MHA Urges House Members to Vote No on ACA Replacement

Released on 03/22/2017

For Immediate Release

Contact: Jeffrey Austin, 207-622-4794
March 22, 2017
 

MHA Urges House Members to Vote No on ACA Replacement

 
The Maine Hospital Association (MHA) today urged Maine’s members of the U.S. House of Representatives to vote against the American Health Care Act (AHCA), saying the legislation is bad for Maine hospitals and their patients. 
 
“In its current form, the AHCA doesn’t address the affordability and access problems in the Affordable Care Act (ACA).  In fact, it makes things much worse,” said MHA President Steven Michaud, adding that amendments to the legislation made Monday night did nothing to alleviate MHA’s serious concerns about the legislation.
 
MHA has four primary observations about the bill, three of which are strong objections:
  • Hospital Cuts Must be Addressed in the AHCA – There were four sources of federal revenue, including cuts in Medicare rates to hospitals, that were used to finance the ACA.  The AHCA keeps those hospital cuts in place despite reductions in ACA benefits.  However, the AHCA cuts all three of the other sources of financing. 
“This is absolutely unfair, unbalanced and unacceptable,” Michaud said, adding that the cuts to Medicare were made because it was assumed hospitals would have more insured patients under the ACA and, therefore, have less bad debt or patients who needed charity care, so their overall costs would drop.  “Maine hospitals have already been hobbled under the ACA because the state has failed to expand Medicaid, so we still have patients who are unable to pay their bills.  Because the AHCA will likely increase the number of uninsured people in Maine, we will have thousands more patients who can’t pay their bills.” 
 
The other sources of revenue were penalties imposed on people who failed to buy health insurance; fees and taxes on insurance companies and employers and taxes on higher-income individuals. 
 
“If the federal government is going to cut its ACA-related revenue by $800 billion over the next ten years, some of that savings should be returned to hospitals,” Michaud said.  “Hospitals shouldn’t be the only group locked out of relief.”
 
  • Broader Medicaid Reform Must be Removed from the AHCA – The AHCA would completely rework the Medicaid program, not just Medicaid expansion.  There is no reason to include reform to the broader Medicaid program in this bill. 
“There simply hasn’t been time, or hearings or debate devoted to this initiative,” Michaud said.  “Medicaid wasn’t dramatically reworked by the ACA.  The entire “per capita cap” proposal should be deleted from this legislation and saved for another bill that goes through the regular legislative process.”
 
  • The AHCA Tax Credit Substitute is Inadequate – The Congressional Budget Office (CBO) projects that market coverage for younger and wealthier individuals would increase and coverage for older and poorer individuals would drop as a result of the restructured subsidies (tax credits) to purchase insurance on the exchanges.  This hurts Maine, which has a population that is older and poorer than the national average.
“We appreciate that the proposed tax credits are available to far more people, both the very poor and the upper middle class, than were the subsidies under the ACA,” Michaud said.  “However, while enticing younger and healthier people into the market is a goal, it only really helps if they balance out older and poorer enrollees—who will need to seek care, whether they have insurance or not.  It is not much of a help to Maine hospitals if coverage increases among the younger and wealthier and healthier (who consume relatively less care) at the expense of coverage among the older and sicker. 
 
“It’s not like people stop being sick when they lose their insurance,” Michaud said.  “But what they do is delay care until it becomes a crisis—a crisis that shows up at our hospitals.  In addition to needlessly subjecting Mainers to more suffering, it’s just bad healthcare business.  It raises costs to all of us, insured or not.”
 
  • Keeping Other Provisions is Appreciated – There were provisions in the ACA that should be preserved and which the AHCA largely does preserve.  Those provisions deal with coverage issues such as maintaining children on parents’ plans until age 26 and providing a system to allow those with pre-existing conditions to be guaranteed coverage.
 “We realize that the ACA needs changes to strengthen the insurance market,” Michaud said.  “But these changes hurt Mainers and they hurt hospitals.  Our hospitals are in very precarious financial positions.  We can’t afford the changes in the AHCA as it is now written.  Our patients can’t afford the AHCA.  We ask that Representatives Pingree and Poliquin vote against this legislation.”
 
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