“Elections have consequences,” said Ken Raske, President of the Greater New York Hospital Association at the December 9th meeting of the WCA Healthcare Advisory Board. With the threat of a repeal of the Affordable Care Act (ACA aka “Obamacare”) without an immediate replacement plan, Raske and others in the healthcare industry are predicting dire consequences. “The level of uncertainty is the highest I’ve ever seen in my career. I am deeply, deeply troubled.”
Ken Raske, President of the Greater New York Hospital
Association, Amy Allen, WCA, and Guy Liebler, Chairman
of the WCA Healthcare Advisory Board
One of Raske’s biggest concerns is that when and if the ACA is repealed as President-elect Donald Trump promised during his presidential campaign, the impact on New York State could be severe. There could be massive service cuts, hospital closures, and layoffs. According to the American Hospital Association, if the ACA’s Medicare reductions are maintained, hospitals will suffer additional losses of $289.5 billion over ten years from reductions in their inflation updates. And as the ACA has promoted an increased focus on quality of care and population health management, that, too is threatened.
“In New York, we face the possibility that 700,000 people will lose coverage and that there could be a dire impact on the New York State budget to the tune of billions of dollars,” he warned. “The series of cuts to hospitals across the country could amount to over half a trillion dollars over the next ten years, according to a recent study. If you get rid of the ACA, you shoot yourself in the head.”
Raske predicts that if the ACA is repealed, which he believes is probable in the first hundred days of the new Administration, Congress will suggest phasing Obamacare out over a two- to three-year period, and crafting a replacement by 2019. This, he says, however, will be problematic. “It will lead to paralysis and investment will dry up. We won’t get a fraction of these dollars back in the next two to three years.”
He also noted that repealing the ACA could have a huge impact on the entire community, including business. “Our industry is the largest employer in the nation and this will have a ripple effect on everything,” he said. “Washington talks about saving jobs, well what about the businesses that manufacture scanners, or medical supplies, or those vendors who launder sheets and towels? The business community has as much at stake as we do. Congress needs to go into this with eyes wide open. Repeal of the ACA could freeze the economy.”
He urged business to join with the healthcare community to advocate for an immediate replacement for the ACA, should it be repealed. “We cannot wait,” he said. “Our representatives in Congress need to understand fully the impact.”
Hospital trade groups are suggesting that a replacement option should not only ensure expanded insurance coverage, which is especially important to low- and moderate-income Americans, but restoring Medicare hospital inflation updates and disproportionate share hospital payments that were cut to offset coverage gains under the ACA. They also want to retain two of the more popular provisions of the ACA, which allows people under the age of 26 to remain on their parents’ health insurance, and the requirement that health insurers cannot refuse coverage to those with pre-existing conditions.
This might be a challenge as the ACA is hugely complex and many have not mastered the details. “The devil is in the details,” he cautions.
Raske believes that nimbleness and agility will be essential in the future of the healthcare system and our ability to act quickly with this variable set of circumstances.
“This industry is a great industry. It does an enormous about of good and provides economic value. It could go down in flames if we don’t act immediately. We need to make our case and make it thoughtfully.”