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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 Focuses on Experiences of the Most Seriously Ill by jkissinger@haponline.org

A new report looks at how those with the most serious illnesses are managing in America, and calls on health care providers and insurers to look at underlying issues that impact the outcome of their life experiences.

Mental Illness Awareness Week Emphasizes Screening and Eliminating Stigma by jshellenberger@haponline.org

During 1990, Congress established Mental Illness Awareness Week. The first week in October marks a time for mental health advocates to collectively educate the public about mental illness and fight the stigma attached to this illness. The week also includes National Depression Screening Day, dedicated to raising awareness and screening people for depression and related mood and anxiety disorders.

October is Health Literacy Month; Engage for Health for Better Outcomes and a More Positive Experience by cglessner@haponline.org

October is Health Literacy Month and an excellent opportunity to focus on the importance of patient and family literacy toward achieving better patient outcomes and providing a more positive patient experience.

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New Study Reinforces Importance of Appropriate Reimbursement for Hospital-level Care by Rmoore@haponline.org

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CMS Launches eMedicare Initiative to Expand Online Resources by Rmoore@haponline.org

The U.S. Centers for Medicare & Medicaid Services (CMS) has launched a new resource to offer Medicare beneficiaries and their families easier access to more information about their plan and coverage.

PA Receives $55.9 Million in Federal Funds to Continue Fight Opioid Epidemic by JCOLLINS@HAPONLINE.ORG

Last week, Pennsylvania secured $55.9 million federal Substance Abuse and Mental Health Services Administration (SAMHSA) grant implementation the state’s response to the opioid epidemic. This funding complements two $26.5 million grants that have been received during the past two years from SAMHSA as part of the 21st Century CURES Act. With the new SAMHSA grant, Pennsylvania has received a total of $108 million in federal funding to fight the opioid epidemic.

Federal, State Efforts to Improve Prescription Drug Transparency Move Forward by JCOLLINS@HAPONLINE.ORG

At the federal level, the U.S. House cleared a pair of Senate bills aimed at making it easier for patients to get the lowest price on prescription drugs at the pharmacy counter, sending the legislation to President Donald Trump. At the state level, the Senate Insurance Committee unanimously approved a bill that would do the same, sending the bill to the Senate for consideration.

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Senate Advances Rural Health Redesign Center by JCOLLINS@HAPONLINE.ORG

Yesterday, Senate Bill 1237, which would establish the Pennsylvania Rural Health Redesign Center (RHRC) Authority and the Pennsylvania Rural Health Redesign Center Fund, was passed unanimously by the Senate’s Health & Human Services Committee.

Related Blogs

New Report Focuses on Experiences of the Most Seriously Ill by jkissinger@haponline.org

A new report looks at how those with the most serious illnesses are managing in America, and calls on health care providers and insurers to look at underlying issues that impact the outcome of their life experiences.

Mental Illness Awareness Week Emphasizes Screening and Eliminating Stigma by jshellenberger@haponline.org

During 1990, Congress established Mental Illness Awareness Week. The first week in October marks a time for mental health advocates to collectively educate the public about mental illness and fight the stigma attached to this illness. The week also includes National Depression Screening Day, dedicated to raising awareness and screening people for depression and related mood and anxiety disorders.

October is Health Literacy Month; Engage for Health for Better Outcomes and a More Positive Experience by cglessner@haponline.org

October is Health Literacy Month and an excellent opportunity to focus on the importance of patient and family literacy toward achieving better patient outcomes and providing a more positive patient experience.

Federal Opioid Policy Package Clears Congress for Enactment into Law by Rmoore@haponline.org

After months of legislative attention and policy negotiation, Congress passed new legislation to address the opioid epidemic.

New Study Reinforces Importance of Appropriate Reimbursement for Hospital-level Care by Rmoore@haponline.org

A new study exploring the characteristics of Medicare patients receiving care in hospital outpatient departments reinforces concerns that new payment proposals—which would significantly cut hospital payments—could threaten access to care for the most vulnerable patients and communities.

CMS Launches eMedicare Initiative to Expand Online Resources by Rmoore@haponline.org

The U.S. Centers for Medicare & Medicaid Services (CMS) has launched a new resource to offer Medicare beneficiaries and their families easier access to more information about their plan and coverage.

PA Receives $55.9 Million in Federal Funds to Continue Fight Opioid Epidemic by JCOLLINS@HAPONLINE.ORG

Last week, Pennsylvania secured $55.9 million federal Substance Abuse and Mental Health Services Administration (SAMHSA) grant implementation the state’s response to the opioid epidemic. This funding complements two $26.5 million grants that have been received during the past two years from SAMHSA as part of the 21st Century CURES Act. With the new SAMHSA grant, Pennsylvania has received a total of $108 million in federal funding to fight the opioid epidemic.

Federal, State Efforts to Improve Prescription Drug Transparency Move Forward by JCOLLINS@HAPONLINE.ORG

At the federal level, the U.S. House cleared a pair of Senate bills aimed at making it easier for patients to get the lowest price on prescription drugs at the pharmacy counter, sending the legislation to President Donald Trump. At the state level, the Senate Insurance Committee unanimously approved a bill that would do the same, sending the bill to the Senate for consideration.

Pennsylvania’s Telemedicine Bill Moves to House for Consideration by JCOLLINS@HAPONLINE.ORG

Earlier this week, the House Professional Licensure Committee unanimously approved Senate Bill 780 (Vogel, R-Beaver), telemedicine legislation. The bill now moves to the House for consideration. Please email your lawmaker today and ask that they support Senate Bill 780.

Senate Advances Rural Health Redesign Center by JCOLLINS@HAPONLINE.ORG

Yesterday, Senate Bill 1237, which would establish the Pennsylvania Rural Health Redesign Center (RHRC) Authority and the Pennsylvania Rural Health Redesign Center Fund, was passed unanimously by the Senate’s Health & Human Services Committee.

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