Tenn. health group: ‘Serious concerns’ about GOP proposal
Hospital association joins others nationwide
KNOXVILLE - The Tennessee Hospital Association has joined other hospital groups nationwide in expressing concerns about the American Health Care Act Republicans have proposed to replace the Affordable Care Act.
THA President and CEO Craig Becker issued a statement Friday saying the new proposed legislation “presents more potential challenges to hospitals.”
“Primarily, we believe a significant number of the roughly 230,000 Tennesseans currently covered could lose their coverage because of an inability to pay for insurance due to significantly reduced federal subsidies” currently available through the ACA, Becker said.
He said THA, which represents 137 hospitals across the state, views the greater state control of Medicaid the new plan proposes as “a potentially positive move” but sees challenges and increased financial risk to states, including Tennessee, under a per capita funding model. The proposal does not make clear exactly how that model will be funded, or how much states will receive, Becker said.
“We must ensure Medicaid enrollees continue to receive comprehensive and adequate benefits with fair reimbursement to providers for health care services,” Becker said. “The current proposal stands to make achieving these goals a major obstacle.”
THA has advocated for “statebased” expansion of TennCare/Medicaid, and in 2014 said it would help fund Gov. Bill Haslam’s plan for alternative Medicaid expansion. Haslam’s Insure Tennessee plan, which went before legislators multiple times without passing, included a tax on hospitals that would have covered the state’s responsibility for paying for expansion as federal payments gradually decreased.
Becker said a “top priority” for THA is the instability of the insurance marketplace in Tennessee, where over the past two years one insurance co-op failed and multiple larger insurers have withdrawn their ACA Marketplace participation. In a state where coverage is already “limited” in many areas and there’s no guarantee of future participation by insurers, Becker said, the proposed American Health Care Act jeopardizes Tennesseans’ ability to get health insurance.
“Tennessee hospitals each year provide nearly $2 billion in services to the uninsured,” Becker said. “When coupled with significant cuts to reimbursement from the ACA — which remain in the AHCA proposal — this presents a dark forecast for the future of hospitals in Tennessee, especially our rural and safety-net facilities.”
Since 2013, at least eight rural Tennessee hospitals have closed or merged, although five of those have been replaced by other satellite campuses of health systems or other clinics that provide some, but not all, the services an inpatient facility did.
On Wednesday, the association for “safety net” hospitals that provide services to the lowest-income residents, including the uninsured, wrote to House committee leaders to voice their concerns about the American Health Care Act — specifically, that the Congressional Budget Office has not yet estimated the effect the bill would have on health care costs and the uninsured rate.
The same day, the American Hospital Association and other associations representing virtually every type of hospital — including children’s hospitals, psychiatric hospitals and Catholic hospitals — wrote to members of Congress to voice their opposition to the proposal. Their letter predicted “tremendous instability for those seeking affordable coverage.”
Becker said health care in America is complex, making “crafting a viable and effective” plan a difficult task.
“However, federal lawmakers must find ways to provide health care coverage to Americans while ensuring such a solution supports the viability of hospitals and other providers, especially those in rural areas,” he said.