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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

Hospitals Seek to Overturn New Payment Policy Jeopardizing Community Care by Rmoore@haponline.org

In a lawsuit filed this week, hospitals and hospital advocates—including the American Hospital Association and Association of American Medical Colleges (AAMC)—argued that the Centers for Medicare & Medicaid Services (CMS) is acting outside the law by imposing a harmful new payment policy that reduces reimbursement and jeopardizes the ability of hospitals to meet the needs of their patients in community-based settings.

U.S. Departments of Health and Human Services, Treasury, Labor Release Health Care Competition Report by Rmoore@haponline.org

In fulfillment of an October, 2017, presidential Executive Order, the U.S. Departments of Health and Human Services, Treasury, and Labor today released a report intended to make recommendations that would facilitate a high-quality, affordable health care system by promoting choice and competition.

Marketplace Open Enrollment in Pennsylvania: Signups Down from Last Year by cglessner@haponline.org

Newly released Open Enrollment numbers from the federal Centers for Medicare & Medicaid Services for health insurance signups via HealthCare.gov show that enrollment for 2019 coverage is down compared to last year. Pennsylvania is among the states with the largest enrollment decrease; Pennsylvania hospitals are encouraged to continue their enrollment and outreach efforts.

Under ACA, Employment Rates and Employer-sponsored Insurance Rose along with Coverage Expansion by jkissinger@haponline.org

New analysis indicates that health insurance coverage gains under the Affordable Care Act were well-targeted to workers and their dependents who most needed help.

VIDEO: HAP Digs Deep into Election Results, Implications for PA Hospitals by jkissinger@haponline.org

HAP's Andy Carter and association advocates dig into the election results and analyze what they mean for the future of health care in Pennsylvania.

Pennsylvanians Encouraged to Research Options, Shop for Health Care Coverage by JCOLLINS@HAPONLINE.ORG

During the first week of open enrollment for the Affordable Care Act’s (ACA) insurance marketplace, Centers for Medicare & Medicaid Services estimates that more than 371,000 individuals selected insurance plans via HealthCare.gov. Pennsylvanians have through December 15 to get covered and stay covered.

Award-winning Tech Expert Highlights Value of Telemedicine by JCOLLINS@HAPONLINE.ORG

Across the nation, telemedicine (also known as telehealth, connected care, and virtual care) is helping patients gain access to physicians through connected devices, helping to address provider and appointment shortages, and provide convenient care at a lower cost. The platform does not represent a new type of care, but rather a different delivery method that is being embraced by highly regarded providers, businesses, insurers, and health care innovators.

New Guide Lists Federal Resources for Addressing Substance Use Disorder in Rural Communities by JCOLLINS@HAPONLINE.ORG

The U.S. Department of Agriculture (USDA) and the Office of National Drug Control Policy (ONDCP) announced a new resource document that lists federal funding and partnership opportunities that can be used to help combat the opioid epidemic in rural communities.

Midterm Elections: Governor Wolf and Senator Casey Reelected, Dozens of New Lawmakers Head to Harrisburg, Washington, D.C. by Rmoore@haponline.org

In a much-anticipated midterm election that featured high voter turnout, Pennsylvanians yesterday elected Governor Tom Wolf (D) to another four-year term with new Lieutenant Governor John Fetterman (D), and reelected U.S. Senator Bob Casey (D).

New Guide Helps Patients to Avoid Unexpected Medical Bills by JCOLLINS@HAPONLINE.ORG

The American Hospital Association (AHA) has partnered with the Healthcare Financial Management Association and America's Health Insurance Plans to develop a new consumer guide to help patients ask the right questions to avoid paying more than expected for health care services.

Related Blogs

Hospitals Seek to Overturn New Payment Policy Jeopardizing Community Care by Rmoore@haponline.org

In a lawsuit filed this week, hospitals and hospital advocates—including the American Hospital Association and Association of American Medical Colleges (AAMC)—argued that the Centers for Medicare & Medicaid Services (CMS) is acting outside the law by imposing a harmful new payment policy that reduces reimbursement and jeopardizes the ability of hospitals to meet the needs of their patients in community-based settings.

U.S. Departments of Health and Human Services, Treasury, Labor Release Health Care Competition Report by Rmoore@haponline.org

In fulfillment of an October, 2017, presidential Executive Order, the U.S. Departments of Health and Human Services, Treasury, and Labor today released a report intended to make recommendations that would facilitate a high-quality, affordable health care system by promoting choice and competition.

Marketplace Open Enrollment in Pennsylvania: Signups Down from Last Year by cglessner@haponline.org

Newly released Open Enrollment numbers from the federal Centers for Medicare & Medicaid Services for health insurance signups via HealthCare.gov show that enrollment for 2019 coverage is down compared to last year. Pennsylvania is among the states with the largest enrollment decrease; Pennsylvania hospitals are encouraged to continue their enrollment and outreach efforts.

Under ACA, Employment Rates and Employer-sponsored Insurance Rose along with Coverage Expansion by jkissinger@haponline.org

New analysis indicates that health insurance coverage gains under the Affordable Care Act were well-targeted to workers and their dependents who most needed help.

VIDEO: HAP Digs Deep into Election Results, Implications for PA Hospitals by jkissinger@haponline.org

HAP's Andy Carter and association advocates dig into the election results and analyze what they mean for the future of health care in Pennsylvania.

Pennsylvanians Encouraged to Research Options, Shop for Health Care Coverage by JCOLLINS@HAPONLINE.ORG

During the first week of open enrollment for the Affordable Care Act’s (ACA) insurance marketplace, Centers for Medicare & Medicaid Services estimates that more than 371,000 individuals selected insurance plans via HealthCare.gov. Pennsylvanians have through December 15 to get covered and stay covered.

Award-winning Tech Expert Highlights Value of Telemedicine by JCOLLINS@HAPONLINE.ORG

Across the nation, telemedicine (also known as telehealth, connected care, and virtual care) is helping patients gain access to physicians through connected devices, helping to address provider and appointment shortages, and provide convenient care at a lower cost. The platform does not represent a new type of care, but rather a different delivery method that is being embraced by highly regarded providers, businesses, insurers, and health care innovators.

New Guide Lists Federal Resources for Addressing Substance Use Disorder in Rural Communities by JCOLLINS@HAPONLINE.ORG

The U.S. Department of Agriculture (USDA) and the Office of National Drug Control Policy (ONDCP) announced a new resource document that lists federal funding and partnership opportunities that can be used to help combat the opioid epidemic in rural communities.

Midterm Elections: Governor Wolf and Senator Casey Reelected, Dozens of New Lawmakers Head to Harrisburg, Washington, D.C. by Rmoore@haponline.org

In a much-anticipated midterm election that featured high voter turnout, Pennsylvanians yesterday elected Governor Tom Wolf (D) to another four-year term with new Lieutenant Governor John Fetterman (D), and reelected U.S. Senator Bob Casey (D).

New Guide Helps Patients to Avoid Unexpected Medical Bills by JCOLLINS@HAPONLINE.ORG

The American Hospital Association (AHA) has partnered with the Healthcare Financial Management Association and America's Health Insurance Plans to develop a new consumer guide to help patients ask the right questions to avoid paying more than expected for health care services.

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