- Former CMS acting Administrator Andy Slavitt reported on conversations he recently had with hospital executives about the ACA as Republican lawmakers seek to repeal or modify the healthcare law.
- Hospitals in states that expanded Medicaid have seen positive financial results, according to Slavitt.
- However, the uncertainty about the ACA's future has led to frozen capital expenses and "people are baffled in the real world by the politics," Slavitt said.
Late last week, Slavitt – a heavy Twitter user – began a tweetstorm, which revealed that at least some hospital executives describe their experience with the ACA positively. The federal healthcare law allowed states to expand the Medicaid program and this has yielded positive results for many hospitals' bottom lines. However, the expansions are among the parts of the ACA that the GOP is expected to reconsider even though many of the states that have expanded Medicaid have Republican governors.
Medicaid expansion led to reduced bad debt and improved financial health, according to the executives that spoke to Slavitt. Different studies on Medicaid expansion states have showed mixed results about emergency room use. The growth of ED visit rates has slowed down in these states but use has remained high in Oregon.
Slavitt was most surprised with the results of a poll that found 39% of hospital executives are reducing hiring because of the uncertainty surrounding the ACA's fate and 31% are reducing capital expenses. The hospitals' top priority is cautiously adopting value-based care, Slavitt said.
NEW FINDING: 30% of those hospitals that are committed 2 value based health say they are now moving 2 a wait & see approach. Surprised me.15— Andy Slavitt (@ASlavitt) February 3, 2017
The ACA uncertainty could continue for some time. On Sunday before the Super Bowl, President Donald Trump in an interview said an ACA replacement may not be ready until 2018, The New York Times reported. Meanwhile, health insurance companies have also been dealing with the uncertainty by warning they would leave the marketplaces if a replacement coverage plan isn't agreed upon by April.
Several replacement plans have already been introduced by several Senators, including Sen. Rand Paul (R-KY), Sen. Bill Cassidy (R-LA) and Sen. Susan Collins (R-ME). A unified plan on ACA replacement has not been presented by Republicans at this time.