Obamacare Repeal Could Trigger Public Health Crisis, Hospital Groups Warn

Report predicts loss of $400 billion in hospital revenues as people lose coverage

The American Hospital Association (AHA) and the Federation of American Hospitals (FAH) have expressed concerns that repealing the Patient Protection and Affordable Care Act (PPACA) could cause hospitals to lose billions of dollars if Congress doesn’t reverse cuts to hospital payments that were meant to finance the 2010 law, according to an article posted on the Morning Consult website.

In a letter to President-elect Donald Trump and congressional Republicans, Richard Pollack, president and chief executive of the AHA, and Charles Kahn, president and CEO of the FAH, expressed their hope that the incoming administration will approve the restoration of Medicare’s hospital inflation update and Medicare and Medicaid Disproportionate Share Hospital payments, which help facilities that care for high levels of uninsured, poor, and disabled patients.

A new report funded by the two hospital groups predicted that the loss of coverage that would result from repealing the PPACA through last year’s budget reconciliation measure would have a net negative effect on hospitals totaling $165.8 billion.

“Losses of this magnitude cannot be sustained and will adversely impact patients’ access to care, decimate hospitals’ and health systems’ ability to provide services, weaken local economies that hospitals help sustain and grow, and result in massive job losses,” Pollack and Kahn wrote. “As you know, hospitals are often the largest employer in many communities, and more than half of a hospital’s budget is devoted to supporting the salaries and benefits of caregivers who provide 24/7 coverage, which cannot be replaced.”

“I think [Trump and Republicans] will take a realistic view that if [the] ACA is going to be unraveled and hopefully eventually replaced, if that’s their intent, that we will be able to participate with them in the process of making a soft landing for the hospital care that Americans expect,” Kahn said during a news conference.

Last week, the AHA wrote to Trump urging him not to repeal the PPACA without including a replacement, although Republicans on Capitol Hill appear to be moving ahead with that plan.

The new report estimated that repealing the Medicaid expansion, premium tax credits, cost-sharing subsidies, and penalties would result in a reduction of approximately $399.8 billion in hospital revenues between 2018 and 2026 as people would lose coverage or take other coverage options. “As people become uninsured,” the report stated, “we estimate that there would be a reduction in utilization of hospital services for an estimated reduction of about $139.4 billion in hospital costs between 2018 and 2026.”

Sources: Morning Consult; December 6, 2016; and AHA/FAH Report; December 6, 2016.