Hospitals Express Concerns with Potential ACA Repeal

The Federation of American Hospitals and American Hospital Association recently released Estimating the Impact of Repealing the Affordable Care Act on Hospitals, a report which modeled the repeal of the Affordable Care Act (ACA) as laid out in the Restoring Americans’ Healthcare Freedom Reconciliation Act (H.R. 3762, vetoed by President Obama on 1/8/16).  The report found, from 2018 till 2026, hospitals would lose $165.8 billion in Medicaid Disproportionate Share Hospital payments and $289.5 billion in Medicare inflation updates, planned ACA funding cuts to hospitals would not be restored, and the number of uninsured would increase to 50 million (compared to the projected 28 million under the ACA).  Currently, Medicare is steering providers toward a value-based purchasing model, and hospitals are asked, or mandated, to invest in Alternative Payment Models (APMs, such as Accountable Care Organizations).  But Medicare does not pay for APM implementation expenses nor compensate hospitals for increased operational risks under APMs.  With the repeal of the ACA, the projected “reversal of coverage would represent an unprecedented public health crisis,” and “present serious challenges to hospitals, which would have to absorb the cost of uncompensated care associated with these newly uninsured individuals who need and receive hospital care.”