ACA Replacement Could Jeopardize Safety Net Hospitals

Philip Betbeze, February 13, 2017

Although the 2015 Obamacare repeal plan would have restored cuts to the DSH, the 2015 plan's proposed coverage losses would still have left these hospitals significantly worse off.

'Unsustainable Losses'
"These numbers really show what's at stake for the patients who depend on the doors being open at essential hospitals," said Bruce Siegel, MD, MPH, president and CEO of America's Essential Hospitals, in a media release.

"These are unsustainable losses that would jeopardize vital services and access to care in communities across the country."


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Many of the association's members operate on zero margin already, and that they provide about 20% of the uncompensated care nationwide, Siegel said.

Anything less than a comprehensive replacement immediately upon a repeal of the ACA would put members in severe financial difficulty, he said.

The association's policy brief advises legislators and policymakers to adhere to the following:

  • Policymakers must pair any repeal of the ACA with a simultaneous, comprehensive replacement.
  • If policymakers repeal the ACA without an immediate replacement, they must also repeal the act's steep cuts to hospital payments.
  • In any scenario, coverage must be maintained during the transition to a replacement plan.

If Congress has neither replaced the ACA nor restored the hospital cuts by the October 1, 2017, start of fiscal year 2018, it must delay for two years the Medicaid DSH cuts scheduled to start in FY 2018, according to the brief.

Philip Betbeze

Philip Betbeze is the senior leadership editor at HealthLeaders Media.

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