Hospitals Could Face Hundreds of Billions in Cuts With ACA Repeal


The nation’s hospital system could lose hundreds of billions of dollars if Republicans and President-elect Donald Trump repeal Obamacare without restoring cuts made in the 2010 health-care law.

Republicans are considering quick passage in early 2017 of legislation similar to what the House and Senate passed in late 2015, which was vetoed by President Barack Obama. That budget bill would have repealed the Affordable Care Act’s Medicaid expansion, premium tax credit and cost-sharing subsidies, as well as penalties for individuals and employers that don’t meet the law’s coverage requirements.

But the repeal bill, the Restoring Americans’ Healthcare Freedom Reconciliation Act, didn’t include replacement legislation, which will need some support from Democrats to overcome the Senate’s 60-vote requirement to stop a filibuster.

If the repeal plan is enacted without a replacement, the number of uninsured would increase by 22 million people by 2026 from a projected 28 million under the ACA to 50 million, according to a study conducted for the American Hospital Association and the Federation of American Hospitals.

“This reversal of coverage would represent an unprecedented public health crisis as individuals would lose their insurance coverage and no longer be able to follow their prescribed regimen of care,” the study said.

Hospitals stand to lose $165.8 billion due to coverage losses from 2018 to 2026 as they would have to absorb the cost of uncompensated care, the study said. The study also said hospitals would suffer a loss of $289.5 billion in Medicare inflation updates if the payment reductions in the ACA aren’t restored.

The two hospital trade associations sent letters to Trump and to congressional leaders urging them to include in legislation repeal of funding reductions for Medicare and Medicaid hospital services that were included in the ACA to help fund coverage for the newly insured.

Otherwise, the funding cuts “will create challenging and potentially unsustainable financial circumstances that could ultimately reduce patients’ care options,” the letter said.

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