The hospital sector offers unanimous thumbs down to the Senate’s proposal to repeal and replace the Affordable Care Act.
The nation’s largest hospital associations united in rejecting the Senate’s proposal to repeal and replace the Affordable Care Act, and urged lawmakers to “hit reset” and “go back to the drawing board.”
Senate Airs Obamacare Repeal 'Draft'
The response to the Senate plan released Thursday was virtually identical to the unanimous disdain shown this spring for the House Republicans' American Health Care Act.
That is not surprising because the two bills are fundamentally the same on key points. They both eliminate the individual mandate, slash Medicaid, and eliminate a 3.8% tax on investment income above $200,000 that is a key funding source for Obamacare.
Moody’s Investors Service said Thursday the Senate bill would hurt hospitals.
“Under the proposed Senate bill, both for-profit and not-for-profit hospitals would face weaker demand for services and higher rates of uncompensated care expense, with the most significant impact on the sector occurring after 2020 when the changes to federal Medicaid funding are phased in,” said Daniel Steingart, a vice president at Moody’s.
“Transitioning federal Medicaid payments to a per-capita, or block grant system, and freezing Medicaid expansion would reduce the number of people with insurance and increase hospitals’ exposure to bad debt and uncompensated care costs.”
The nonpartisan Congressional Budget Office has yet score the bill, but by some estimates as many as 11 million people who gained coverage under the Medicaid expansion would be booted from the rolls under the Senate plan.
Hospitals Say ‘Hit Reset’
Rick Pollack, president and CEO of the American Hospital Association, said the Senate Better Care Reconciliation Act “moves in the opposite direction” from “key principles” the AHA had set down to protect health insurance coverage, particularly for vulnerable patients.
“The Senate proposal would likely trigger deep cuts to the Medicaid program that covers millions of Americans with chronic conditions such as cancer, along with the elderly and individuals with disabilities who need long-term services and support,” Pollack said in a statement issued shortly after the Republican plan was made public.
“Medicaid cuts of this magnitude are unsustainable and will increase costs to individuals with private insurance. We urge the Senate to go back to the drawing board and develop legislation that continues to provide coverage to all Americans who currently have it.”
Those sentiments were echoed in a statement by Sister Carol Keehan, DC, president and CEO of the Catholic Health Association, who said the Senate proposal “will have a devastating impact on our nation's most vulnerable populations.”
“After weeks of working behind closed doors, and despite claims that the Senate would start over and develop its own legislation, there is very little that differs from the House bill,” Keehan said.
“The small tweaks made in the newly released Senate bill do not change the fact that millions will lose their health care especially through a complete restructuring and deep federal funding reduction to the Medicaid program.”
Bruce Siegel, MD, president and CEO of America’s Essential Hospitals, accused Senate Republicans of putting “ideology ahead of lives with a plan that puts health and home at risk for millions of working Americans and that would badly weaken essential services for everyone in communities across the country.”
“For the hospitals that protect millions of Americans and their communities — our essential hospitals — this bill might even accelerate decisions by some to reduce services or close their doors,” Siegel said.
“Particularly troubling is the opaque process senators have followed to reach this point. Legislation of this scope and with such potential for harm demands a fair and public hearing, but Senate leaders so far have rejected that. This is a slap in the face to the democratic process and bad policymaking for the country.”
Federation of American Hospitals President Chip Kahn said the Senate still has time “to hit reset” and make critical revisions in the bill.
“FAH has been explicit about our health reform core principles: maintain coverage levels, reasonable Medicaid structural reforms, sustain affordable, high quality individual coverage, protect employer-sponsored insurance and roll back untenable cuts to hospital reimbursement,” Kahn said.
“At this time, the BCRA draft does not sufficiently meet those principles which are so important to those Americans our community hospitals serve and our employees who care for those patients every day. Now is the time for the Senate to hit reset and make key improvements to this legislation.”
Association of American Medical Colleges President and CEO Darrell G. Kirch, MD, said his members “are extremely disappointed by the Senate bill released today.”
“Despite promises to the contrary, it will leave millions of people without health coverage, and others with only bare bones plans that will be insufficient to properly address their needs,” he said.
“As the nation’s medical schools and teaching hospitals see every day, people without sufficient coverage often delay getting the care they need. This can turn a manageable condition into a life-threatening and expensive emergency. Rather than stabilizing the healthcare marketplace, this legislation will upend it by crippling the Medicaid program while also placing untenable strain on states and providers.”
Payers Peeved
Compared to the hospital lobby, the health insurance industry was restrained in its criticism of the Senate plan. America’s Health Insurance Plans spokeswoman Kristine Grow said it would “continue to analyze the bill, consistent with our previous positions.”
In May, AHIP CEO Marilyn Tavenner urged the Senate “to ensure the continued strength of the Medicaid program, which delivers real value to more than 70 million Americans.”
John Commins is the news editor for HealthLeaders.