Healthcare News & Insights

ACA repeal fails: What’s next for health care & hospitals?

The Affordable Care Act (ACA) saga continues. Two recent efforts to repeal the bill have failed to get enough support to go forward, but its future still remains uncertain, leaving hospitals in limbo. 

Earlier this summer, Republicans crafted their second piece of legislation designed as a replacement for the ACA. But the bill, the Better Care Reconciliation Act, couldn’t get enough votes from party members to advance.

Citing concerns from their constituents about losing insurance coverage if the law was passed, several Republican senators said they couldn’t vote for the bill – and every vote was needed.

According to an article in the New York Times, as a last-ditch effort to get rid of the ACA, Majority Leader Sen. Mitch McConnell proposed another bill designed just to repeal the ACA, without any replacement legislation behind it.

This tactic received even less support than the previous two bills did, with at least four Republicans publicly saying they refused to vote for an ACA repeal that didn’t come with a replacement law.

Now both options have been tabled, and Donald Trump has pledged to allow the ACA to “fail” on its own instead of directly repealing the law.

This could mean several things: The government could refuse to fund existing subsidies, stop advertisements that remind people to purchase insurance coverage and stop enforcing the mandate that requires Americans to have health insurance.

Unclear future

By leaving the ACA to its own devices, Trump said his goal would be to force Democrats to work with Republicans and find a solution for the rising costs of premiums and other issues with the existing law.

Not surprisingly, many are unhappy with this approach. If subsidy payments aren’t guaranteed, costs could skyrocket for consumers, leaving many with no way to purchase insurance. And more payors could leave the marketplace, which means fewer options for patients in the market for plans.

The ripple effect of this inaction would be felt in hospitals, too, as more uninsured patients could cause uncompensated care costs to rise, making a significant impact on facilities’ bottom lines.

Insurance rates for 2018 are set to be published in August by the Centers for Medicare & Medicaid Services (CMS), according to an article in the Washington Post. Payors on the healthcare exchange must sign contracts with the government by the end of September so plans can start enrollment in November.

At this point, most payors and patients want clarity around what’s to come from healthcare reform, and besides the fact that no new laws are currently in the works, nothing’s certain. For now, hospitals must wait and see what’s coming down the pike. We’ll keep you posted.

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