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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

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The Centers for Medicare & Medicaid Services (CMS) recently issued a final rule updating the Medicare Advantage program to allow for innovative plan design and more choices for patients. The popularity of Medicare Advantage plans has been on the rise and new flexibilities, including additional telehealth and nontraditional benefits will likely continue this trend. 

Warm Hand-off Study Resolution Clears First Hurdle by JCOLLINS@HAPONLINE.ORG

Today, the House Human Services Committee considered House Resolution 216. Sponsored by freshman lawmaker Todd Polinchock (R-Bucks), the resolution establishes a task force within the House of Representatives on “overdose recovery” and directs the Joint State Government Committee to establish an advisory committee aimed at studying the warm hand-off treatment for individuals with substance abuse disorder.

New Report Outlines Potential Pitfalls of Site-neutral Payment Policies by Rmoore@haponline.org

A recent American Hospital Association (AHA) report provides new insight into site-neutral payments, which may impact the reimbursement rate for the care that hospitals provide to patients in outpatient settings.

Pennsylvania Highlighted for Rural Health Care Innovation by Rmoore@haponline.org

The transformative changes hospitals and health systems face are front and center at this year’s American Hospital Association (AHA) Annual Meeting. During an executive session centered on rural issues, Pennsylvania’s hospitals were highlighted for their innovative work through the Rural Health Model.

Nurse Leaders, Lawmakers Rally in Support of Full Practice Authority for Certified Nurse Practitioners by Rmoore@haponline.org

Nurse practitioners and health care champions met in Harrisburg today to rally in support of legislative proposals to help advanced practices professionals obtain full practice authority in Pennsylvania.

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The Pennsylvania Insurance Department is proposing to create a state-based health insurance exchange to better serve Pennsylvanians with a target implementation date of 2021. 

Senate Advances HAP-Supported Nurse Practitioner Bill by JCOLLINS@HAPONLINE.ORG

Today, the Senate Consumer Protection and Professional Licensure Committee voted HAP-supported Senate Bill 25 out of committee with two negative votes. Sponsored by Senator Camera Bartolotta (R-Washington), the bill allows certified nurse practitioners (CNP) to practice to the full scope of their license without the need for physician supervision after they have worked under such supervision for three years and 3,600 hours.

Future of ACA in Focus as Administration Challenges Law and U.S. House Democrats Reaffirm Support by JCOLLINS@HAPONLINE.ORG

As the U.S. Department of Justice called for the 5th Circuit Court of Appeals to uphold a Texas District Court decision invalidating the Affordable Care Act (ACA), U.S. House Democrats are pursuing a legislative strategy to reinforce patient protections under the ACA and protect the ACA insurance markets from actions by the Trump Administration to undermine the law.

PA House Continues Work on Workforce Development, Advancing Several Bills by JCOLLINS@HAPONLINE.ORG

As a part of the bipartisan state initiative to ensure the professional stability and economic success of every Pennsylvanian, House Republican leaders have recently passed several workforce development bills.

HAP Statement: HAP Takes Action to Protect Patients’ Access to Care by Rmoore@haponline.org

On behalf of Pennsylvania patients and the hospitals they count on for care, The Hospital and Healthsystem Association of Pennsylvania (HAP) today filed a motion in the Middle District Federal Court to intervene in a lawsuit resulting from the significant policy consequences of recent actions by the Pennsylvania Attorney General.

Related Blogs

Medicare Advantage Enrollees May Have More Access to Telehealth Services by JCOLLINS@HAPONLINE.ORG

The Centers for Medicare & Medicaid Services (CMS) recently issued a final rule updating the Medicare Advantage program to allow for innovative plan design and more choices for patients. The popularity of Medicare Advantage plans has been on the rise and new flexibilities, including additional telehealth and nontraditional benefits will likely continue this trend. 

Warm Hand-off Study Resolution Clears First Hurdle by JCOLLINS@HAPONLINE.ORG

Today, the House Human Services Committee considered House Resolution 216. Sponsored by freshman lawmaker Todd Polinchock (R-Bucks), the resolution establishes a task force within the House of Representatives on “overdose recovery” and directs the Joint State Government Committee to establish an advisory committee aimed at studying the warm hand-off treatment for individuals with substance abuse disorder.

New Report Outlines Potential Pitfalls of Site-neutral Payment Policies by Rmoore@haponline.org

A recent American Hospital Association (AHA) report provides new insight into site-neutral payments, which may impact the reimbursement rate for the care that hospitals provide to patients in outpatient settings.

Pennsylvania Highlighted for Rural Health Care Innovation by Rmoore@haponline.org

The transformative changes hospitals and health systems face are front and center at this year’s American Hospital Association (AHA) Annual Meeting. During an executive session centered on rural issues, Pennsylvania’s hospitals were highlighted for their innovative work through the Rural Health Model.

Nurse Leaders, Lawmakers Rally in Support of Full Practice Authority for Certified Nurse Practitioners by Rmoore@haponline.org

Nurse practitioners and health care champions met in Harrisburg today to rally in support of legislative proposals to help advanced practices professionals obtain full practice authority in Pennsylvania.

HAP Supports a State-based Health Insurance Exchange in Pennsylvania by Rmoore@haponline.org

The Pennsylvania Insurance Department is proposing to create a state-based health insurance exchange to better serve Pennsylvanians with a target implementation date of 2021. 

Senate Advances HAP-Supported Nurse Practitioner Bill by JCOLLINS@HAPONLINE.ORG

Today, the Senate Consumer Protection and Professional Licensure Committee voted HAP-supported Senate Bill 25 out of committee with two negative votes. Sponsored by Senator Camera Bartolotta (R-Washington), the bill allows certified nurse practitioners (CNP) to practice to the full scope of their license without the need for physician supervision after they have worked under such supervision for three years and 3,600 hours.

Future of ACA in Focus as Administration Challenges Law and U.S. House Democrats Reaffirm Support by JCOLLINS@HAPONLINE.ORG

As the U.S. Department of Justice called for the 5th Circuit Court of Appeals to uphold a Texas District Court decision invalidating the Affordable Care Act (ACA), U.S. House Democrats are pursuing a legislative strategy to reinforce patient protections under the ACA and protect the ACA insurance markets from actions by the Trump Administration to undermine the law.

PA House Continues Work on Workforce Development, Advancing Several Bills by JCOLLINS@HAPONLINE.ORG

As a part of the bipartisan state initiative to ensure the professional stability and economic success of every Pennsylvanian, House Republican leaders have recently passed several workforce development bills.

HAP Statement: HAP Takes Action to Protect Patients’ Access to Care by Rmoore@haponline.org

On behalf of Pennsylvania patients and the hospitals they count on for care, The Hospital and Healthsystem Association of Pennsylvania (HAP) today filed a motion in the Middle District Federal Court to intervene in a lawsuit resulting from the significant policy consequences of recent actions by the Pennsylvania Attorney General.

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