Local impact of repealing ACA remains to be seen

Jan. 28--It's too early to tell how repealing and replacing the federal health care law would affect Mercy Hospital Ada, President Lori Wightman said Tuesday.

"It's very fair to say the situation is fluid," she said. "But what I do know is that we're going to continue to focus on what we have been focusing on: Improving quality, decreasing cost -- our cost structure.

"We're also going to start getting better at transparency. Because I think any hospital or health system that focuses on those things is going to be successful, no matter what happens."

The Affordable Care Act allows Americans who lack job-based health care coverage to obtain subsidized private insurance. The 2010 law also gives states the option of expanding Medicaid for low-income people.

Republicans in the U.S. House have led a four-year effort to abolish the Affordable Care Act, also known as Obamacare, and replace it with a new health care law. That effort has gained new momentum now that former President Barack Obama is no longer in office.

President Donald Trump and the Republican-dominated Congress are moving forward with plans to dismantle the ACA, commonly referred to as Obamacare. They took the first step toward that goal earlier this month, when Trump directed the U.S. Department of Health and Human Services and other agencies to take steps to reduce the law's financial burden for health care providers, insurers and others.

However, the GOP has not united yet behind a possible alternative to the health care law.

Payment for

performance

Lawmakers have targeted several provisions of the Affordable Care Act for elimination, including a mandate requiring most Americans to maintain health insurance or pay a fine. But other elements of the law -- such as a provision barring insurers from denying coverage to people with pre-existing conditions -- are more popular.

Those provisions and others will all be in play as lawmakers work on devising an alternative plan.

Wightman said she has reviewed several possible scenarios for what a new health care law might look like, and all of them emphasize paying health care providers based on their performance. She said hospitals that reduce the number of readmissions, eliminate infections and minimize other complications will be reimbursed at higher rates from the designated payer.

Wightman also said all health care providers -- not just hospitals -- must look at ways to hold down costs while continuing to provide top-notch care. She said providers that belong to a larger system -- such as Mercy -- have an advantage over independent providers because they can pool their resources in areas such as billing, payroll and legal services.

"More things are added to that list every year of things that are being centralized because you can then spread the cost," she said. "We don't have to duplicate that cost here. We don't have to duplicate the expertise. But we can tap into that expertise at any time."

Wightman said providers also need to find ways to boost transparency, because people are having to take responsibility for covering a greater share of their health care costs. As a result, she said, people want more information about the cost of care.

Finding a

comprehensive

solution

Wightman said she hopes lawmakers will come up with a comprehensive health care policy that continues coverage for people who already have it while reducing the number of Americans without insurance. She said she would also like to see a new policy that protects vulnerable patients, promotes access to care at the appropriate level and supports rural providers.

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