- American Hospital Association (AHA) President and CEO Richard Pollack urged the Senate on Monday to "reset the discussion" around making major changes to the Affordable Care Act (ACA) with the repeal bill it is crafting.
- Pollack, speaking at the AHA's annual meeting, said he believes that the American Health Care Act (AHCA) would reverse the progress that has been made in increasing access to care and reducing the number of uninsured Americans.
- Tom Nickels, the AHA executive vice president of government relations and public policy, argued that the Senate will likely view the Medicaid provisions in the AHCA as the No. 1 issue because GOP senators won't want to roll back access in red states that have expanded the program under the ACA.
The House passed the AHCA last week despite heavy opposition from the AHA, the American Medical Association and the AARP, among other leading organizations in the healthcare industry. They argue that the bill drastically rolls back protections for people with pre-existing conditions and and makes destructively large cuts to Medicaid.
"We opposed this measure [the AHCA] and now it moves to the Senate where we face an entirely different political environment," Pollack said. Just like many Republican senators, the AHA believes that any changes to the ACA must be guided by continuing to provide coverage to those with preexisting conditions, Pollack added.
The Senate has already said it will work on its own bill and the AHA is working to ensure the end result looks substantially different.
The Congressional Budget Office (CBO) has yet to release a score on the latest version of the AHCA. The earlier version was not voted on in the House because Speaker Paul Ryan didn't think he had the votes needed to pass it. The CBO's last score showed the repeal-and-replace efforts would result in 24 million more uninsured Americans over the next decade.
Nickels said he believes that the Senate will wait for a new CBO score before voting on its ACA repeal bill. He also argued that the Senate's process with crafting its measure will likely take up to six months and noted that more than a dozen GOP senators have spoken out in opposition to the Medicaid provisions in the AHCA, which include phasing out state Medicaid expansion.
Both Pollack and Nickels also urged Congress to act now to stabilize the individual health insurance marketplace by continuing funding for cost-sharing reduction (CSRs) payments. CSRs help to reduce out-of-pocket expenses for about 7 million individuals and addressing this issue, which is currently being considered in court, must be a "top priority," Pollack said.
The White House and Congress have yet to say whether the payments will continue, but insurers face a late June deadline to set rates for the coming year. More and more are pulling out of ACA exchange markets, saying there is too much uncertainty. President Donald Trump, however, has said he would wait to see how the health bill played out before taking action on CSR payments.
Nickels said the AHA will continue to work with other organizations in the industry to ensure that the concerns of hospitals across the U.S. are heard by the senators who want to make major changes to the ACA.