Editor's note: This story has been updated.
Senate Republicans' efforts to repeal and replace the Affordable Care Act appear to have reached a dead end, but industry stakeholders on Tuesday stressed that the need for health care reform has not passed and urged lawmakers to work together on a plan to bolster the U.S. health care system and protect the individual market.
Providers and provider groups: 'Repeal-and-delay' is not the answer; bipartisanship could be
American Medical Association President David Barbe in a statement said, "Congress must begin a collaborative process that produces a bipartisan approach to improve health care in our country." He said, "Near-term action is needed to stabilize the individual/nongroup health insurance marketplace," adding, "In the long term, stakeholders and policymakers need to address the unsustainable trends in health care costs while achieving meaningful, affordable coverage for all Americans."
American Hospital Association President and CEO Rick Pollack in a statement criticized the Senate's plan to vote on a "repeal-and-delay" measure. Instead, Pollack said, "Our hope is that the Senate will use this opportunity to regroup and work in a bipartisan manner to make the much-needed repairs and refinements, creating a health care system that can stand the test of time."
Association of American Medical Colleges President and CEO Darrell Kirch in a statement said his organization has maintained that an ACA repeal "must be accompanied by a simultaneous replacement that provides at least comparable health care coverage," adding, "Any health care reform legislation must put patients first by maintaining or improving current levels of coverage."
America's Essential Hospitals President and CEO Bruce Siegel in a statement said his organization "welcome[s] Senate leaders' decision to pull back the [BCRA]," but added that the repeal-and-delay plan "is not the way to protect coverage and almost certainly would jeopardize care for people who face financial hardships." Siegel said, "We hope lawmakers seize on this opportunity to bring all stakeholders to the table and develop a plan to protect coverage for everyone—especially those in greatest need."
Catholic Health Association of the United States President and CEO Sister Carol Keehan in a letter to senators wrote, "I strongly urge you to start anew in an open dialogue and bipartisan effort to improve health care coverage in our country. We believe that this moment calls for statesmanship on the part of both political parties to work together to make the improvements in our health care system that will stabilize the individual insurance market, improve affordability, and strengthen and expand the coverage gains already achieved."
Hospital executives also raised concerns about the new uncertainty surrounding health reform and its potential effect on the individual insurance market and uninsured population.
John Jurenko, vice president of government relations at NYC Health & Hospitals, said he was relieved the Senate abandoned the BCRA, which he said would have "ended Medicaid as we know it." But that the industry needs to remain "vigilant" as the health reform debate continues.
Denver Health CEO Robin Wittenstein said any increase in uninsured "would have a devastating effect" on hospital finances.
Insurer reaction: It's time to resolve uncertainty around CSRs, individual mandate
For their part, insurers said the uncertainty surrounding health reform efforts and the future of the Affordable Care Act's cost-sharing reduction (CSR) payments need to be resolved soon. The administration, so far, has yet to say whether it will continue the CSR payments, which are due to be made this Thursday.
John Baackes—CEO of L.A. Care Health Plan, which sells both Medicaid and exchange coverage plans—said insurers "can't operate" with all the uncertainty. "We have to make business decisions here, and it's like, 'is it going to be A or B?'"
Jerry Dworak—CEO of Montana Health Co-op, a not-for-profit offering exchange plans in Montana and Idaho—said President Trump could "destroy Obamacare" by stopping the CSR payments. He said without the payments the insurer would have to increase premiums by about 20 percentage points.
Meanwhile, others, such as University of Pittsburgh Medical Center Health Plan CEO Diane Holder, said they want more clarity around how the administration will enforce the individual mandate.
Justine Handelman, senior vice president for Blue Cross and Blue Shield Association, said, "We have consistently urged that there be immediate, certain funding for the cost-sharing reduction program, which helps those most in need with out-of-pocket costs when they access medical care, and other actions to stabilize the market including dedicated funding to care for those with significant medical needs" (Wilde Mathews/Evans, Wall Street Journal, 7/18; Gooch, Becker's Hospital Review, 7/18; Lee, Modern Healthcare, 7/18; Demko/Dawsey, Politico, 7/18; Tracer, Bloomberg, 7/18; Fox Business, 7/18; American Medical Association statement, 7/18).
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