Health care leaders prefer changes to the Patient Protection and Affordable Care Act (PPACA) rather than wholesale “repeal and replace,” according to a survey from HealthLeaders Media. Two-thirds of respondents (66%) said the best option for the health care industry regarding the PPACA is to make some changes but otherwise retain it. At the opposite ends of the spectrum, 27% of respondents favored full repeal and replacement, while only 7% said “keep it as it is,” indicating the extent of dissatisfaction with the PPACA.
Interestingly, a greater proportion of health systems (78%) than hospitals (66%) and physician organizations (65%) favored making some changes to the PPACA. On the other hand, a greater share of hospitals (28%) and physician organizations (27%) than health systems (17%) preferred full repeal and replacement.
Among the 66% of respondents who said that the best option for the PPACA is to make some changes, the top three changes they advocated were adding a public health-insurance option (61%); eliminating the excise tax on high-cost employer health-benefit plans (the so-called “Cadillac tax”) (50%); and eliminating the individual mandate and noncompliance penalty (37%).
The two changes receiving the fewest responses were eliminating Medicaid expansion (10%) and abandoning the focus on value-based care and reimbursement (16%).
Asked to identify the best solution for the health care industry, most of the respondents (52%) favored models with less governmental involvement, such as consumer-directed health care (38%) and employer-sponsored health care (14%)––approaches that generally represent politically conservative views.
On the other hand, 39% of respondents preferred government-based solutions, such as government-funded universal single-payer health care (25%) and government-mandated universal health insurance (14%)––models that are generally aligned with liberal views.
A greater share of physician organizations (28%) than hospitals (18%) and health systems (13%) said regulations should be reduced and that most are unnecessary and burdensome.
In December 2016, an online survey was sent to the HealthLeaders Media Council and to select members of the HealthLeaders Media audience. A total of 535 completed surveys were included in the analysis.