Amid GOP silence, Pa. health care groups voice hopes for Senate bill

June 21--As Republicans in the U.S. Senate work behind closed doors to replace the Affordable Care Act, several health care advocacy groups in Pennsylvania are speaking out about what they fear will be in the bill when it's finally released.

Republican Senate leaders are pushing mightily to write and pass a bill to replace former President Barack Obama's signature health care law by the end of June.

After "many productive discussions" with GOP senators, Senate Republicans "will soon have a chance to turn the page of this failed law," Senate Majority Leader Mitch McConnell of Kentucky said Tuesday.

But with less than two weeks to vote on the measure before the Senate's summer recess, GOP lawmakers have yet to tell their Democratic colleagues -- and many Republican senators -- what will be in the bill.

For organizations that might have to overhaul their plans and strategies to comply with a new health care bill, details are also scarce.

Bad starting point: Jeff Bechtel, senior vice president of health economics and policy for the Hospital and Healthsystem Association of Pennsylvania (HHAP), said he believes the Senate's plan will mostly resemble the American Health Care Act passed by the House, but "it looks like the Senate bill may be less favorable than the House bill."

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While the Senate's proposal might allow for a longer phase-in period for funding cuts to Medicaid expansion, Bechtel said HHAP staff fear the Senate could try to shift more of the payment responsibilities to state governments by lowering the AHCA's per-capita caps on what the federal government will cover.

If the federal government eliminates its funding for states that expanded Medicaid access under the ACA, Pennsylvania would be faced with the "very difficult decision" to come up with $2.5 billion to $3 billion annually for the expanded coverage or slash coverage, Bechtel said.

The AHCA's plan to replace the individual subsidies provided under the Affordable Care Act with less-flexible tax credits is "not sufficient" for individuals with very low incomes to provide their own coverage, Bechtel said.

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Instead of trying to overhaul the nation's health care system, lawmakers should be focusing on maintaining coverage and taking measures to stabilize health insurance markets around the country, Bechtel said.

"We are committed to preserving affordable and reliable access to health care. We support insurance coverage for Pennsylvanians," Bechtel said. "Simply put, we do not believe that the American Health Care Act is an acceptable starting point for reforming the system."

Fund Medicaid: Though Pennsylvania Health Care Association (PHCA) members had "open and candid" conversations with Pennsylvania Sens. Bob Casey and Pat Toomey during a recent trip to the nation's capital, the organization still only knows what the general public knows about the bill -- which isn't much, PHCA president and CEO W. Russell McDaid said Tuesday.

PHCA is a statewide advocacy organization working on behalf of more than 500 health care providers, nursing homes, pharmacies and other groups to ensure quality care for more than 50,000 vulnerable elderly and disabled residents.

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The uncertainty surrounding the Senate's proposal is just a distraction for PHCA providers who work every day to care for their patients, but for PHCA management, "it's very difficult to plan for anything at this point," McDaid said.

McDaid said PHCA is "extremely concerned" about both the Senate's upcoming proposal and the House GOP-approved American Health Care Act "because neither is a good option."

Lawmakers should be digging deep to keep the country's commitment to its senior citizens by protecting access to Medicaid and Medicare services, McDaid said.

PHCA has "significant concerns" about any plan that reduces Medicaid spending below current projected rates, as Pennsylvania's elderly population is one of the largest in the country and continues to grow.

"More people aren't going to need less care," McDaid said.

At current funding levels, the average Medicaid reimbursement is already $25 short of costs, McDaid said, while any bill that promises savings over the next five to 10 years will only exacerbate that funding gap.

"The cost realities of those programs (Medicaid and Medicare) aren't pretty for policy makers, and they're even less pretty for politicians (facing re-election), but they're reality," McDaid said.

Senate leaders are expecting to have a draft of the bill by Thursday.

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