Republicans’ evolving views on repealing and replacing the Affordable Care Act mean an uncertain future for healthcare and poor patients, a panel of industry leaders said Wednesday at Edgewood College in Madison.
“The ACA isn’t perfect, but no legislation is,” said Dr. Frank Byrne, president emeritus of St. Mary’s Hospital.
“However, we have made progress and 20 million people who were uninsured now have coverage,” he said. He cited a Rand Corp. study that showed people who have “lousy or no health insurance” delay medical care and are worse off, requiring more costly treatments when they do seek care.
Byrne called Obamacare an “experiment.” He hopes Trump keeps an open mind to ACA changes and maintains the more popular provisions, including the requirement that health insurance companies accept people with pre-existing conditions and allow parents to keep children on the health insurance policies until they reach age 26.
But he said President-elect Trump’s choice of U.S. Rep. Tom Price, to head of the Department of Health and Human Services was disappointing, because the Georgia Republican had been one of the staunchest opponents of the ACA in Congress.
Worse, Byrne said Price – an orthopedic surgeon – is a “big fan of the disastrous” and expensive fee-for-service payment model and a member of the conservative Association of American Physicians and Surgeons, which Byrne said has advocated for the abolition of Medicare and Medicaid.
Price is also the author of Empowering Patients First Act, a Republican alternative to the ACA that includes tax deductions and credits to aid in the purchasing of health insurance, the promotion of state-based high-risk insurance pools and the creation of individual and small employer membership associations and association health plans.
Christine Kleckner, associate director of the Middleton Memorial Veterans Hospital in Madison, said she too is hopeful Trump will keep the better parts of Obamacare. But she warned of a big risk in dumping the ACA and “starting over with a completely new healthcare system because I worry about what will happen to the patients who fall in between the gaps.”
Phillip Rossing of Unity Health Insurance said the ACA is “broken and unsustainable,” and badly in need of repair. He said some sections of the country have only one Obamacare insurer, adding many companies are dropping out because the economic model is unprofitable.
He said positive parts of Trump’s tentative proposals include promotion of Health Savings Accounts, which would encourage people to take a greater role in managing the costs of their healthcare. But he worries that block grants to states to fund Medicaid may not be adequate to meet poor patients’ needs
Jonathan Lewis, vice president of operations at St. Mary’s Hospital, agreed that coverage for people with pre-existing conditions should stay in any new plan. And he lauded tentative proposals by Trump to have more transparency in insurance plans, which he said should help reduce costs.
“Clearly the president-elect’s background is business,” he said. “And what he’s promoting is market competition to have insurers compete for business to drive costs down. In an economic model, that makes a lot of sense.
“Unfortunately, what we’ve seen with the ACA… is a program that people aren’t trusting that it can work and provide benefits to them.”
He said the industry will be watching closely as Trump and Congress unveil their plans.
“We are a hospital, and we have a budget that’s based on a system that’s going to change in coming months,” he said. “We just don’t know. If nothing else, we are prepared to live with reality… and achieve the highest quality at the lowest cost.”
–By Brian E. Clark
–WisBusiness.com
