ACA, healthcare legislation hot topics at AHA meeting

The 2017 meeting of the American Hospital Association (AHA) led off with an unsurprising topic: the legislation to repeal and replace the Affordable Care Act (ACA).  

The American Health Care Act (AHCA) was opposed by the AHA (along with many major medical associations), but it managed to pass the House of Representatives with one vote to spare the week prior to the meetings. In his May 8 remarks at the meeting, AHA President and CEO Rick Pollack called on the U.S. Senate to “reset” the discussion on the bill, arguing the version which passed the House would jeopardize the coverage gains made under the ACA.

“We believe that any legislation must be viewed through this lens—and carefully evaluated regarding its impact on both individuals and the ability of hospitals and health systems to care for all who walk through our doors,” Pollack said, according to a copy of his prepared remarks provided to HealthExec.

Among the provisions singled out by Pollack were protections for patients with pre-existing conditions. While the legislation maintains the ACA’s ban on insurers denying coverage based on medical history, states could waive requirements and allow the return of medical underwriting for individual customers, potentially pricing those with chronic conditions out of the individual market.

He also took issue with how the legislation would affect Medicaid—$839 billion would be cut from the program over the course of a decade, rolling back much of the program’s expansion under the ACA. While Pollack expressed concern about this loss of coverage, he also said the bill wouldn’t restore all of the lost disproportionate share hospital (DSH) payments the ACA took away, leaving hospitals on the hook for the expected rise in uncompensated care.

“If coverage is not maintained at the current level, those resources need to be returned to hospitals and health systems in order to provide services to what will likely be an increased number of uninsured Americans,” he said.

His remarks weren’t free of criticism of the ACA, noting the association has advocated for specific tweaks to the law. The AHCA doesn’t follow its recommendations for improvement, so Pollack said they’ll be pressuring for changes in the Senate, where the Republican majority is smaller and largely believed to be more moderate.

“The House bill is not consistent with our deeply held principles of providing coverage for those who need it and ensuring that the most vulnerable are not left behind,” he said. “That’s why the Senate must reject the House bill as a starting point.”