General Announces Partnership with Hospitals to Combat Opioid Abuse by JCOLLINS@HAPONLINE.ORG

The U.S. Surgeon General Jerome Adams, M.D., announced that this fall his office will partner with the American Hospital Association to further combat the opioid epidemic.

Voters across Parties Value Protections for Pre-existing Conditions by admin

The latest Kaiser Health Tracking Poll looks at how important a candidate’s positions on seven health care issues are to voters. Continued protections for people with pre-existing conditions tops the list, with 63 percent of registered voters ranking these protections as the single most important factor, or a very important factor, in their 2018 vote.

CMS Restarts ACA Insurer Risk Adjustments to Stabilize Individual and Small Group Markets by admin

Centers for Medicare and Medicaid Services (CMS) has issued a new rule to restart the insurer risk-adjustment program under the Affordable Care Act (ACA). CMS’ stated goal is to “maintain stability and predictability in the individual and small group health insurance markets” nationwide.

Related Blogs

New Report Looks at Correlation Between Disabilities, Health Care Disparities, and Population Health Efforts by jshellenberger@haponline.org

According to a report in the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report, one in four U.S. adults (61 million) have a disability that impacts major life activities. CDC specialists say that if we can learn more about this population, we can better meet their health needs.

Low-Cost Health Insurance Options Get Mixed Reviews by cglessner@haponline.org

Discussions around health insurance options that were previously prohibited or limited under the Affordable Care Act (ACA) continue to draw mixed reactions from industry experts, consumer advocates, and state and federal officials.

Pennsylvanians That Didn’t Receive New Medicare Cards Urged to Follow-up by jshellenberger@haponline.org

The Centers for Medicare & Medicaid Services (CMS), in conjunction with its distribution timeline, has completed mailing new Medicare cards to beneficiaries in Pennsylvania. Federal officials have provided instructions for residents who haven’t received their new card.

Employers are Adopting Value Innovations to Manage Health Care Costs and Improve Health by jkissinger@haponline.org

The Duke Margolis Center for Health Policy recently released a brief which highlights new initiatives that employers are adopting to manage rising health care costs and improve employee health.

PA Hospital Perspective, Economic Impact Shared During Federal Opioid Policy Roundtable by JCOLLINS@HAPONLINE.ORG

Federal and state policymakers received input from business leaders, local officials and hospital and health care providers during a roundtable policy discussion this week in Somerset exploring the impact of the opioid crisis on economic development in Appalachia counties.

PA Insurance Commissioner Issues Letter to HHS on State’s Plan to Implement Association Health Plans Rule by JCOLLINS@HAPONLINE.ORG

Today, Pennsylvania Insurance Commissioner Jessica Altman sent a letter to the U.S. departments of Labor and Health and Human Services outlining the state Insurance Department’s position on the implementation of a federal rule aiming to expand association health plans (AHP).

Trump Administration Continues to Promote Less-Costly, Less-Generous Coverage by JCOLLINS@HAPONLINE.ORG

A newly finalized federal policy significantly extends the amount of time individuals may remain enrolled in short-term health insurance plans from three months to up to three years. The stated intent of the policy is to expand access to less expensive alternative insurance options; however, these plans are not subject to the full patient protections and benefits assured under the Affordable Care Act (ACA).

Surgeon General Announces Partnership with Hospitals to Combat Opioid Abuse by JCOLLINS@HAPONLINE.ORG

The U.S. Surgeon General Jerome Adams, M.D., announced that this fall his office will partner with the American Hospital Association to further combat the opioid epidemic.

Voters across Parties Value Protections for Pre-existing Conditions by admin

The latest Kaiser Health Tracking Poll looks at how important a candidate’s positions on seven health care issues are to voters. Continued protections for people with pre-existing conditions tops the list, with 63 percent of registered voters ranking these protections as the single most important factor, or a very important factor, in their 2018 vote.

CMS Restarts ACA Insurer Risk Adjustments to Stabilize Individual and Small Group Markets by admin

Centers for Medicare and Medicaid Services (CMS) has issued a new rule to restart the insurer risk-adjustment program under the Affordable Care Act (ACA). CMS’ stated goal is to “maintain stability and predictability in the individual and small group health insurance markets” nationwide.

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