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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

CMS Projects Insurance Exchange Carriers in Every PA County, PA Insurance Market Shows Signs of Stability by admin

The Centers for Medicare & Medicaid Services (CMS) recently released an updated map of projected health insurance exchange issuers by county. CMS projects that Pennsylvania will have at least one health insurance exchange carrier in every county with most counties having two or more.

U.S. House Committee Reviews State Opioid Efforts and Ongoing Challenges by admin

In a hearing today, Combating the Opioid Crisis: Battles in the States, Congressional leaders heard testimony from state officials offering insight on successful strategies to address the opioid epidemic and ongoing challenges in prevention and treatment.

Studies Find Uninsured Grows, Insurance Market Stabilizes as PA Hospitals Urge Lawmakers to Protect Health Coverage by admin

A recent Gallup poll shows that the percentage of adults in the country without health insurance grew slightly between the first and second quarters of 2017, while the latest Kaiser Family Foundation finds that the individual insurance market has continued to stabilize with insurers regaining profitability, after experiencing issues with financial performance in 2014 and 2015. HAP encourages members of Pennsylvania’s hospital community to speak out and email Pennsylvania’s U.S. Senators Pat Toomey and Robert Casey to urge the Senate to protect health coverage for all Pennsylvanians.

 

PA Hospitals Support House Bill on Telemedicine by admin

Rep. Marguerite Quinn introduced a top priority for the hospital community, House Bill 1648, which defines the key components of telemedicine, sets licensing requirements, and requires health insurers to provide reimbursement for telemedicine services if they pay for the same service in person. Pennsylvania hospitals urge the legislature to continue to move this important piece of legislation through the process.

Pennsylvania Will Undergo Severe Economic and Employment Challenges Under Senate’s Proposed Better Care Reconciliation Act by jshellenberger@haponline.org

This week, The Commonwealth Fund released an economic and employment assessment of the Better Care Reconciliation Act (BCRA) on the United States. According to the study, enactment of the BCRA would lead to nearly 110,000 jobs lost in Pennsylvania by 2026 and more than $19 billion lost in business output.

Shift to Value-Based Payment Still Strong Under New Administration by jshellenberger@haponline.org

The Centers for Medicare & Medicaid Services Center for Clinical Standards and Quality Director, Kate Goodrich, said that value-based payment programs are likely to continue under the new administration during an accountable care organization event in Virginia last week.

CBO Releases Analysis of Longer-Term Effects of Senate Legislation on Medicaid Spending by jkissinger@haponline.org

The Congressional Budget Office  and Joint Committee on Taxation released an additional analysis on the longer-term effect of the proposed Better Care Reconciliation Act of 2017 (BCRA) on Medicaid spending, projecting that spending would be reduced by $160 billion during 2026, as compared to current law. 

PA Providers to Senators Toomey and Casey: Reject the BCRA by jshellenberger@haponline.org

News Release: Although U.S. Senate leaders have postponed a vote on the Better Care Reconciliation Act (BCRA) until after the July 4 recess, Pennsylvania’s health care provider community continues its push to protect access to affordable, reliable health care coverage.

As Senate Delays Vote on BCRA, PA Hospital Community Urged to Email Senators Toomey & Casey to Help Protect Coverage for Pennsylvanians by jshellenberger@haponline.org

Last week, the U.S. Senate released the Better Care Reconciliation Act of 2017, its version of legislation to repeal and replace the Affordable Care Act (ACA). The proposal jeopardizes coverage, weakens Medicaid, and undermines critical protections.

HAP Statement on CBO Score of “Better Care Reconciliation Act of 2017” by Rmoore@haponline.org

News Release:  The Congressional Budget Office (CBO) today released its analysis of the U.S. Senate’s “Better Care Reconciliation Act of 2017.” Andy Carter, president and CEO of The Hospital and Healthsystem Association of Pennsylvania released the following statement. 

Related Blogs

CMS Projects Insurance Exchange Carriers in Every PA County, PA Insurance Market Shows Signs of Stability by admin

The Centers for Medicare & Medicaid Services (CMS) recently released an updated map of projected health insurance exchange issuers by county. CMS projects that Pennsylvania will have at least one health insurance exchange carrier in every county with most counties having two or more.

U.S. House Committee Reviews State Opioid Efforts and Ongoing Challenges by admin

In a hearing today, Combating the Opioid Crisis: Battles in the States, Congressional leaders heard testimony from state officials offering insight on successful strategies to address the opioid epidemic and ongoing challenges in prevention and treatment.

Studies Find Uninsured Grows, Insurance Market Stabilizes as PA Hospitals Urge Lawmakers to Protect Health Coverage by admin

A recent Gallup poll shows that the percentage of adults in the country without health insurance grew slightly between the first and second quarters of 2017, while the latest Kaiser Family Foundation finds that the individual insurance market has continued to stabilize with insurers regaining profitability, after experiencing issues with financial performance in 2014 and 2015. HAP encourages members of Pennsylvania’s hospital community to speak out and email Pennsylvania’s U.S. Senators Pat Toomey and Robert Casey to urge the Senate to protect health coverage for all Pennsylvanians.

 

PA Hospitals Support House Bill on Telemedicine by admin

Rep. Marguerite Quinn introduced a top priority for the hospital community, House Bill 1648, which defines the key components of telemedicine, sets licensing requirements, and requires health insurers to provide reimbursement for telemedicine services if they pay for the same service in person. Pennsylvania hospitals urge the legislature to continue to move this important piece of legislation through the process.

Pennsylvania Will Undergo Severe Economic and Employment Challenges Under Senate’s Proposed Better Care Reconciliation Act by jshellenberger@haponline.org

This week, The Commonwealth Fund released an economic and employment assessment of the Better Care Reconciliation Act (BCRA) on the United States. According to the study, enactment of the BCRA would lead to nearly 110,000 jobs lost in Pennsylvania by 2026 and more than $19 billion lost in business output.

Shift to Value-Based Payment Still Strong Under New Administration by jshellenberger@haponline.org

The Centers for Medicare & Medicaid Services Center for Clinical Standards and Quality Director, Kate Goodrich, said that value-based payment programs are likely to continue under the new administration during an accountable care organization event in Virginia last week.

CBO Releases Analysis of Longer-Term Effects of Senate Legislation on Medicaid Spending by jkissinger@haponline.org

The Congressional Budget Office  and Joint Committee on Taxation released an additional analysis on the longer-term effect of the proposed Better Care Reconciliation Act of 2017 (BCRA) on Medicaid spending, projecting that spending would be reduced by $160 billion during 2026, as compared to current law. 

PA Providers to Senators Toomey and Casey: Reject the BCRA by jshellenberger@haponline.org

News Release: Although U.S. Senate leaders have postponed a vote on the Better Care Reconciliation Act (BCRA) until after the July 4 recess, Pennsylvania’s health care provider community continues its push to protect access to affordable, reliable health care coverage.

As Senate Delays Vote on BCRA, PA Hospital Community Urged to Email Senators Toomey & Casey to Help Protect Coverage for Pennsylvanians by jshellenberger@haponline.org

Last week, the U.S. Senate released the Better Care Reconciliation Act of 2017, its version of legislation to repeal and replace the Affordable Care Act (ACA). The proposal jeopardizes coverage, weakens Medicaid, and undermines critical protections.

HAP Statement on CBO Score of “Better Care Reconciliation Act of 2017” by Rmoore@haponline.org

News Release:  The Congressional Budget Office (CBO) today released its analysis of the U.S. Senate’s “Better Care Reconciliation Act of 2017.” Andy Carter, president and CEO of The Hospital and Healthsystem Association of Pennsylvania released the following statement. 

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