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North Carolina Hospital Association

Serving North Carolina Hospitals & Health Systems

Affordable Care Act & Senate Health Bills

October 13, 2017 NCHA Responds to Executive Order Cancelling Cost Sharing Cost-Sharing Reduction Payments to Health Insurers

NCHA and our member health systems are concerned with any action that destabilizes the insurance market. The likelihood of even higher health insurance premiums will jeopardize the coverage gains our state has seen under the Affordable Care Act. As the healthcare safety net, North Carolina’s hospitals and health systems are committed to protecting the health of our communities and to working with policymakers to safeguard access to affordable healthcare coverage.

October 13, 2017   Administration to end CSR payments to insurers

The Trump administration will stop making cost-sharing reduction payments to health insurers, the White House announced last night. Insurers use the federal payments to reduce out-of-pocket costs for low-income individuals purchasing coverage through the Health Insurance Marketplaces. The Congressional Budget Office in August estimated that premiums for silver-level plans would be 20% higher in 2018 and 25% higher in 2026 if the CSR payments were to end. CBO also estimated the changes would increase the federal deficit by $194 billion from 2018 through 2026.

July 18, 2017 Statement by the American Hospital Association Regarding Status of Senate Health Bill:

Senate Majority Leader Mitch McConnell (R-KY) today said he will not move forward with the Better Care Reconciliation Act, legislation to repeal and replace parts of the Affordable Care Act, after Sens. Mike Lee (R-UT) and Jerry Moran (R-KS) said they could not support the bill. Sens. Susan Collins (R-ME) and Rand Paul (R-KY) had already said they would not vote for a Motion to Proceed on the bill. McConnell has indicated he intends to hold a vote on outright repeal of the ACA "in the very near future."

"Throughout this debate, we have remained consistent in our call: Protect care for patients," said AHA President and CEO Rick Pollack today in a statement. "This is grounded in the belief that coverage must be preserved for all who currently have it. Repeal without any effort to replace would leave millions of patients at risk during their most vulnerable times. We have urged Congress to consider advancing solutions aimed at making our health care system stronger, protecting access and coverage, and exploring new delivery system reforms that have the potential to make care both more affordable and safer. 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. We ask Congress to extend the Children's Health Insurance Program and vital rural health programs and stabilize the Health Insurance Marketplaces by funding the cost-sharing reduction payments. America's hospitals and health systems stand ready to help."

June 22, 2017 North Carolina Hospital Association Statement on the Better Care Reconciliation Act of 2017:

The Senate Better Care Act released today does not address the concerns we have raised with our U.S. Senators. It keeps the devastating cuts from the Affordable Care Act in Medicare and compounds them with further Medicaid cuts. The proposal punishes North Carolina for being prudent with Medicaid funds and provides no support for North Carolina’s uninsured population. NCHA recognizes that the Affordable Care Act needs improvement and will continue to ask our Senators to develop a plan that ensures North Carolinians have access to coverage and assures our ability to provide care to all.

June 22, 2017 American Hospital Association Statement on the Better Care Reconciliation Act of 2017:

From the onset of this debate, America’s hospitals and health systems have been guided by a set of key principles that would protect coverage for Americans.

Unfortunately, the draft bill under discussion in the Senate moves in the opposite direction, particularly for our most vulnerable patients. 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.

We urge the Senate to go back to the drawing board and develop legislation that continues to provide coverage to all Americans who currently have it.

June 16, 2017: The U.S. Senate is expected to vote on health care reform legislation prior to the July 4 recess, but negotiations behind closed doors mean that most Senators and the public do not know how closely the bill will match the American Health Care Act (AHCA), which the U.S. House of Representatives passed last month. According to the nonpartisan Congressional Budget Office estimates, the AHCA would reduce federal spending by $119 billion while leaving 23 million more Americans without health insurance. It is possible that the Senate could vote on its version of health care reform legislation on June 28 with little opportunity for the public to see the bill in advance of the vote. (This summary provided by the North Carolina Center for Nonprofits.)

May 4, 2017: The U.S. House of Representatives has voted 217-213 to pass the American Health Care Act (AHCA), legislation to repeal and replace parts of the Affordable Care Act (ACA). The bill would make significant changes to the Medicaid program, including repealing the ACA’s Medicaid expansion and cutting nearly $840 billion from the program. An amendment by Rep. Tom MacArthur (R-NJ) would allow states to waive certain insurance rules and consumer protections required under the ACA, specifically those related to essential health benefits and community rating, thereby impacting pre-existing conditions. An additional amendment by Rep. Fred Upton (R-MI) would establish an $8 billion pool to support individuals with pre-existing conditions. 

March 24, 2017: The U.S. House cancelled a vote on the American Health Care Act because of a lack of support for the bill. The future of congressional action addressing the ACA is uncertain at this time. NCHA and its member hospitals and health systems remain committed to working with elected officials and agency administrators on improvements to the ACA to ensure high quality healthcare for all North Carolinians. The Congressional Budget Office (CBO) on March 13th estimated that, under the March 9th AHCA bill, 14 million people would lose coverage in 2018, 5 million of whom would be Medicaid recipients. Over 10 years, CBO estimated that nearly 24 million people would lose coverage, 14 million of whom would be Medicaid recipients. The bill also would reduce Medicaid program funding by $880 billion over 10 years – a 25 percent reduction from current law.


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