Hospitals Pan Senate ACA Repeal Plan

http://www.healthleadersmedia.com/health-plans/hospitals-pan-senate-aca-repeal-plan?spMailingID=11326677&spUserID=MTY3ODg4NTg1MzQ4S0&spJobID=1182001298&spReportId=MTE4MjAwMTI5OAS2#

Image result for Hospitals Thumbs Down

he hospital sector offers unanimous thumbs down to the Senate’s proposal to repeal and replace the Affordable Care Act.

The nation’s largest hospital associations united in rejecting the Senate’s proposal to repeal and replace the Affordable Care Act, and urged lawmakers to “hit reset” and “go back to the drawing board.”


Senate Airs Obamacare Repeal ‘Draft’


The response to the Senate plan released Thursday was virtually identical to the unanimous disdain shown this spring for the House Republicans’ American Health Care Act.

That is not surprising because the two bills are fundamentally the same on key points. They both eliminate the individual mandate, slash Medicaid, and eliminate a 3.8% tax on investment income above $200,000 that is a key funding source for Obamacare.

Moody’s Investors Service said Thursday the Senate bill would hurt hospitals.

“Under the proposed Senate bill, both for-profit and not-for-profit hospitals would face weaker demand for services and higher rates of uncompensated care expense, with the most significant impact on the sector occurring after 2020 when the changes to federal Medicaid funding are phased in,” said Daniel Steingart, a vice president at Moody’s.

“Transitioning federal Medicaid payments to a per-capita, or block grant system, and freezing Medicaid expansion would reduce the number of people with insurance and increase hospitals’ exposure to bad debt and uncompensated care costs.”

The nonpartisan Congressional Budget Office has yet score the bill, but by some estimates as many as 11 million people who gained coverage under the Medicaid expansion would be booted from the rolls under the Senate plan.

Hospitals Say ‘Hit Reset’

Rick Pollack, president and CEO of the American Hospital Association, said the Senate Better Care Reconciliation Act “moves in the opposite direction” from “key principles” the AHA had set down to protect health insurance coverage, particularly for vulnerable patients.

Conflicts of interest: Time for world’s top health journalism organization to reconsider fundraising practices. Part 2 of 3

https://www.healthnewsreview.org/2017/06/conflicts-interest-time-worlds-top-health-journalism-organization-reconsider-fundraising-practices-part-2-3/

Perhaps few journalism organizations have tried harder to minimize conflicts of interest than the Association of Health Care Journalists (AHCJ), the leading professional organization for journalists who report on health care.

The two of us know AHCJ well, having been members almost since its launch 20 years ago. We’ve both served on AHCJ’s board, attended most of its 18 annual conferences, and served on many panels as speakers or moderators over the years. Gary wrote the AHCJ’s Statement of Principles, which was adopted by the Board in 2004.

AHCJ states that its educational arm, the Center for Excellence in Health Care Journalism, won’t take money from pharmaceutical companies, device makers, insurers or even most advocacy groups such as the American Cancer Society. That strict standard distinguishes AHCJ from some other journalism training organizations, which have no qualms about accepting money from companies that journalists routinely report on.

In fact, when AHCJ agreed to collaborate with the World Conference of Science Journalists (WCSJ), which meets in San Francisco this fall, it raised its own money for a health care track “because the broader funding of the conference includes funders that we would not take money from,” AHCJ Executive Director Len Bruzzese told us. As noted in part one of this series, WCSJ accepted $400,000 in support from drug company Johnson & Johnson and another $50,000 from drug company Bayer. Each of the funders that AHCJ lists for its track at WCSJ is a philanthropic foundation. Bruzzese added: “There is easier money out there if you’re willing to take it from other organizations that may want to have more influence than we believe they should have on journalists.”

How the American Health Care Act’s Changes to Medicaid Will Affect Hospital Finances in Every State

http://www.commonwealthfund.org/publications/blog/2017/jun/how-changes-to-medicaid-will-affect-hospital-finances-in-every-state?omnicid=EALERT1231316&mid=henrykotula@yahoo.com

The American Health Care Act (AHCA), as passed by the U.S. House of Representatives, will reduce federal spending on Medicaid by more than $834 billion over the next 10 years. And the recently released Senate bill appears to cut Medicaid even more deeply. In addition to repealing the Medicaid expansion, the bills place caps on the federal dollars that states receive to provide health insurance to millions of low-income Americans, including the elderly, disabled, and people with opioid addiction.

We modeled the impact of this loss of Medicaid funding on U.S. hospitals and found that, over the next 10 years, hospitals in all states, but especially hospitals in Medicaid expansion states, will see an increase in uncompensated care—a treatment or service not paid for by an insurer or patient. We also saw declines in hospitals’ operating margins, particularly among hospitals in expansion states. Rural hospitals in nonexpansion states also would face marked operating margin decreases.

In the interactive state-by-state maps below, we present the estimated impact of the Medicaid provisions in the House-passed AHCA on the finances of all U.S. hospitals. The hospitals in the District of Columbia and the 31 states that expanded Medicaid are projected to see a 78 percent increase in uncompensated care costs between 2017 and 2026. Eleven of these states will see uncompensated care costs at least double between 2017 and 2026. For example, Nevada hospitals will see a 98 percent increase, West Virginia a 122 percent increase, and Kentucky a 165 percent increase.

In addition to growing uncompensated care, our projections indicate that under the AHCA, hospitals in most states will experience a decline in Medicaid revenues, even though the law restores Medicaid disproportionate share hospital (DSH) payments. Hospitals in Medicaid expansion states may experience a 14 percent drop in Medicaid revenues between 2017 and 2026, compared to a 3 percent anticipated reduction among hospitals in the 19 states that did not expand. Some states may see more dramatic drops. Arkansas hospitals, for example, are estimated to see a 31 percent decline in Medicaid revenue over the next 10 years.

The Health 202: Here’s what’s in the Senate health-care bill

https://www.washingtonpost.com/news/powerpost/paloma/the-health-202/2017/06/22/the-health-202-here-s-what-s-in-the-senate-health-care-bill/594aa367e9b69b2fb981dde9/?utm_term=.fd77d3f3481a

Image result for aca repeal

The Senate version of the repeal (and “replacement”) of the Affordable Care Act — which Mitch McConnell is now sharing with Senate Republicans — eliminates just about all of its extra taxes on the rich by deeply cutting Medicaid and reducing subsidies to the poor. But McConnell figures he can keep moderate Republicans in the fold (he needs almost all their votes) by delaying these provisions and allowing states to reduce insurance coverage.

The plan:

1. Basically retains Obamacare’s insurance subsidies. But starting in 2020 this assistance wouldn’t be available for most of the working-class who now receive them, nor for anyone ineligible for Medicaid. See #2.

2. Cuts Medicaid more deeply than the House version by giving states an amount per person that grows more slowly than the growth in healthcare costs. This provision won’t kick in for 7 years, well past senators’ next reelection battles.

3. Ends the Affordable Care Act’s Medicaid expansion in 5 years — gradually reducing the extra federal payments starting in 2021.

4. Continues to protect patients with preexisting conditions, but allows states to reduce insurance coverage to everyone, including people with preexisting conditions.

In other words, all cuts are made through the back door of delays and state waivers. It only looks like a kinder, gentler version of the House repeal of the Affordable Care Act — but 7 to 10 years from now its result would be even crueler.

The Senate health bill is out. Here’s your speed read

https://www.axios.com/the-senate-bill-is-out-heres-your-speed-read-2446201141.html

Image result for aca repeal bill

You can read it here, and a summary here. The highlights:

  • Ends the Affordable Care Act’s mandates and most of its taxes.
  • Phases out its Medicaid expansion over three years, ending in 2024.
  • Limits Medicaid spending with per capita caps, or block grants for states that choose them. The spending growth rate would become stricter in 2025.
  • States could apply for waivers from many of the insurance regulations.
  • The ACA’s tax credits would be kept in place, unlike the House bill — but their value would be reduced.
  • Funds the ACA’s cost-sharing subsidies through 2019, but then repeals them.

Want more? Keep reading.

  • There’s a stabilization fund to help states strengthen their individual health insurance markets.
    • $15 billion a year in 2018 and 2019, $10 billion a year in 2020 and 2021.
    • There’s also a long-term state innovation fund, $62 billion over eight years, to help high-cost and low-income people buy health insurance.
  • The ACA tax credits continue in 2018 and 2019.
  • After that, they’d only be available for people with incomes up to 350 percent of the poverty line.
  • The “actuarial value” — the amount of the medical costs that insurance would have to cover — would be lowered to 58 percent, down from 70 percent for the ACA’s benchmark plans. That’s likely to reduce the value of the tax credits.
  • All ACA taxes would be repealed except for the “Cadillac tax” for generous plans, which would be delayed.
  • Medicaid spending growth rate under per capita caps would be same as House bill until 2025. Then it switches to the general inflation rate, which is lower than House bill.
  • States would be able to impose work requirements for people on Medicaid, except for the elderly, pregnant women and people with disabilities.
  • Children with complex medical needs would be exempt from the per capita caps.

Meet The Republican Men Reshaping Your Health Care

http://californiahealthline.org/news/meet-the-republican-men-secretly-reshaping-your-health-care/

Who are the GOP senators who worked on the American Health Care Act behind closed doors? You’ve likely heard they are all white men chosen by Majority Leader Mitch McConnell. Here are some of their vital stats that may have influenced the outcome.