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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

American Hospital Association Names Human Trafficking a Key Focus for 2019 Anti-violence Initiative by Rmoore@haponline.org

January is National Slavery and Human Trafficking Prevention Month, and the American Hospital Association’s Hospitals Against Violence Initiative has named human trafficking as a main focus area for 2019

CMS Announces Completion of New Medicare Card Distribution by Rmoore@haponline.org

The Centers for Medicare & Medicaid Services (CMS) today announced that it has completed distribution of new Medicare cards to more than 61 million beneficiaries across the country.

Governor Wolf Sworn in to Second Term with New Lieutenant Governor Fetterman by Rmoore@haponline.org

Today, Pennsylvania Governor Tom Wolf (D) was sworn in for his second term as the commonwealth’s top executive and John Fetterman (D) was installed as the state’s new Lieutenant Governor.

PA Hospitals Congratulate Wolf and Fetterman on Inauguration by Rmoore@haponline.org

Earlier today, Governor Tom Wolf was sworn in to a second term and John Fetterman was sworn in as Pennsylvania’s new Lieutenant Governor. Andy Carter, President and CEO of The Hospital and Healthsystem Association of Pennsylvania (HAP), released the following statement following the swearing-in ceremony.

For 2017, Uncompensated Care in Pennsylvania Goes Down as National Trend Remains Steady by jshellenberger@haponline.org

The American Hospital Association recently issued a report stating that United States hospitals provided $38.4 billion worth of uncompensated medical care during 2017.

Pennsylvania’s Mid-Year Revenue Collections Exceed Estimates by cglessner@haponline.org

As reported, Pennsylvania’s revenue collections exceeded estimates by more than $400 million for the halfway point of the 2018–2019 fiscal year, thanks to corporate revenue tax and a significant uptick in the sales and use tax. While there is still another six months left in the fiscal year, Governor Wolf’s budget secretary also expressed optimism in the health of Pennsylvania’s fiscal situation when presenting the commonwealth’s mid-year budget briefing.

HAP Achievement Awards Spotlight: Washington Health System by cglessner@haponline.org

Each year HAP recognizes hospitals from around the state that develop innovative programs to improve the quality of care, patient experience, and technology to meet the needs of the communities they serve. Washington Health System was awarded HAP’s “Excellence in Care” 2018 Achievement Award for its Ambulatory Heart Failure: Pathway to a Better Life initiative, which focused on congestive heart failure care and improving the quality of life for heart failure patients.

Federal Court Ruling Blocks Detrimental Payment Cut Impacting 340B Hospitals by cglessner@haponline.org

The D.C. District Court blocked a nearly 30 percent payment cut impacting many hospitals in the 340B Drug Pricing Program—a program that helps hospitals and patients manage the ever-increasing burden of prescription drug costs.

Lawmakers Taking Action in Face of Texas Court Ruling about Affordable Care Act by jkissinger@haponline.org

A number of state and federal lawmakers plan to fight to protect the key provisions of the Affordable Care Act during early 2019.

Nearly 370,000 Pennsylvanians Sign Up for ACA Marketplace Coverge, Part of Nearly 8.5 Million Nationwide by admin

According to preliminary data from Centers for Medicare & Medicaid Services (CMS), 369,954 Pennsylvanians used HealthCare.gov to select Affordable Care Act (ACA) marketplace health plans for 2019—about a five percent drop in enrollment compared to last year.

Related Blogs

American Hospital Association Names Human Trafficking a Key Focus for 2019 Anti-violence Initiative by Rmoore@haponline.org

January is National Slavery and Human Trafficking Prevention Month, and the American Hospital Association’s Hospitals Against Violence Initiative has named human trafficking as a main focus area for 2019

CMS Announces Completion of New Medicare Card Distribution by Rmoore@haponline.org

The Centers for Medicare & Medicaid Services (CMS) today announced that it has completed distribution of new Medicare cards to more than 61 million beneficiaries across the country.

Governor Wolf Sworn in to Second Term with New Lieutenant Governor Fetterman by Rmoore@haponline.org

Today, Pennsylvania Governor Tom Wolf (D) was sworn in for his second term as the commonwealth’s top executive and John Fetterman (D) was installed as the state’s new Lieutenant Governor.

PA Hospitals Congratulate Wolf and Fetterman on Inauguration by Rmoore@haponline.org

Earlier today, Governor Tom Wolf was sworn in to a second term and John Fetterman was sworn in as Pennsylvania’s new Lieutenant Governor. Andy Carter, President and CEO of The Hospital and Healthsystem Association of Pennsylvania (HAP), released the following statement following the swearing-in ceremony.

For 2017, Uncompensated Care in Pennsylvania Goes Down as National Trend Remains Steady by jshellenberger@haponline.org

The American Hospital Association recently issued a report stating that United States hospitals provided $38.4 billion worth of uncompensated medical care during 2017.

Pennsylvania’s Mid-Year Revenue Collections Exceed Estimates by cglessner@haponline.org

As reported, Pennsylvania’s revenue collections exceeded estimates by more than $400 million for the halfway point of the 2018–2019 fiscal year, thanks to corporate revenue tax and a significant uptick in the sales and use tax. While there is still another six months left in the fiscal year, Governor Wolf’s budget secretary also expressed optimism in the health of Pennsylvania’s fiscal situation when presenting the commonwealth’s mid-year budget briefing.

HAP Achievement Awards Spotlight: Washington Health System by cglessner@haponline.org

Each year HAP recognizes hospitals from around the state that develop innovative programs to improve the quality of care, patient experience, and technology to meet the needs of the communities they serve. Washington Health System was awarded HAP’s “Excellence in Care” 2018 Achievement Award for its Ambulatory Heart Failure: Pathway to a Better Life initiative, which focused on congestive heart failure care and improving the quality of life for heart failure patients.

Federal Court Ruling Blocks Detrimental Payment Cut Impacting 340B Hospitals by cglessner@haponline.org

The D.C. District Court blocked a nearly 30 percent payment cut impacting many hospitals in the 340B Drug Pricing Program—a program that helps hospitals and patients manage the ever-increasing burden of prescription drug costs.

Lawmakers Taking Action in Face of Texas Court Ruling about Affordable Care Act by jkissinger@haponline.org

A number of state and federal lawmakers plan to fight to protect the key provisions of the Affordable Care Act during early 2019.

Nearly 370,000 Pennsylvanians Sign Up for ACA Marketplace Coverge, Part of Nearly 8.5 Million Nationwide by admin

According to preliminary data from Centers for Medicare & Medicaid Services (CMS), 369,954 Pennsylvanians used HealthCare.gov to select Affordable Care Act (ACA) marketplace health plans for 2019—about a five percent drop in enrollment compared to last year.

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