Report: ACA repeal could cost SJGH $50 million

STOCKTON — San Joaquin General Hospital stands to lose some $50 million a year if the Affordable Care Act is repealed, according to The California Association of Public Hospitals and Health Systems.

The estimate from the association is $40 million higher than what San Joaquin General Hospital chief executive officer David Culbertson reported to the Board of Supervisors last week.

The hospital receives a total of $290 million in funding annually, Culbertson said Thursday.

Culbertson noted, however, that the $50 million figure reflects only a repeal without a replacement program if that is enacted by the Trump administration.

“What we’re estimating to be done isn’t coming immediately,” he said. “There’s been a lot of talk and activity about what will happen, that (the discussion) has gotten to be so much different than when it first began.”

The association represents 21 of the state’s public health care systems, including county hospitals and the University of California medical centers.

It released a new report this week that outlines the impacts of a potential repeal on the state’s health care industry. It is urging lawmakers to ensure that, if repealed, the ACA is replaced with a program that provides the same level of benefits so citizens do not lose their health coverage.

In addition, the organization is asking that, in the event of a repeal, the Medicaid expansion created under the ACA be preserved.

Under provisions in the ACA, Medicaid was expanded to cover some of the nation’s more low-income residents as well as children.

Residents in all states can qualify for Medicaid based on income, household size, disability, family status and other factors.

In states with expanded coverage, like California’s Medi-Cal program, residents can qualify based on income alone if the household income is below 138 percent of the federal poverty level.

Since the ACA’s approval in 2010, Medi-Cal and Covered California have reduced the uninsured rate from 17.2 percent to 7.7 percent, according to the hospital association.

Since 2014, San Joaquin General has become the primary care provider to 23,900 people who gained Medi-Cal insurance. Primary care visits to the hospital also increased by 53 percent, the association reports.

If the ACA is repealed with no replacement program, those newly insured residents could lose health coverage.

Across San Joaquin County, the association estimates that 66,000 residents would lose health coverage, and as many as 4,000 health care workers would lose their jobs.

At SJGH alone, the job loss would be about 200, Culbertson said. The hospital has 1,552 positions, both full-time and part-time, according to the county’s budget.

The association said California’s uninsured rate could double to more than 17 percent and estimates a $16 billion loss in federal revenue if the ACA and Medicaid expansion are repealed. There would be another $5 billion lost with the elimination of tax subsidies for Covered California enrollees.

In addition, the association expects some 200,000 Californians would lose their jobs.

According to the University of California Berkeley Center for Labor Research, some 135,000 of those jobs lost across the state would be in the health care industry with only a partial repeal of the ACA.

Another 8,000 would be lost in the restaurant hospitality industry. The Real Estate and insurance industries would both lose an estimated 6,000 jobs. The employment services industry would lose some 5,000 jobs.

“No matter what happens, San Joaquin General will continue to evolve and meet the needs of the community in the most cost-effective way it can,” Culbertson said.

Congressman Jeff Denham, R-Turlock, has been a vocal opponent of the ACA, but his office said he had not seen this report.

He will be meeting with constituents in his district, which includes Escalon, Manteca, Ripon and Tracy and much of southern San Joaquin County, late next week to hear their concerns about health care.