Affordable Care Act Archives - Page 2 of 16 - Safety-Net Association of Pennsylvania

ACA Repeal Would Drive Up Uninsured, Uncompensated Care

At the same time that the Trump administration announced that it has asked a federal court to repeal the entire Affordable Care Act, the Urban Institute has published a report detailing the potential impact of the health care reform law’s repeal.

According to the Urban Institute report, repealing the entire Affordable Care Act would add almost 20 million Americans to the ranks of the uninsured. Medicaid and CHIP enrollment would fall by 15.4 million people and millions of others would lose the tax credits they used to purchase insurance. Some would purchase insurance with limited benefits and individual plan premiums would rise while others would go uninsured.

In addition, repeal of the Affordable Care Act would lead to an 82 percent increase in hospital uncompensated care, to more than $50 billion. About half of the states would see the amount of uncompensated care provided by their hospitals double, the Urban Institute estimates.

Repeal of the Affordable Care Act would pose an especially great financial challenge for Pennsylvania safety-net hospitals because they care for so many Medicaid- and CHIP-covered and low-income patients who might lose their coverage if the reform law is repealed. About 700,000 new people have enrolled in the state’s Medicaid program since the state implemented the Affordable Care Act’s optional Medicaid expansion.

Learn more from the Healthcare Dive article “Killing ACA would lead to huge spikes in uncompensated care” and from the Urban Institute report State-by-State Estimates of the Coverage and Funding Consequences of Full Repeal of the ACA.

PA Safety Net Admin2019-03-28T06:00:09+00:00March 28th, 2019|Affordable Care Act, Federal Medicaid issues, Pennsylvania safety-net hospitals|Comments Off

MACPAC: Slow Medicaid DSH Cuts

Slow the pace of scheduled cuts in Medicaid disproportionate share hospital payments (Medicaid DSH), the non-partisan agency that advises Congress and the administration will tell Congress in its next report of policy recommendations.

The Medicaid and CHIP Payment and Access Commission voted 16-1 recently to recommend to Congress that Medicaid DSH cuts, mandated by the Affordable Care Act but delayed three times by Congress, be reduced in size and spread out over a longer period of time.

Currently, Medicaid DSH allotments to the states are scheduled to be reduced $4 billion in FY 2020 and then $8 billion a year in FY 2021 through FY 2025. MACPAC recommends that the cuts be reduced to $2 billion in FY 2020, $4 billion in FY 2021, $6 billion in FY 2022, and $8 billion a year from FY 2023 through FY 2029.

MACPAC commissioners also voted to urge Congress to restructure the manner in which Medicaid DSH allotments to the states are calculated based on the number of low-income individuals who reside in the states.

Most Pennsylvania safety-net hospitals receive Medicaid DSH payments and consider them a vital resource in helping to underwrite the uncompensated care they provide to uninsured patients.

MACPAC is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide array of issues affecting Medicaid and the State Children’s Health Insurance Program.

Learn more about MACPAC’s actions on Medicaid DSH in the Fierce Healthcare article “MACPAC calls for Congress to delay cuts to safety-net hospitals.”

PA Safety Net Admin2019-02-04T06:00:11+00:00February 4th, 2019|Affordable Care Act, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania safety-net hospitals|Comments Off

The Continued Need for Medicaid DSH

While the Affordable Care Act has greatly increased the number of Americans with health insurance and reduced the demand for uncompensated care from hospitals, many hospitals still see significant numbers of uninsured patients.
Some of those patients simply have not taken advantage of the health reform law’s creation of easier access to affordable insurance while others live in states that have not expanded their Medicaid programs.
Hospitals that care for especially large numbers of such uninsured patients qualify for Medicaid disproportionate share hospital payments, commonly referred to as Medicaid DSH. The purpose of these payments is to help these hospitals with the unreimbursed costs they incur caring for such patients.
The Affordable Care Act calls for reducing Medicaid DSH payments to hospitals. Many hospitals and hospital groups oppose this cut and are asking Congress to block its implementation. Pennsylvania’s safety-net hospitals benefit considerably from Medicaid DSH payments.
The Commonwealth Fund recently published a commentary calling for delaying scheduled Medicaid DSH cuts. Go here to see the article “Keep Harmful Cuts in Federal Medicaid Disproportionate Share Hospital Payments at Bay.”

PA Safety Net Admin2017-12-27T06:00:23+00:00December 27th, 2017|Affordable Care Act, Federal Medicaid issues, Medicaid supplemental payments|Comments Off

Wolf Asks Ryan to Preserve Medicaid Expansion

In a letter to House Speaker Paul Ryan, Pennsylvania Governor Tom Wolf urged Congress, no matter how it addresses the Affordable Care Act, to preserve that law’s expansion of access to Medicaid-covered health care services.
The governor specifically pointed to the many people who receive substance abuse treatment through those services.

If the Affordable Care Act, or Obamacare, is repealed and not replaced, over a million Pennsylvanians could lose access to health care and tens of thousands of people – people who are our friends, our neighbors, and our family members that are currently receiving treatment for a substance use disorder – would lose insurance coverage and no longer be able to afford their treatment.

See Governor Wolf’s complete letter to House Speaker Ryan here.

PA Safety Net Admin2017-02-15T06:00:28+00:00February 15th, 2017|Affordable Care Act, Uncategorized|Comments Off

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its January 2017 newsletter.
Included in this edition are stories about:

impending changes in the lineup of managed care providers that serve Medicaid participants in the state’s HealthChoices program for physical health services;
the status of the state’s implementation of its Community HealthChoices program of managed long-term services and supports for low-income, elderly Pennsylvanians who seek to continue living independently in the community;
the potential impact of a repeal of the Affordable Care Act on Pennsylvanians; and
Pennsylvania’s receipt of a Certified Community Behavioral Health Clinic demonstration grant from the federal government to improve services and care coordination for individuals on Medicaid or CHIP.

Go here for the latest edition of PA Health Law News.

PA Safety Net Admin2017-02-08T17:39:17+00:00February 8th, 2017|Affordable Care Act, HealthChoices PA, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

Who’s Still Uninsured?

Hispanics.
Young people between the ages of 19 and 34.
Men.
Low-income people, especially those living in states that have not expanded their Medicaid programs.
People in the South – again, especially those living in states that have not expanded their Medicaid programs.
Those who work for small companies.
The uninsured rate in the U.S., 20 percent before the Affordable Care Act took effect, is now 13 percent.
Learn more about how the Affordable Care Act has changed the rate at which different groups of Americans are insured in this Commonwealth Fund survey.

PA Safety Net Admin2016-08-29T06:00:54+00:00August 29th, 2016|Affordable Care Act|Comments Off

ACA Slowly, Surely Improving Health Status

A new survey has found that the combination of Affordable Care Act-driven enhanced access to health insurance and improved performance by health care providers is producing better health status in communities across the U.S.
The survey looked at health status in 306 regional health care markets based on factors such as access to care, quality, avoidable hospital use, health care costs, and health outcomes found modest improvements in these areas and attributed those improvements to expanded access to health insurance and government quality programs introduced through the Affordable Care Act. The gains the survey documented occurred from 2011 through 2014.
To learn more about how the survey was administered and what it found and to see and compare health status in individual communities, go here to read the Commonwealth Fund report Scorecard on Local Health System Performance.

PA Safety Net Admin2016-07-21T06:00:22+00:00July 21st, 2016|Affordable Care Act|Comments Off

Medicaid Expansion Producing Benefits for Safety-Net Providers

Seeing fewer uninsured patients, safety-net hospitals in states that have expanded their Medicaid programs as provided for under the Affordable Care Act are finding themselves able to use money previously caring for the uninsured for things like more and better primary and behavioral health services, more staff, new or improved health centers and clinics, and better equipment.
This conclusion is drawn in a new study from the Georgetown University Health Policy Institute based on interviews with leaders of eleven hospital systems and federally qualified health centers (FQHCs) in seven states: four that expanded their Medicaid programs and three that did not.
While Pennsylvania was not one of the states included in the study, it is one of more than 30 states that has expanded its Medicaid program.
To learn more about what the study revealed, go here to read Beyond the Reduction in Uncompensated Care: Medicaid Expansion is Having a Positive Impact on Safety Hospitals and Clinics.

PA Safety Net Admin2016-06-21T06:00:03+00:00June 21st, 2016|Affordable Care Act, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

Fewer People Skipping Care for Financial Reasons

Fewer Americans are choosing not to pursue medical care for financial reasons, according to new information from the Centers for Disease Control and Prevention.
According to the CDC’s National Health Interview Survey, 4.5 percent of the people surveyed reported not getting medical attention they needed for financial reasons in 2015, down from 6.9 percent in 2009 and 2010.
This suggests that the Affordable Care Act’s changes in providing access to health insurance are making a different in the ability of people to get the care they believe they need.
Prior to the reform law’s passage, the proportion of people reporting that they chose not to seek care for financial reasons had been rising steadily since 1998.
This is good news for Pennsylvania safety-net hospitals, which often must deal with the medical and financial implications of serving especially large numbers of patients who, for financial reasons, have had limited and sporadic contact with the health care system over the years.
To learn more about the survey’s findings see this CQ HealthBeat report presented by the Commonwealth Fund and go here to see the CDC report Early Release of Selected Estimates Based on Data From the 2015 National Health Interview Survey.

PA Safety Net Admin2016-06-06T06:00:03+00:00June 6th, 2016|Affordable Care Act, Pennsylvania safety-net hospitals|Comments Off

Affordability a Challenge for Many Newly Insured

Many Americans who have obtained private health insurance through the Affordable Care Act continue to have problems affording health care.
According to a Kaiser Family Foundation report based on focus groups six states, low-income individuals with new private insurance report continued problems with:

medical debt
affording care that is not covered by their insurance plans
handling out-of-pocket expenses, including deductibles
unexpected bills for treatment they thought was covered

Such patients pose a challenge for many Pennsylvania safety-net hospitals because of their inability to afford their co-pays and deductibles, leaving these hospitals with unexpected uncompensated care and bad debt. Because they care for more low-income patients than the average hospital, this is a bigger problem for the state’s safety-net hospitals.
For a closer look at how the study and focus groups were conducted and what they found, go here for the Kaiser Family Foundation report Is ACA Coverage Affordable for Low-Income People? Perspectives from Individuals in Six Cities.

PA Safety Net Admin2016-05-11T06:00:32+00:00May 11th, 2016|Affordable Care Act, Uncategorized|Comments Off

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