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Access to Care

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.

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

NEW 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

POSITION PAPER: Repealing the ACA: Addressing Insurance Rate Increases (Download PDF) - 3/17/17

NEW POSITION PAPER: Repealing the ACA: Stabilizing the Insurance Market (Download PDF) - 4/28/17

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

The Centers for Medicare & Medicaid Services (CMS) released Hospice Compare, an informational website that allows consumers to learn more about hospice care in their area.

CMS Announces Major Changes to Bundled Programs by admin

This week the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would significantly reduce mandatory bundled programs.

CMS Extends Deadline for Insurers to File 2018 Rates by admin

The Centers for Medicare & Medicaid Services (CMS) announced that insurers participating in the Health Insurance Marketplaces (HealthCare.gov) have until September 5 to file their final rates for 2018. The action provides additional time for insurers to adjust their premiums due to continued uncertainty surrounding the Affordable Care Act, including the possibility that cost-sharing reduction (CSR) subsidies will go unfunded next year.

CMS to Explore New Behavioral Health Payment Model—Open Forum Scheduled September 8 by Rmoore@haponline.org

The Centers for Medicare & Medicaid Service (CMS) announced interest in launching a new payment model for behavioral health services. To gather input, CMS is holding a public forum on Friday, September 8, 2017, at the CMS Central Office in Baltimore, Maryland. Community health organizations, medical societies, health care providers, state Medicaid agencies, advocacy groups, non-profit organizations, and other interested parties are invited to participate.

U.S. Senate Rejects ACA “Skinny Repeal” Legislation by admin

Early this morning, the Senate voted 51 to 49 against the Health Care Freedom Act, also known as “skinny repeal” legislation. The legislation would have repealed limited portions of the Affordable Care Act (ACA), including the individual and employer mandates.

HAP Statement on U.S. Senate’s Rejection of “Skinny Repeal” by Rmoore@haponline.org

News Release: Early this morning, the U.S. Senate rejected the so-called “skinny” plan to repeal certain portions of the Affordable Care Act. The measure failed by a vote of 49-51, culminating weeks of Congressional efforts to overhaul the nation’s health care landscape. Andy Carter, president and CEO of The Hospital and Healthsystem Association of Pennsylvania (HAP), gave the following statement on the result.

U.S. Senate Contemplates Skinny Repeal, Repealing the Individual Mandate by admin

Still pursuing consensus that would produce 50 votes, the Republican majority in the U.S. Senate is evaluating narrowly crafted legislation that would repeal targeted provisions of the Affordable Care Act (ACA), including the individual and employer mandates.

Debate Continues in U.S. Senate on ACA Repeal Legislation by admin

After clearing a procedural motion yesterday to begin consideration of legislation to repeal and replace the Affordable Care Act (ACA), the Senate has been working through 20 hours of debate. When the debate time has elapsed, the chamber will vet amendments through “vote-a-rama.”

U.S. Senate Proceeds to Consideration of Repeal Legislation by admin

The U.S. Senate passed a procedural motion that will allow the chamber to begin consideration of legislation to repeal the Affordable Care Act (ACA). The Motion to Proceed passed by a vote of 51 to 50 with Vice President Mike Pence casting the deciding vote.

HAP President and CEO: Lawmakers Should Start Fresh on Health Care Bill by Rmoore@haponline.org

News Release: The U.S. Senate today voted in favor of a motion to proceed to consideration of legislation to repeal and replace the Affordable Care Act. Andy Carter, president and CEO of The Hospital and Healthsystem Association of Pennsylvania (HAP), released a statement.