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Access to Care

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.

View Map

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 115^th 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

During a hearing before the U.S. Senate Health, Education, Labor & Pensions Committee, the federal agency in charge of the 340B Drug Discount Program outlined how the program works and provided an overview of steps that have been taken to strengthen oversight.

National Health Care Groups Act to Support Health Care Coverage for People with Pre-existing Conditions by JCOLLINS@HAPONLINE.ORG

A group of national hospital, physician, and insurance advocacy groups are taking legal action to protect health care coverage for people with pre-existing conditions.

Consumers and Hospitals Help Get Votes to Pass Critical Telemedicine Bill by cglessner@haponline.org

Hospitals and consumers played a key role in getting a telemedicine bill approved that will expand access to health care. Today, the Senate unanimously passed Senate Bill 780, sponsored by Senator Elder Vogel (R-Beaver).

Report Details Opioid Overdose Hospitalization Trends, HAP Continues Work to Address Opioid Crisis by JCOLLINS@HAPONLINE.ORG

The Pennsylvania Health Care Cost Containment Council (PHC4) today released a report detailing hospitalization trends related to the opioid overdoses. While the research shows that Pennsylvania is making progress in addressing the opioid crisis, it also highlights the heartbreaking reality that the opioid use disorder touches every part of the state, and all demographic and socioeconomic groups.

News Release: PA Senate Approves Telemedicine Legislation by Rmoore@haponline.org

News Release: The Pennsylvania Senate today took a major step in helping expand access to telemedicine across the commonwealth.

Trump Administration Argues that Key Parts of ACA Should be Invalidated by cglessner@haponline.org

Yesterday, the Trump Administration sided with Texas and a coalition of 19 other Republican-led states that filed a lawsuit in federal court challenging the constitutionality of the Affordable Care Act (ACA).

National and State Suicide Rates Continue to Increase; Access to Behavioral Health Care Critical by cglessner@haponline.org

The U.S. Centers for Disease Control and Prevention (CDC) released a VitalSigns monthly report highlighting the increasing rate of suicide across the nation. It states that suicide rates have increased in almost every state from 1999 through 2016. In Pennsylvania, the suicide rate increased 34.3 percent; a startling statistic that underscores the pressing need for more focused attention on behavioral health care services.

HAP Congratulates PA Hospitals Receiving Grants to Improve Care Coordination for Medicaid Patients by cglessner@haponline.org

This morning, the Pennsylvania Department of Human Services (DHS) announced it awarded nearly $8 million in onboarding grant funds to increase efficiency in health care service delivery to Medicaid patients through health information exchange.

More Men Accessing Behavioral Health Care through Telemedicine; Time to Pass Senate Bill 780 by cglessner@haponline.org

New information from the nation’s largest telemedicine provider, Teledoc, shows the increasing value of telehealth in providing convenient access to care. The company reports that, so far this year, about half of its behavioral health visits have been with men between the ages of 20 and 35. This new information provides one more reason to expand access to telemedicine services in Pennsylvania.

Pennsylvania Expects Modest Premium Increases for 2019 by cglessner@haponline.org

Today, Pennsylvania’s Insurance Commissioner Jessica Altman announced that Pennsylvania health insurers are requesting an aggregate statewide increase of 4.9 percent for 2019 health insurance plans. This increase is a much lower increase than the national trend. All of the health insurers that participated in the 2018 Pennsylvania health insurance market will remain in the market for 2019.