With Republican efforts to repeal and replace Obamacare in disarray, several healthcare-provider organizations are calling on Congress to set aside party rancor and cut a bipartisan deal on healthcare reforms.
"The best approach would be for Congress members to reach across the aisle and address some of the specific problem areas of the Affordable Care Act," Elizabeth "Betsy" Ryan, JD, president and CEO of the New Jersey Hospital Association, told HealthLeaders today.
"To me, letting Obamacare fail would be a dereliction of government’s responsibility to the people. This is not just a political fight to be won—these are real people, real families, whose healthcare is at stake."
Partisan congressional approaches to repealing, replacing, or repairing the PPACA are likely destined for the scrapheap, Nicholas Schilligo, MS, vice president of public policy at the Chicago-based American Osteopathic Association (AOA), told HealthLeaders today. "Any meaningful solution is going to require bipartisan discussion, including hearings that thoroughly examine and vet a lot of the issues that are going to be put forward."
This past weekend's collapse of the Senate's Obamacare repeal-and-replace bill, the Better Care and Reconciliation Act (BCRA), prompted Majority Leader Mitch McConnell to call on his Senate colleagues to pass repeal-only legislation. The Kentucky Republican's repeal-only plan includes a two-year grace period to give Congress time to craft a replacement for the Patient Protection and Affordable Care Act (PPACA).
McConnell's repeal-only proposal would land a crushing financial blow on healthcare providers, Ryan says.
"A repeal of the ACA without an adequate replacement would be devastating. Hospitals and other healthcare providers conceded billions of dollars in federal funding under the ACA, because they knew those reductions would be balanced by more insured patients. If we lose both—federal funding and healthcare coverage—it would be unsustainable for our healthcare system, and that would impact all of us."
Allowing the Obamacare insurance exchanges to collapse would also have a negative impact on healthcare providers and patients, Schilligo says. "It would be devastating to patients, hospital systems, and physicians. It would be a huge step backward from where we were and where we have gone. De-stabilizing the insurance market would compromise patients' access to care that they need to resolve their comprehensive and complex healthcare needs."
Congress should take action as quickly as possible to stabilize the PPACA exchanges, Herb Kuhn, president and CEO, of the Missouri Hospital Association, told HealthLeaders today.
"Although the ACA's marketplace is fragile—Missouri was one of a handful of states that could have had 'bare' counties in 2018—it is functioning. Most other aspects of the law are working; although there are holes, including 19 states that have opted out of Medicaid expansion. Nonetheless, failure could occur—by not addressing the marketplace subsides, not enforcing the individual mandate, or indifference to other aspects of the law."
Following the collapse of Republican-senator support BCRA, President Donald Trump's renewed calls to take no action on the Obamacare exchanges and allow the individual insurance market to implode are misguided, Kuhn says.
"What's certain is that, absent repeal, the ACA's demise is unlikely to occur overnight. If the ACA is destined to collapse, it could be a long and excruciating end with millions of Americans sharing the pain."
Christopher Cheney is the senior clinical care editor at HealthLeaders.