Uncertainty lingers for medical professionals as legislators work on a healthcare reform solution. How would the death of Obamacare affect hospitals? Will Medicare and Medicaid spending be cut or only capped on future growth? Is moving to a single-payer healthcare system a possibility in the near future? We examine these questions that are on the minds of healthcare leaders and finance officers in detail.

As healthcare reform continues to take shape, questions about Medicaid spending and single-payer healthcare emerge.

“If you take a million people who are currently insured and phase them out over a couple years you’re going to cause severe problems to those providing them care.”

How Will Healthcare Reform Affect the Poorest Populations?

Could the Senate’s latest health reform efforts cut funding for low-income Americans? Critics of the bill say yes. Stat News reports that the major hospital associations, including the American Hospital Association (AHA), the Federation of American Hospitals (FAH), and America’s Essential Hospitals – criticize the latest reform efforts. Furthermore, both the FAH and AHA called for the Senate to completely scrap this bill and start over from scratch.

Those who oppose the Senate draft include lobbyists that represent healthcare providers from all over the country including rural community hospitals and inner-city safety-net hospitals. The article from Stat News explains how the disabled and low-income populations could be affected by the repeal of the ACA: “Hospitals focused their concerns on proposed cuts to the Medicaid program, which currently provides health insurance to some 73 million low-income and disabled Americans. The House bill slashed hundreds of billions in federal spending for the program, and the Senate bill would effectively enact those cuts more steeply and more quickly.”

House and Senate bills proposed would end future additional funding for states to expand Medicare. Rick Pollack, CEO of the American Hospital Association, released the following statement:

“The Senate proposal would likely trigger deep cuts to the Medicaid program that covers millions of Americans with chronic conditions such as cancer, along with the elderly and individuals with disabilities who need long-term services and support. Medicaid cuts of this magnitude are unsustainable and will increase costs to individuals with private insurance.”

Hospitals Could Close Their Doors. Forever.

In particular, rural hospitals and safety-net facilities are worried that additional cuts could cause them to permanently close as they are already struggling to stay open. Both the American Health Care Act (AHCA) that was passed by the House of Representatives and the proposed Senate bill are designed to cut Medicaid spending in the next decade, which could have a profound effect on hospitals.

According to a Commonwealth Fund article, the healthcare organizations in Medicaid Expansion states would take the hardest hit and see a substantial increase in uncompensated care. Furthermore, their analysis showed potential declines in the operating margins for all hospitals. Ohio Hospital Association President and CEO, Michael Abrams, talks about the threat the Republican legislation to repeal and replace the Affordable Care Act (ACA) poses to hospitals:

“If you take a million people who are currently insured and phase them out over a couple years you’re going to cause severe problems to those providing them care.”

Amidst the chaos surrounding the plan to repeal and replace the ACA, one topic that is gaining significant attention is the concept of a single-payer healthcare system for the United States. In fact, on Wednesday, USA Today reported that Sen. Bernie Sanders told his supporters in an email earlier this week that his ultimate goal is for a single-payer system, which is a federally-sponsored program that would eliminate private insurance companies for basic healthcare. His request is for his supporters to sign on as citizen co-sponsors. He wrote:

“It is time to wage a moral and political war against a dysfunctional health care system in this country. When I introduce the legislation, I want it to be clear that the American people believe health care should be a right in this country.”

New light has dawned upon the issue of single-payer following the demise of the Republicans’ repeal efforts. Progressives and Democrats comprise the majority of law makers that are in favor of a Medicare-for-all system.

New Republic quotes Democrat Kyle Horton in a recent article covering the single-payer debate: “There may be more complacency. In particular, I am thinking about the big pharma and insurance lobbyists and how much power they have right now in Washington. They could easily gut certain aspects [of the Affordable Care Act] as they’re pushing to ensure they’re not paying their fair share or to protect their corporate tax inversion schemes.”  She feels that the Democratic party needs to “redouble our efforts to ensure that we’re educating people…. Probably not change our message, but ensure that the message never goes away between now and 2018, even if [Republicans] move on to tax reform and other issues.”

The SSI Group provides advanced revenue cycle management solutions to hospitals, ambulatory surgery centers, and providers that utilize tools to maximize profit and minimize revenue leakage. Because our clients will be affected by the upcoming healthcare reform, we will continue to monitor and report on the developments as law makers work on legislation to reform healthcare, whether that may be a revised AHCA, a single-payer healthcare system, or something else entirely.