Republican plans to repeal and replace the Affordable Care Act (ACA) with their own design have put healthcare CEOs in a state of “high anxiety,” according to a recent survey conducted by Modern Healthcare.
The first-quarter survey of Modern Healthcare’s CEO Power Panel received 81 responses from 110 of the CEOs contacted. It also included interviews with some of the respondents.
Of CEOs responding to the survey, 77.9 percent oppose repealing the ACA, even with the promise of a replacement plan and a transition period. And 79.2 percent favor keeping the law’s expansion of Medicaid coverage to low-income adults, which would be eliminated or phased out in the current Republican proposal.
Nearly two-thirds want to preserve generous premium subsidies so no one pays more than a set percentage of income for health insurance. That contrasts with the House GOP plan to base premium tax credits on age rather than income. About the same percentage prefers to keep the ACA’s minimum essential benefits, which would be erased under Republican plans.
Specifically, the survey results showed that:
- Only 2.6 percent of the respondents said that individual health plans sold on the insurance exchanges should not be a required purchase for the uninsured (the individual mandate).
- 4 percent said that individual health plans sold on the insurance exchanges should be subsidized so no individual or family pays more than a set percentage of income in premiums.
Healthcare leaders are more open to Republican proposals to give states greater autonomy to custom-design their own Medicaid programs by converting Medicaid into a program of federal block grant or per-capita payments to the states; 55.7 percent said they would support that model. But they would back it only on the condition that current funding levels are maintained. The current GOP proposal includes major reductions over time in federal payments to the states for Medicaid and the Children’s Health Insurance Program, which together cover 74 million Americans.
The CEOs want details of the Republican plan regarding federal Medicaid payments, and how each state would be affected, whether or not it had expanded Medicaid. “How people will function under a block grant is entirely dependent on how much money they get,” one hospital CEO said. “What’s the base level of funding, and how is that indexed going forward? That’s the whole deal.”
“If we’re going to use the restructuring of Medicaid as a vehicle to achieve big budget reductions, leaving lots of people uninsured, that’s not a productive discussion,” said Rick Pollack, CEO of the American Hospital Association.
(Source: “High anxiety: Healthcare execs want coverage continuity,” Modern Healthcare, March 4, 2017)
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