Hospitals: ACA Repeal Would Hurt Patients
PORTSMOUTH - Before the Affordable Care Act became law, Dr. Matt Davis literally lost sleep when he had to keep patients involuntarily in the hospital if they didn't have health insurance.
He would sometimes have to keep patients involuntarily "because they were not safe to be discharged, knowing at the same time that at the end of their admission, they were going to get socked with a huge bill," Davis said during a panel discussion held Monday at Portsmouth Regional Hospital.
They would come out "saddled with this albatross of debt and bankruptcy," said Davis, the medical director of Portsmouth's Behavioral Health Services.
The ACA and its expansion of Medicaid coverage allowed for mental health patients to get the coverage they needed because they now have insurance, Davis said.
Monday's discussion was held to address what could happen if the ACA is repealed - as President Donald Trump and the Republican majority in Congress are trying to do - and the impact it would have on patients.
Sen. Jeanne Shaheen, D-NH, said if the ACA is repealed, there will be no guarantee that patients with pre-existing conditions will be covered.
She pointed to her granddaughter, Elle Shaheen, who has Type 1 diabetes.
Elle hasn't had "too many episodes," Shaheen said Monday, but "when she's taken by ambulance to the hospital, this is where she comes."
"I appreciate the challenges that people with pre-existing conditions have," Shaheen said.
She acknowledged problems with the ACA, including rising costs and "uncertainty in the healthcare market."
"We need to address that and the best way to do that is to work together to make sure we build on what has been working and fix what's not working," Shaheen said.
She believes that should be done "in a bipartisan approach" but said "sadly we're not seeing that."
The Republican bills have been "put together behind closed doors," she said.
The House passed a bill that repeals the ACA, commonly known as Obamacare, that would result in about 23 million Americans losing coverage, according to the Congressional Budget Office.
Shaheen predicted the Senate's bill could be finished by the end of June and said, "We have no idea what's going to be in the bill."
She urged the people who attended Monday's meeting to reach out to Republican Gov. Chris Sununu and state lawmakers about the proposed repeal.
"People need to hear at the grassroots what people are thinking," Shaheen said.
Sununu has supported the repeal and replacement of the Affordable Care Act, better known as Obamacare. He supported passage of its replacement, known as the AHCA, in the U.S. House but noted that the U.S. Senate would need to address its shortcomings.
Dean Carucci, chief executive officer of Portsmouth Regional Hospital, warned that "when you reduce the access and people don't see a pathway, they go about their lives until they end up in a hospital."
The ACA and Medicaid expansion have allowed more people to have better access to preventative medicine, he said.
Steve Ahnen, president of the New Hampshire Hospital Association, said "as we look at all of the discussions around health-care reform, we look at this from the perspective of the patient."
He believes the conversations in Washington about health coverage are "moving in the wrong direction."
Proposed cuts would "reduce coverage for millions of people across the country and tens of thousands of folks here in the Granite State," he said.
Ahnen said "several hundreds of billions of dollars in Medicaid funding" could be cut from the state's Medicaid program, which he said is already "probably one of the most underfunded of any in the country."
"Who among us is one of the 23 million that's going to lose coverage?" he asked. "If that was one of us, what would that mean for our family, what would that mean for our children and their ability to get the care they need?"
Helen Taft, the executive director of Families First in Portsmouth, said her group serves low income patients. Thanks to Medicaid expansion, they now have about 2,500 people who have health coverage.
"That has just created a whole new world for our patients," she said.
"They now can come in for preventative care and can they can do follow up."
She noted that because of expanded Medicaid, Families First opened a primary care office in Seabrook.
"But that's also a program that's very reliant on having a steady stream of reimbursement," Taft said, adding she is "really concerned" about what would happen if that funding is cut.
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