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HCA Calls on Congress to Oppose ACA Repeal and Replacement Bill, With Its Deep Cuts to Medicaid  

As Congress continues to deliberate on the Republican-led health care plan, HCA late last week sent a letter urging New York’s Congressional Delegation to oppose the bill’s current iteration, with its dramatic proposals to overhaul the Medicaid program.

Our letter joins the growing chorus of hospital and community health groups, insurance representatives, practitioner organizations and consumer groups “who recognize that this bill would deprive citizens of life-saving coverage, recklessly destabilize insurance markets, and create a fiscal crisis for states like New York,” writes HCA President Joanne Cunningham.

On Thursday, the U.S. House budget committee moved the bill forward for consideration by the full House. However, opposition to the bill has grown louder, with Democrats near-universally opposed to the measure and some Republicans – especially the Freedom Caucus – stating that they will be seeking amendments because the bill doesn’t move fast enough on some of the Medicaid changes sought by the more Conservative wing of the party, among other concerns.

HCA’s letter notes that the bill, intended to repeal and replace the Affordable Care Act (ACA), would undercut health care coverage for one million New Yorkers, including coverage obtained by the home care workforce and individuals who receive home care through Medicaid and Medicare.

And while supporters of the American Health Care Act (AHCA) say it will offer states flexibility to administer their Medicaid programs, HCA argues that “New York State has relied on ACA’s Medicaid expansion, and the bedrock of Medicaid’s core structure and existing waivers, to implement programs that are already are driving service and payment delivery changes,” including the Delivery System Reform Incentive Payment and Value Based Payment Programs.

Even more alarming, however, is the fact that the bill’s proposed Medicaid disinvestments would “knock a multi-billion-dollar hole in New York’s state budget for safety-net health care services and program innovation.”

Ms. Cunningham adds: “The bill’s per-capita Medicaid spending caps are expected to substantially reduce the federal-share of state Medicaid funding, resulting in major fiscal instability for New York’s health care system and, in turn, threatening dislocation of existing fund obligations, the potential elimination of Medicaid benefits impacting lower-income home care recipients, or provider funding reductions at a time when two-thirds of New York’s home care programs are already operating in the red on services to both Medicare and Medicaid beneficiaries.”

HCA acknowledges that ACA is “by no means perfect,” and it includes provisions that negatively impact home care providers, from new regulatory requirements, to unfunded labor costs, to employer penalties, to Medicare reimbursement cuts. “These elements can – and should – be addressed in a surgical way,” Ms. Cunningham says. “HCA has strongly advocated for these modifications to the ACA for many years. However, the AHCA legislation cuts deep into fundamental programs, funding mechanisms and coverage provisions that would cause massive disruption in services, financial structures and markets throughout the entire health care continuum.”

HCA’s letter can be read at