That’s not an ironic headline. Leading House Republicans have included a number of transformative and consequential reforms in their American Health Care Act, the full text of which was published Monday evening. But those reforms are overshadowed by the bill’s stubborn desire to make health insurance unaffordable for millions of Americans, and trap millions more in poverty. Can such a bill garner the near-universal Republican support it will need to pass Congress?
http://www.healthcaredive.com/news/nonprofit-salaries-for-healthcare-executives-on-the-rise/437566/
The largest nonprofit compensation package discovered by The Wall Street Journal analysis went to Anthony Tersigni, president and CEO of Ascension, a hospital operator based in Missouri. He received a total of $17.6 million.
Compensation provided by hospitals correlated more with the size of an organization, location, and academic status, according to a 2013 study published in JAMA on salaries for 1,877 CEOs at 2,681 hospitals. The average CEO earned about $600,000 per year, but the average salaries for CEOs of small rural hospitals were just $118,000 while CEOs at top teaching hospitals earned an average of about $1.7 million.
The Wall Street Journal analysis reflect results from the JAMA study. While CEOs of urban teaching hospitals tend to earn more, compensation can vary widely. For instance, the chief executive of Mercy Health System, which had around $1 billion in operating revenue in 2014, earned about $8 million, Meanwhile, Catholic Health Systems collected about 15 times as much in 2015 and paid its CEO half as much.
These policy ideas popular among conservatives could certainly push health insurance costs down for some — like those with few healthcare needs and reliable income — but they also would undoubtedly offer fewer benefits to those with low incomes and high healthcare costs.
“The value of the policies that insurers are offering is going to go down under all these options,” Blumberg said. “They’re going to end up attracting the higher needs population and they can’t sustain that.”
Hospitals would see significant revenue losses if millions lose coverage under repeal of the ACA and are unable to afford new coverage under the replacement plans the GOP has put forward. Some executives have warned they would have to cut vital services, such as behavioral health.
A report prepared for the American Hospital Association found that hospital revenues would decrease nearly $400 billion between 2018 and 2026 with ACA repeal. The plans put forward by Republicans would barely dent that projection, experts say.
Hospital revenues are projected to decrease by $400 billion between 2018 and 2026 under ACA repeal, according to the AHA.
The leaders of the American Hospital Association and Federation of American Hospitals have written to President Donald Trump asking him not to repeal the ACA without an adequate replacement.
“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,” they 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.”
Republicans continue to debate whether, how and when to replace the ACA. Just as the reform law had major impacts on the industry, the process of finding alternatives will have significant consequences as well.
Healthcare organizations are adopting innovative practices as they prepare for a new future.
http://thehill.com/policy/healthcare/322609-gop-releases-bill-to-repeal-and-replace-obamacare
Click to access AmericanHealthCareAct.pdf
Click to access AmericanHealthCareAct_WM.pdf
House Republicans on Monday unveiled their long-awaited legislation to repeal and replace ObamaCare, with plans to quickly push the measure through committee votes this week.
The two measures dismantle the core aspects of ObamaCare, including its subsidies to help people buy coverage, expansion of Medicaid, taxes and mandates for people to have insurance. The bills also dramatically restructure the Medicaid program overall by capping federal payments.
In its place, Republicans would put a new system centered on a tax credit to help people buy insurance.
House Republicans plan to take up the legislation at a breakneck pace, with two committees — Energy and Commerce and Ways and Means — scheduled to hold votes on Wednesday. A vote in the full House is expected to soon follow, within weeks.
House Ways and Means Committee Chairman Kevin Brady (R-Texas) said Monday on Fox News that he’s confident the legislation will pass with solid Republican support despite recent party infighting over the details.
“We’ve been listening very carefully to our Republican members for months now to make sure we get it right,” he said. “I am confident we are going to pass this.”
Brady noted that many of the elements of the bills have passed the House “a number of times” over the years.
Speaker Paul Ryan (R-Wis.) in a statement claimed that ObamaCare “is rapidly collapsing” and vowed the GOP’s plan — dubbed the American Health Care Act — will “give every American access to quality, affordable health insurance.”
Republicans acknowledge that their plan will cover fewer people, saying that unlike ObamaCare, they are not forcing people to buy coverage through a mandate. They say their system is less intrusive and provides people a tax credit without mandates or a range of tax increases.
But the measures face a rocky path, particularly in the Senate. Four Republican senators earlier Monday objected to an earlier version of the House plan, saying that it fails to protect ObamaCare’s Medicaid expansion.
Even in the House, there are objections. Conservatives in the House Freedom Caucus object that the new tax credit is a “new entitlement.” They have enough votes to kill the legislation, but it remains to be seen whether they will actually vote against a bill that dismantles the core of ObamaCare.
The GOP measure significantly restructures the Medicaid program, which provides coverage for around 70 million poor, disabled and elderly people, to cap federal payments.
The repeal of the Medicaid expansion and ObamaCare’s subsidies would not take effect until 2020, meaning current enrollees could keep their coverage this year.
Republicans would also grandfather in current Medicaid enrollees so that they can stay on the program. But once 2020 arrives, the federal government would no longer provide the extra federal funds that allow for expansion.
That plan has drawn objections from more centrist Republican senators, who want to protect the expansion and are worried about constituents losing coverage and their states losing federal funds.
The legislation would maintain ObamaCare’s protections for people with pre-existing conditions, who could still not be denied coverage by insurers. Instead of ObamaCare’s mandate, the GOP plan would seek to encourage healthy people to sign up by allowing insurers to charge people 30 percent higher premiums if a new enrollee has had a gap in coverage.
The legislation also repeals nearly all of the taxes created by ObamaCare, including the medical device tax and health insurance tax, starting in 2018. The bills scrap a controversial Republican proposal in earlier drafts that would have started taxing some employer-sponsored health insurance.
To ensure that the legislation passes muster under special budgetary rules, it keeps ObamaCare’s “Cadillac tax” on generous plans after 2025. That provision, which could prove controversial, will help ensure that the measure does not add to the federal deficit in that decade.
HENRY KOTULA 