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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

Rate of Health Care Spending Growth Decreases by JCOLLINS@HAPONLINE.ORG

According to a study by the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS), overall health spending grew by 4.3 percent during 2016, as compared to 5.8 percent in 2015.

PA CHIP Receives Legislative Approval; Uncertainty Around Federal Funding Remains by JCOLLINS@HAPONLINE.ORG

The Pennsylvania legislature approved legislation to reauthorize the state’s Children’s Health Insurance Program (CHIP) through 2019. House Bill 1388 (Irvin, R-Huntingdon) now heads to Governor Wolf for his signature which he has indicated he will sign.

PA Hospitals, Governor Urge Residents to Enroll for Coverage by December 15 by JCOLLINS@HAPONLINE.ORG

Friday marks the deadline for the 2018 federal Health Insurance Marketplace open enrollment and HAP, Pennsylvania’s hospitals, and Governor Tom Wolf are reminding individuals to make plan selections and complete enrollment by Friday, December 15.

As CHIP Turns 25, Funding Extension Still Uncertain by Rmoore@haponline.org

This weekend, the Children’s Health Insurance Program (CHIP) celebrated its 25th anniversary in Pennsylvania. Former Governor Robert P. Casey signed the original state CHIP authorization into law on December 2, 1992. The program served as a national model, and nearly seven years later, former President Bill Clinton signed legislation that enacted CHIP across the United States.

News Release: HAP Statement about U.S. Senate-Passed Tax Plan by Rmoore@haponline.org

During Saturday, December 2, the U.S. Senate passed H.R. 1, the “Tax Cuts and Jobs Act.” Following the vote, Andy Carter, president and CEO of The Hospital and Healthsystem Association of Pennsylvania (HAP) released the following statement.

CMS Updates Medicare Advantage Value-Based Insurance Design Model by admin

The Centers for Medicare & Medicaid Services (CMS) has announced updates for its Medicare Advantage Value-Based Insurance Design Model. The agency plans to expand the model from the seven states, including Pennsylvania, that are currently participating to 25 states by 2019.

Pennsylvania Sees 100,000 Insurance Sign-ups During First Three Weeks; PA Hospitals Urge Consumers to Continue Signing Up for Health Care Coverage by jshellenberger@haponline.org

During the first three weeks of open enrollment (November 1–18), Pennsylvania has had 101,286 plan selections for health insurance enrollment. Nearly 800,000 people have selected health plans using the HealthCare.gov platform. This puts nationwide open enrollment selections near 2.3 million during the first three weeks of open enrollment, including more than 550,000 new consumers.

American College of Physicians Highlights the Need for Increased Transparency; HAP’s Care in PA Provides Quality and Price Transparency in Pennsylvania by jshellenberger@haponline.org

A recently released report from the American College of Physicians (ACP) recognizes transparency efforts to mend the fragmentation of health care. The report provides recommendations to improve transparency to address cost and quality challenges.

HAP Thanks State’s Veterans for Their Service, Highlights Health Systems’ Veterans Health Programs by jkissinger@haponline.org

HAP thanks Pennsylvania's veterans for their service and sacrifices to protect our freedom. The association and its members recognize that, as a result of these sacrifices, our veterans and their families sometimes need additional support, including help for health care challenges.

 

State Delays Phases 2 and 3 of Community HealthChoices Program, Allowing More Time to Learn from Initial Rollout in West by jkissinger@haponline.org

Today, the Pennsylvania Department of Human Services (DHS) announced that it is delaying the start dates for Phases 2 and 3 of Community HealthChoices (CHC), Pennsylvania’s new Managed Long-Term Services and Supports (MLTSS) program. DHS says it wants to learn from the Phase 1 rollout and allow time to make any necessary adjustments before implementing further phases.   

Related Blogs

Rate of Health Care Spending Growth Decreases by JCOLLINS@HAPONLINE.ORG

According to a study by the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS), overall health spending grew by 4.3 percent during 2016, as compared to 5.8 percent in 2015.

PA CHIP Receives Legislative Approval; Uncertainty Around Federal Funding Remains by JCOLLINS@HAPONLINE.ORG

The Pennsylvania legislature approved legislation to reauthorize the state’s Children’s Health Insurance Program (CHIP) through 2019. House Bill 1388 (Irvin, R-Huntingdon) now heads to Governor Wolf for his signature which he has indicated he will sign.

PA Hospitals, Governor Urge Residents to Enroll for Coverage by December 15 by JCOLLINS@HAPONLINE.ORG

Friday marks the deadline for the 2018 federal Health Insurance Marketplace open enrollment and HAP, Pennsylvania’s hospitals, and Governor Tom Wolf are reminding individuals to make plan selections and complete enrollment by Friday, December 15.

As CHIP Turns 25, Funding Extension Still Uncertain by Rmoore@haponline.org

This weekend, the Children’s Health Insurance Program (CHIP) celebrated its 25th anniversary in Pennsylvania. Former Governor Robert P. Casey signed the original state CHIP authorization into law on December 2, 1992. The program served as a national model, and nearly seven years later, former President Bill Clinton signed legislation that enacted CHIP across the United States.

News Release: HAP Statement about U.S. Senate-Passed Tax Plan by Rmoore@haponline.org

During Saturday, December 2, the U.S. Senate passed H.R. 1, the “Tax Cuts and Jobs Act.” Following the vote, Andy Carter, president and CEO of The Hospital and Healthsystem Association of Pennsylvania (HAP) released the following statement.

CMS Updates Medicare Advantage Value-Based Insurance Design Model by admin

The Centers for Medicare & Medicaid Services (CMS) has announced updates for its Medicare Advantage Value-Based Insurance Design Model. The agency plans to expand the model from the seven states, including Pennsylvania, that are currently participating to 25 states by 2019.

Pennsylvania Sees 100,000 Insurance Sign-ups During First Three Weeks; PA Hospitals Urge Consumers to Continue Signing Up for Health Care Coverage by jshellenberger@haponline.org

During the first three weeks of open enrollment (November 1–18), Pennsylvania has had 101,286 plan selections for health insurance enrollment. Nearly 800,000 people have selected health plans using the HealthCare.gov platform. This puts nationwide open enrollment selections near 2.3 million during the first three weeks of open enrollment, including more than 550,000 new consumers.

American College of Physicians Highlights the Need for Increased Transparency; HAP’s Care in PA Provides Quality and Price Transparency in Pennsylvania by jshellenberger@haponline.org

A recently released report from the American College of Physicians (ACP) recognizes transparency efforts to mend the fragmentation of health care. The report provides recommendations to improve transparency to address cost and quality challenges.

HAP Thanks State’s Veterans for Their Service, Highlights Health Systems’ Veterans Health Programs by jkissinger@haponline.org

HAP thanks Pennsylvania's veterans for their service and sacrifices to protect our freedom. The association and its members recognize that, as a result of these sacrifices, our veterans and their families sometimes need additional support, including help for health care challenges.

 

State Delays Phases 2 and 3 of Community HealthChoices Program, Allowing More Time to Learn from Initial Rollout in West by jkissinger@haponline.org

Today, the Pennsylvania Department of Human Services (DHS) announced that it is delaying the start dates for Phases 2 and 3 of Community HealthChoices (CHC), Pennsylvania’s new Managed Long-Term Services and Supports (MLTSS) program. DHS says it wants to learn from the Phase 1 rollout and allow time to make any necessary adjustments before implementing further phases.   

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