Health care reform could cost region $2B

Study is released by 2 hospital groups as Senate works on bill.

The current version of health care reform Congress is considering would cost the 11-county region served by the Greater Dayton Area Hospital Association billions, according to a new study.

The bill as it stands would mean more than $2 billion less in Medicaid spending in the region over the next decade and close to $300 million in uninsured costs for 29 area hospitals, according to a joint study by GDAHA and the

American Hospital Association.

Bryan Bucklew, president and chief executive of GDAHA, says those problems are reasons why U.S. Rep. Mike Turner, R-Dayton, voted against the bill in the House last month, and why he hopes Sen. Rob Portman will stand against the bill being crafted in the Senate.

In the past, Portman has expressed misgivings about the bill, saying he can’t support the version passed by the House.

“We really hoping Sen. Portman listens to us also,” Bucklew said Tuesday.

In early May, the House passed its version of a bill to repeal and replace the Affordable Care Act, also known as “Obamacare.” The Senate is working on its own version of the bill now, and media reports Tuesday said the Senate could vote on it as early as next week.

Little is known at this point about the Senate’s version of the legislation. Broadly speaking, the House bill would do away tax penalties for people who choose not to get health insurance, and it would pull back state expansions of Medicaid, including Ohio’s. Ohio Gov. John Kasich has urged opposition to the bill.

Instead of government-subsidized insurance policies offered on ACA “marketplaces,” the House-passed bill would offer tax credits of $2,000 to $4,000 a year.

The 10-year impact — from fiscal year 2017 to fiscal 2026 — of the replacement bill, called the “American Health Care Act,” would hit Montgomery County especially hard, Bucklew said.

“We’re trying to deal with this opioid issue,” he said. “The state government, the federal government is asking us to be more engaged, to provide more services, more detox. A lot of this is funded through that Medicaid and through that Medicaid expansion.”

Having said that, Bucklew readily acknowledges there are problems with the status quo in health care.

“Everybody agrees that the individual insurance market is not working well,” he said. “It needs to be fixed. But it’s less than 7 percent of the entire health care population.”

The rising premiums that attract so much attention are generally within that individual market, he said.

He added, “We’re very supportive of trying to find solutions to that.”

Deborah Feldman, president and chief executive of Dayton Children’s Hospital, is concerned about how the new legislation might affect children, especially with any revision of Medicaid. Of 2.4 million children in Ohio, half are covered by Medicaid, she said.

Similarly, half of the children who visit Dayton Children’s are covered by Medicaid, she said.

“Our great fear here is that in all the discussion and debate around concerns about the Affordable Care Act, at no point have you heard anything in relation to kids,” she said.

Messages seeking comment were sent to or left with the offices of U.S. Reps. Warren Davidson, R-Troy, and Jim Jordan, R-Lima, who voted for the AHCA, as well as Portman. A message was also left for Turner, who voted against the AHCA last month.

Republicans generally have long criticized Obamacare for, they say, making premiums and deductibles less affordable and giving health care consumers fewer options.

After Davidson voted for the AHCA last month, he released a statement saying in part that its passage “marks an important step forward towards fixing our broken health care economy. Reforms to Medicaid, work requirements for able-bodied adults, and defunding Planned Parenthood are no small victories. Americans are actively suffering under Obamacare and this bill brings much-needed and long-promised relief.

“House Republicans must remember that the AHCA is just the first step,” Davidson added in that statement. “The AHCA deals with the individual market; it does not directly address the way most Americans access health care coverage.”

After his vote against the bill on May 4, Turner released a statement saying in part, “This bill will leave our most vulnerable citizens with inadequate health coverage. I cannot support a health plan to replace Obamacare that puts my constituents’ health benefits at risk.”

Pamela Morris, CEO of CareSource, was among 10 executives who sent letters to senators on Tuesday reinforcing the impact the proposed reforms would have on Medicaid. CareSource is a Dayton-based nonprofit that manages one of the nation’s largest Medicaid managed care plans.

GDAHA represents hospitals in Auglaize, Butler, Darke, Champaign, Clark, Greene, Miami, Montgomery, Preble, Shelby, and Warren counties.