To see more clearly what's at stake in the sometimes mind-numbing debate about whether to overhaul or outright scrap the Affordable Care Act, look around
For example, those federal subsidies covered nearly two-thirds of the premiums that local residents enrolled in Obamacare health exchanges paid last year. That's an average of
The expansion of the
These significant jumps in the number of people with insurance coverage spurred substantial investments from health-care providers.
Perhaps it is no surprise, then, that the health-care industry is lobbying hard against the
The legislation gained early approvals from several House committees this week and is scheduled to continue its path toward congressional approval with more committee meetings next week. An all-important cost score from the nonpartisan
If lower federal assistance is coupled with the demise of Obamacare's requirement to buy insurance or pay a penalty, many health-industry experts have predicted the result will be a large drop in the number of insured Americans. That would likely mean cutbacks for hospitals, clinics and other medical providers as well.
"We always staff to patient volume. If volume drops, we will reduce our staffing. We always do, and our employees know that," Van Gorder said.
Murphy said likewise: "If volume changes, then staffing would change accordingly. And I think that would be true in all health-care organizations."
Both executives noted that while cutting Obamacare coverage mandates and subsidies could reduce the ranks of the currently insured, that doesn't mean hospitals would be able to remove certain services from their budgets. Because they are required to treat all comers, a reduction in demand for primary care in doctors' offices could mean an increase in other areas like hospital emergency rooms.
And while the current
Murphy said failing to roll back the
"Roughly 60 percent of our revenue, and this is true for most hospitals, comes from government-sponsored programs like
The executive said he has really started to feel that anxiety in his daily visits to Scripps facilities.
"This is an anxious time for people. Probably the first question I get asked anywhere I go is, 'What will the impact on Scripps be?'" Van Gorder said.
Murphy said he is urging his staff to keep calm. He stressed that there are not enough details yet to truly believe the
"There is a long way from here to regulation," Murphy said. "We're in the beginning of 2017. There is a bill that is not law yet and, just as we adjusted to the ACA, should this become law, then we'll have to make adjustments."
Anxiety is also being felt by people who currently or recently enrolled in an Obamacare plan.
Lessard said she watched her as her share of premiums increased each year. But every step of the way, she said, her low income qualified her for a significant subsidy from the government. Last year, the government paid
Yet Lessard said she can see both sides of the debate. She never felt completely comfortable with receiving so much taxpayer money for her premiums, but she also appreciated the opportunity to get insurance coverage that she could finally afford.
Also, she was forced to switch insurance carriers this year due to a large price hike from the company whose policy she had bought in previous years. That situation, she said, along with the requirement that she be covered for maternity care and, in the first year, pediatric dental coverage -- two things she clearly didn't need -- left her believing the entire system needed fixing.
"I am conflicted. I was thrilled that Obamacare was helping people, but now I see that there was a price to pay," Lessard said.
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