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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

Study Shows Value of Medicaid in Providing Access to Care and Preventive Services by Rmoore@haponline.org

A study conducted by the America’s Health Insurance Plans (AHIP) found that adults and children in a Medicaid health plan had significantly better access to care and preventive services than did people with no health coverage.

CMS Finalizes Rules Governing Health Insurance Marketplaces by Rmoore@haponline.org

The Centers for Medicare & Medicaid Services (CMS) yesterday issued its final rule impacting insurance plans offered on the health insurance marketplaces under the Affordable Care Act. 

More than 389,000 Pennsylvanians Sign Up for Health Insurance under the ACA, Part of More than 11.8 Million Nationwide by admin

During the 2018 open enrollment period (November 1–December 15, 2017), 389,081 Pennsylvanians signed up for health insurance through the Affordable Care Act’s (ACA) health insurance marketplace, HealthCare.gov.

New Kaiser Poll Shows Americans Value Having Health Insurance by admin

Recently released findings from the Kaiser Health Tracking Poll for March 2018 show that Americans, including those in the non-group market, value having health insurance. 

Increased Powers for FDA to Fight Opioid Crisis May Be Coming by jkissinger@haponline.org

A U.S. Senate Committee Chairman has introduced two draft bills designed to give the U.S. Food and Drug Administration (FDA) more authority to address the opioid crisis.

Senate Health and Human Services Committee Advances Four Bills Impacting Health by JCOLLINS@HAPONLINE.ORG

Earlier today, the Senate Health and Human Services Committee reported four bills intended to improve access to care, improve data collection on a key public health concern, and evaluate how the commonwealth protects the health and welfare of children.

Overwhelming Majority of Americans Support Access to Affordable Health Insurance by jshellenberger@haponline.org

New survey results about Americans’ health insurance coverage indicate that an overwhelming majority (92%) support the right of all Americans to have access to affordable health care insurance. In addition, almost nine out of ten agree with paying into Medicare to ensure access to health care for older Americans. However, many with health insurance outside of employer-based coverage are concerned about the future of their own health insurance because of uncertainty surrounding the Affordable Care Act (ACA).

Market Stabilization Policies Under Review at Federal Level by jshellenberger@haponline.org

Leading up to the March 23 deadline to fund the government, federal lawmakers, the Administration, and stakeholders are engaged in negotiations over a stabilization package that would steady health insurance marketplaces.

Wolf Administration Announces Efforts to Streamline Access to Medication-assisted Treatments by Rmoore@haponline.org

Governor Tom Wolf today held a press conference at Crozer-Chester Medical Center to announce his administration’s intention to streamline access to treatment for Pennsylvanians suffering from opioid use disorder.

As PA’s Overdose Deaths Rise, U.S. Senate Leaders Look to Technology to Address Opioid Crisis by Rmoore@haponline.org

As the health care community and federal, state, and local governments continue to work to find ways to curb the opioid crisis and help patients get on a path to recovery, the Senate Health, Education, Labor & Pensions (HELP) Committee today held a hearing titled, “The Opioid Crisis:  The Role of Technology and Data in Preventing and Treating Addiction.” 

Related Blogs

Study Shows Value of Medicaid in Providing Access to Care and Preventive Services by Rmoore@haponline.org

A study conducted by the America’s Health Insurance Plans (AHIP) found that adults and children in a Medicaid health plan had significantly better access to care and preventive services than did people with no health coverage.

CMS Finalizes Rules Governing Health Insurance Marketplaces by Rmoore@haponline.org

The Centers for Medicare & Medicaid Services (CMS) yesterday issued its final rule impacting insurance plans offered on the health insurance marketplaces under the Affordable Care Act. 

More than 389,000 Pennsylvanians Sign Up for Health Insurance under the ACA, Part of More than 11.8 Million Nationwide by admin

During the 2018 open enrollment period (November 1–December 15, 2017), 389,081 Pennsylvanians signed up for health insurance through the Affordable Care Act’s (ACA) health insurance marketplace, HealthCare.gov.

New Kaiser Poll Shows Americans Value Having Health Insurance by admin

Recently released findings from the Kaiser Health Tracking Poll for March 2018 show that Americans, including those in the non-group market, value having health insurance. 

Increased Powers for FDA to Fight Opioid Crisis May Be Coming by jkissinger@haponline.org

A U.S. Senate Committee Chairman has introduced two draft bills designed to give the U.S. Food and Drug Administration (FDA) more authority to address the opioid crisis.

Senate Health and Human Services Committee Advances Four Bills Impacting Health by JCOLLINS@HAPONLINE.ORG

Earlier today, the Senate Health and Human Services Committee reported four bills intended to improve access to care, improve data collection on a key public health concern, and evaluate how the commonwealth protects the health and welfare of children.

Overwhelming Majority of Americans Support Access to Affordable Health Insurance by jshellenberger@haponline.org

New survey results about Americans’ health insurance coverage indicate that an overwhelming majority (92%) support the right of all Americans to have access to affordable health care insurance. In addition, almost nine out of ten agree with paying into Medicare to ensure access to health care for older Americans. However, many with health insurance outside of employer-based coverage are concerned about the future of their own health insurance because of uncertainty surrounding the Affordable Care Act (ACA).

Market Stabilization Policies Under Review at Federal Level by jshellenberger@haponline.org

Leading up to the March 23 deadline to fund the government, federal lawmakers, the Administration, and stakeholders are engaged in negotiations over a stabilization package that would steady health insurance marketplaces.

Wolf Administration Announces Efforts to Streamline Access to Medication-assisted Treatments by Rmoore@haponline.org

Governor Tom Wolf today held a press conference at Crozer-Chester Medical Center to announce his administration’s intention to streamline access to treatment for Pennsylvanians suffering from opioid use disorder.

As PA’s Overdose Deaths Rise, U.S. Senate Leaders Look to Technology to Address Opioid Crisis by Rmoore@haponline.org

As the health care community and federal, state, and local governments continue to work to find ways to curb the opioid crisis and help patients get on a path to recovery, the Senate Health, Education, Labor & Pensions (HELP) Committee today held a hearing titled, “The Opioid Crisis:  The Role of Technology and Data in Preventing and Treating Addiction.” 

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