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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

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

State Releases Individual and Small Group Insurance Rates; Individual Rate Increases Reflect Federal Elimination of CSR Payments by admin

The Pennsylvania Insurance Department has released the final 2018 rates for individual and small group health insurance products that comply with the reforms of the Affordable Care Act (ACA).

Cancellation of Cost-Sharing Reduction Payments Raises Concern for Premium Increases, Destabilization of Insurance Markets by jshellenberger@haponline.org

The announcement that the Trump Administration will not fulfil cost-sharing reduction (CSR) payments required under the Affordable Care Act (ACA)—designed to help reduce health care costs for lower-income Americans—raises serious concern for the stability of the health insurance marketplaces and significant premium increases.

News Release: Pa. Hospital Community Troubled by Cancellation of Cost-Sharing Reduction Payments by Rmoore@haponline.org

News Release:  Yesterday, the Trump Administration announced that it would not fulfil cost-sharing reduction payments, a provision of the Affordable Care Act designed to help reduce health care costs for lower-income Americans. Andy Carter, president and CEO of The Hospital and Healthsystem Association of Pennsylvania (HAP), released the following statement.

Administration Pursues Insurance Market Policy Changes through Executive Order by jshellenberger@haponline.org

An executive order issued today by President Donald Trump seeks to promote health insurance options that do not have to adhere to all of the requirements and protections under the Affordable Care Act (ACA). Under the executive order—Promoting Healthcare Choice and Competition Across the United States, the Secretaries of the Departments of Treasury, Labor, and Health & Human Services (HHS) are directed to review existing policies and put forth proposed regulations or revised guidance that will expand the availability and use of those insurance mechanisms.

Congressional Committee Hears How Hospitals Use 340B Drug Pricing Program by jshellenberger@haponline.org

In a hearing before the U.S. House Energy & Commerce Oversight and Investigations Subcommittee, health care providers testified to how the 340B Drug Pricing Program helps them expand and improve access to care.

Federal Lawmakers Urge Delay of DSH Payment Cuts; Eight from PA Sign Letter by jkissinger@haponline.org

More than 220 members of the U.S. House, including eight from Pennsylvania, called for a delay in cuts to hospitals that serve a high proportion of Medicaid and uninsured patients.

Pennsylvania Delegation Pushes CHIP Funding Extension by jkissinger@haponline.org

Seventeen members of the Pennsylvania Congressional delegation penned a letter to Congressional leaders urging swift action to extend federal funding for the Children’s Health Insurance Program (CHIP).

Bipartisan U.S. House Letter Urges CMS to Rescind Proposed Cuts to 340B Drug Pricing Program by jkissinger@haponline.org

Ten members of the Pennsylvania Congressional delegation have signed a bipartisan letter urging the Centers for Medicare & Medicaid Services (CMS) to abandon a proposed policy that will limit hospitals' use of the 340B Drug Pricing Program to better serve their patients. 

News Release: HAP Statement about Graham-Cassidy-Heller-Johnson by Rmoore@haponline.org

News Release:  Yesterday, U.S. Senators abandoned a last-ditch effort to repeal and replace the Affordable Care Act (ACA) before the September 30 budget reconciliation deadline. They did not obtain the commitments for the 50 votes needed to pass the bill. Following the announcement, Andy Carter, president and CEO of The Hospital and Healthsystem Association of Pennsylvania (HAP), released the following statement.

U.S. Senate Abandons Graham-Cassidy-Heller-Johnson ACA Repeal and Replace Proposal by jkissinger@haponline.org

Faced with a tide of opposition from health care stakeholders, advocates, patients and consumers, the U.S. Senate abandoned an effort to vote on the Graham-Cassidy-Heller-Johnson (GCHJ) plan to repeal and replace the Affordable Care Act (ACA).

Related Blogs

State Releases Individual and Small Group Insurance Rates; Individual Rate Increases Reflect Federal Elimination of CSR Payments by admin

The Pennsylvania Insurance Department has released the final 2018 rates for individual and small group health insurance products that comply with the reforms of the Affordable Care Act (ACA).

Cancellation of Cost-Sharing Reduction Payments Raises Concern for Premium Increases, Destabilization of Insurance Markets by jshellenberger@haponline.org

The announcement that the Trump Administration will not fulfil cost-sharing reduction (CSR) payments required under the Affordable Care Act (ACA)—designed to help reduce health care costs for lower-income Americans—raises serious concern for the stability of the health insurance marketplaces and significant premium increases.

News Release: Pa. Hospital Community Troubled by Cancellation of Cost-Sharing Reduction Payments by Rmoore@haponline.org

News Release:  Yesterday, the Trump Administration announced that it would not fulfil cost-sharing reduction payments, a provision of the Affordable Care Act designed to help reduce health care costs for lower-income Americans. Andy Carter, president and CEO of The Hospital and Healthsystem Association of Pennsylvania (HAP), released the following statement.

Administration Pursues Insurance Market Policy Changes through Executive Order by jshellenberger@haponline.org

An executive order issued today by President Donald Trump seeks to promote health insurance options that do not have to adhere to all of the requirements and protections under the Affordable Care Act (ACA). Under the executive order—Promoting Healthcare Choice and Competition Across the United States, the Secretaries of the Departments of Treasury, Labor, and Health & Human Services (HHS) are directed to review existing policies and put forth proposed regulations or revised guidance that will expand the availability and use of those insurance mechanisms.

Congressional Committee Hears How Hospitals Use 340B Drug Pricing Program by jshellenberger@haponline.org

In a hearing before the U.S. House Energy & Commerce Oversight and Investigations Subcommittee, health care providers testified to how the 340B Drug Pricing Program helps them expand and improve access to care.

Federal Lawmakers Urge Delay of DSH Payment Cuts; Eight from PA Sign Letter by jkissinger@haponline.org

More than 220 members of the U.S. House, including eight from Pennsylvania, called for a delay in cuts to hospitals that serve a high proportion of Medicaid and uninsured patients.

Pennsylvania Delegation Pushes CHIP Funding Extension by jkissinger@haponline.org

Seventeen members of the Pennsylvania Congressional delegation penned a letter to Congressional leaders urging swift action to extend federal funding for the Children’s Health Insurance Program (CHIP).

Bipartisan U.S. House Letter Urges CMS to Rescind Proposed Cuts to 340B Drug Pricing Program by jkissinger@haponline.org

Ten members of the Pennsylvania Congressional delegation have signed a bipartisan letter urging the Centers for Medicare & Medicaid Services (CMS) to abandon a proposed policy that will limit hospitals' use of the 340B Drug Pricing Program to better serve their patients. 

News Release: HAP Statement about Graham-Cassidy-Heller-Johnson by Rmoore@haponline.org

News Release:  Yesterday, U.S. Senators abandoned a last-ditch effort to repeal and replace the Affordable Care Act (ACA) before the September 30 budget reconciliation deadline. They did not obtain the commitments for the 50 votes needed to pass the bill. Following the announcement, Andy Carter, president and CEO of The Hospital and Healthsystem Association of Pennsylvania (HAP), released the following statement.

U.S. Senate Abandons Graham-Cassidy-Heller-Johnson ACA Repeal and Replace Proposal by jkissinger@haponline.org

Faced with a tide of opposition from health care stakeholders, advocates, patients and consumers, the U.S. Senate abandoned an effort to vote on the Graham-Cassidy-Heller-Johnson (GCHJ) plan to repeal and replace the Affordable Care Act (ACA).

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