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Advocacy

Access to Care

ACA Repeal and Replace

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

American Health Care Act Meets Financial Target and Moves to Senate; HAP Hopeful Senate Rewrite Will Protect Coverage for Pennsylvanians by jshellenberger@haponline.org

The Congressional Budget Office (CBO) analysis, released late today, estimates that enacting the House-passed American Health Care Act (AHCA) would reduce the federal deficit by $119 billion over the coming decade and increase the number of people who are uninsured by 23 million in 2026 relative to current law.

Trump Budget Proposal Slashes Medicaid, Threatens Access to Key Health Care Programs by jshellenberger@haponline.org

Today, the Trump Administration’s Office of Management and Budget released its budget plan for Fiscal Year (FY) 2018.

Pennsylvania Attorney General Joins 15 States to Protect Cost-Sharing Payments under the ACA by admin

Pennsylvania’s Attorney General Josh Shapiro joined 15 states and the District of Columbia attorneys general in petitioning to intervene in the lawsuit filed by the U.S. House of Representatives over the legality of cost-sharing payments under the Affordable Care Act (ACA).

Chronic Care Management Legislation Advances in U.S. Senate Finance Committee by admin

Today, federal efforts to improve the Medicare program for seniors suffering from chronic conditions advanced in the U.S. Senate Finance Committee. Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 (or S.870) won unanimous approval from the committee.

Grant Funds Available to Support Telemedicine by admin

This week, the United States Department of Agriculture (USDA) announced that hospitals and others could apply for grants up to $500,000 for equipment and technical assistance to provide telemedicine services in rural areas.

Nationally Insured Coverage Relatively Stable Between 2015 and 2016; Pennsylvania Uninsured Dropped by admin

The National Center for Health Statistics (NCHS), part of the Centers for Disease Control and Prevention, released the 2016 findings from their national survey, which found that there was relatively no change in the uninsured between 2015 and 2016 nationally. However, in Pennsylvania, the survey reflects a continued drop in the percentage of uninsured from 2013 through 2016.

New Study About Medicare Beneficiaries Emphasizes Importance of Access and Affordability by jkissinger@haponline.org

A new report issued by The Commonwealth Fund found that more than one-fourth of Medicare  beneficiaries—an estimated 15 million elderly and disabled people—spent 20 percent or more of their household income on out-of-pocket medical expenses and monthly premiums during 2016.  

New Poll Measures Voter Sentiment About ACA Repeal and Replace by jkissinger@haponline.org

As the United States Senate determines its approach to a repeal and replace of the Affordable Care Act (ACA), a new poll looks at voter sentiment about the issue.

Passage of AHCA Threatens Hard-won Progress Towards Improving Health by admin

Today, the U.S. House of Representatives voted 217 to 213 to pass the American Health Care Act (AHCA), legislation that would partially repeal and replace the Affordable Care Act (ACA). Pennsylvania hospitals oppose the legislation, which would jeopardize coverage for more than 1.1 million Pennsylvanians and undermine critical protections benefiting millions across the Commonwealth.

HAP: AHCA Vote Threatens Coverage For More Than 1.1 Million Pennsylvanians by jshellenberger@haponline.org

News Release:  Today, the U.S. House of Representatives approved the American Health Care Act (AHCA), a measure to repeal and replace the Affordable Care Act (ACA).

Related Blogs

American Health Care Act Meets Financial Target and Moves to Senate; HAP Hopeful Senate Rewrite Will Protect Coverage for Pennsylvanians by jshellenberger@haponline.org

The Congressional Budget Office (CBO) analysis, released late today, estimates that enacting the House-passed American Health Care Act (AHCA) would reduce the federal deficit by $119 billion over the coming decade and increase the number of people who are uninsured by 23 million in 2026 relative to current law.

Trump Budget Proposal Slashes Medicaid, Threatens Access to Key Health Care Programs by jshellenberger@haponline.org

Today, the Trump Administration’s Office of Management and Budget released its budget plan for Fiscal Year (FY) 2018.

Pennsylvania Attorney General Joins 15 States to Protect Cost-Sharing Payments under the ACA by admin

Pennsylvania’s Attorney General Josh Shapiro joined 15 states and the District of Columbia attorneys general in petitioning to intervene in the lawsuit filed by the U.S. House of Representatives over the legality of cost-sharing payments under the Affordable Care Act (ACA).

Chronic Care Management Legislation Advances in U.S. Senate Finance Committee by admin

Today, federal efforts to improve the Medicare program for seniors suffering from chronic conditions advanced in the U.S. Senate Finance Committee. Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 (or S.870) won unanimous approval from the committee.

Grant Funds Available to Support Telemedicine by admin

This week, the United States Department of Agriculture (USDA) announced that hospitals and others could apply for grants up to $500,000 for equipment and technical assistance to provide telemedicine services in rural areas.

Nationally Insured Coverage Relatively Stable Between 2015 and 2016; Pennsylvania Uninsured Dropped by admin

The National Center for Health Statistics (NCHS), part of the Centers for Disease Control and Prevention, released the 2016 findings from their national survey, which found that there was relatively no change in the uninsured between 2015 and 2016 nationally. However, in Pennsylvania, the survey reflects a continued drop in the percentage of uninsured from 2013 through 2016.

New Study About Medicare Beneficiaries Emphasizes Importance of Access and Affordability by jkissinger@haponline.org

A new report issued by The Commonwealth Fund found that more than one-fourth of Medicare  beneficiaries—an estimated 15 million elderly and disabled people—spent 20 percent or more of their household income on out-of-pocket medical expenses and monthly premiums during 2016.  

New Poll Measures Voter Sentiment About ACA Repeal and Replace by jkissinger@haponline.org

As the United States Senate determines its approach to a repeal and replace of the Affordable Care Act (ACA), a new poll looks at voter sentiment about the issue.

Passage of AHCA Threatens Hard-won Progress Towards Improving Health by admin

Today, the U.S. House of Representatives voted 217 to 213 to pass the American Health Care Act (AHCA), legislation that would partially repeal and replace the Affordable Care Act (ACA). Pennsylvania hospitals oppose the legislation, which would jeopardize coverage for more than 1.1 million Pennsylvanians and undermine critical protections benefiting millions across the Commonwealth.

HAP: AHCA Vote Threatens Coverage For More Than 1.1 Million Pennsylvanians by jshellenberger@haponline.org

News Release:  Today, the U.S. House of Representatives approved the American Health Care Act (AHCA), a measure to repeal and replace the Affordable Care Act (ACA).

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