Despite the Senate’s failure to pass any of several measures to repeal and replace the Affordable Care Act last week, healthcare executives are watching Washington closely to see what’s next—and what role they can play in future debates.
Michael Dowling, the CEO of Northwell Health, which includes providers and a health plan, said in an interview with National Public Radio that the Trump administration still has many tools at its disposal to hinder key parts of the healthcare law.
"One thing that has to be done is make sure that they don’t sabotage what currently exists, even though legislation wasn’t passed,” Dowling said. “That would be an unbelievable thing for the administration to do. It would be, I think, pretty ridiculous.”
Instead, he believes that lawmakers should come together and look to fix certain elements of the ACA, such as adjusting the individual mandate to better encourage younger, healthier people to enroll in individual market plans and taking a look at what Dowling called “unnecessary micro-regulations” in the healthcare law.
Sister Carol Keehan, CEO of Catholic Health Association, echoed Dowling’s sentiment, saying in an interview with America Magazine that her organization is relieved that the ACA remains intact. The GOP’s efforts to repeal the law were “poorly thought-out,” she said, and were done with limited input from the healthcare industry and the public. Now that several variations of a repeal have failed, there’s room for a bipartisan solution.
“The American genius,” she told the publication, “can make [the ACA] so much better. We need to marshall that genius, to use everybody’s input and gifts to make this bill so much more of service to the American people and the American economy.”
A number of healthcare CEOs opposed the Senate’s original bill, the Better Care Reconciliation Act, prior to last week’s series of votes, expressing concern about significant cuts to Medicaid funding. Many providers benefited from the ACA's expansion of Medicaid, as it cut down on uncompensated care costs.
Mason VanHouweling, CEO of the University Medical Center of Southern Nevada, told the Las Vegas Sun that those cuts could significantly undo financial gains made by the hospital. In 2015, University Medical Center required a $70 million subsidy from its county and $45 million in emergency loans just to continue operating. It also had to lay off hundreds of staff as well.
But by 2016 it was in the black, with much thanks to expanded Medicaid coverage. Prior to the expansion, 29% of UMC’s patient population was on Medicaid, and 24% was self-pay, but now 47% of its patients are on Medicaid and just 10% are self-pay, according to the article.
“The ACA was a true blessing,” Lawrence Weekly, chairman of the UMC board, told the newspaper. “There wasn’t a whole lot of love when it came to the hospital. We were there through some tough times. I’m grateful for management stepping up.”