A shaky future for ‘Obamacare’? As Senate starts process to repeal, healthcare providers watch and wait

Jan. 13--With the Senate taking the first steps toward repealing the Affordable Care Act, commonly known as Obamacare, health care and insurance providers are watching to see what it means to them and those they serve.

Senators voted 51-48 Thursday on a budget blueprint that would allow legislators to remove some or all of the provisions provided by the Affordable Care Act without fear of a Democratic filibuster. Legislators have mentioned that they intend to repeal and replace the act, but no specific plan has been offered.

The uncertainty has left state institutions in a wait-and-see mode.

"At this time, the Illinois Department of Insurance cannot speculate as to the effect any proposed changes to the health insurance marketplace will have under a new administration," according to an Illinois Department of Insurance representative.

"The law is the law and until that law is changed or altered, that's what we are working with and will continue to do so," said Illinois Department of Insurance representative Michael Batkins.

Those covered under the act are insured through the Illinois Get Covered Now marketplace. About 11.5 million are already enrolled nationally, including more than 351,000 in Illinois, according to U.S. Department of Health and Human Services regional director Kathleen Falk.

Many of those covered in Illinois under the Affordable Care Act marketplace would find themselves placed either on Medicaid, Medicare or with the state's most popular option -- or only option through the exchange depending on the county and desired plan -- Blue Cross Blue Shield of Illinois.

BCBS Illinois representatives emphasized that, for now, there is no change in coverage.

"We will continue to focus on what's best for our customers and that includes access to care and establishing a stable market for the long term," said Colleen Miller, senior manager of communications for BCBS Illinois. "For more than 80 years, [BCBS] of Illinois has been providing access to quality cost-effective health insurance coverage. ... That long history leaves us well-equipped to adapt to the evolving health-care landscape -- just as we did when the Affordable Care Act was passed in 2010."

Dave Bolen, chief financial officer for Passavant Area Hospital, said that when the Affordable Care Act was passed, there were cuts to Medicare reimbursements to hospitals with the idea that more customers would be paying for individual insurance plans. These cuts resulted in a $1 million loss each year for Passavant Hospital.

Although patients paying for their medical costs did drop from 5 percent to 1 1/2 percent, patients without insurance often did not end up buying insurance but found instead that they were eligible for Medicaid. Medicaid reimbursements are significantly lower than health insurance plans, though the Affordable Care Act supplied provisions to provide additional reimbursements to cover those patients.

Without the Affordable Care Act providing those reimbursements, the hospital could stand to lose another $2-3 million a year.

"This was all so new to all of us, the election wasn't all that long ago, and we're still working to figure out the next step if it does get repealed," Bolen said. "We may have to end up cutting expenses and that kind of thing if we do lose that money. If they do repeal it, hopefully they'll replace it with something so they can replace those funds."

Nick Draper can be reached at 217-245-6121, ext. 1223, or on Twitter @nick_draper.

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