Reasons why Inland Empire health care leaders fear the end of Obamacare

April 09--Leaders in the Inland Empire health care community are concerned that any change to Obamacare could hurt recent inroads for patient coverage and have an alarming effect on health care sector jobs and economic growth in the region.

Under the Affordable Care Act, "we've gone from over 750,000 people with no health care to about 350,000 with no health care" in the Inland Empire, said economist John Husing.

"If they don't keep those people covered, it would hurt both the people, but also the providers and the jobs that go along with that."

House members headed home Thursday for a two-week recess with the Republican health care bill that would replace Obamacare still in shambles. GOP leaders announced a modest amendment to curb some premium increases, but the party still faced sharp divisions over how to achieve their promise of repealing former President Barack Obama's law.

Ontario-based Prime Healthcare Services operates 44 hospitals in 14 states. Fred Ortega, Prime's director of government relations, is hoping any replacement bill will continue to insure the millions of Californians who gained coverage in recent years, so they "have access to the health care safety net they need and deserve."

Since the ACA's implementation, Prime's hospitals now receive fewer uninsured patients, saving the company has $337 million in "bad debt and charity care," Ortega said. That money, he said, instead went toward employment and capital improvements.

"(Any potential) reduction in the savings we've experienced will definitely impact the amount of capital that we can reinvest in equipment, employment and capital improvement for our hospitals," Ortega said.

Harris Koenig, president of San Antonio Regional Hospital, is equally concerned, especially about a reduction in coverage.

"Either they won't be getting coverage on the (insurance) exchange, or they will be losing coverage because they lose access to Medi-Cal and the loss of medical funding in the state," Koenig said Friday in a phone interview.

Accordingly, hospitals, often major employers in their communities, will see an impact on employment, capital expenditures and program accessibility, Koenig said.

As of last year, health care ranks as the sixth largest sector of the Inland Empire economy, Husing said.

Hospitals are just one source of employment in the sector, which also includes medical offices, pharmacies, laboratories and insurers, according to Bradley Gilbert, CEO of Rancho Cucamonga-based Inland Empire Health Plan. The IEHP organizes health care contracts for patients, doctors and hospitals in San Bernardino and Riverside counties.

In response to 335,000 ACA-prompted new members, his organization grew from 700 employees in 2012 to 1,900 today, Gilbert said by phone.

"If we were not able to provide some alternative for those members for some kind of alternative insurance product, some way for them to be covered, our membership could be down by 25 percent, and that could have an impact on employment at IEHP. But it would also be pulling a billion dollars (from the regional economy in health care-related revenue), and put 24,000 (regional) jobs at risk," Gilbert said.

Another major health plan player in the region is Molina Healthcare, a managed health care company based in Long Beach, that serves 3.5 million people through government-funded health care programs in 15 states. With an administrative office in San Bernardino, Molina Healthcare has a significant presence serving members in the Inland Empire.

Repealing the Affordable Care Act without a replacement could lead to 24 million people losing coverage across the country, according to the Congressional Budget Office, creating a ripple effect on growth and employment, Deborah Miller, plan president of Molina Healthcare of California, said in an emailed statement.

Replacing the Affordable Care Act could be a viable solution -- depending on the new plan's details, including keeping cost-sharing reductions and holding onto the individual mandate, which requires that most Americans get health insurance, or an exemption, each month, or pay a tax penalty, Miller said.

Husing said that the Inland Empire health care sector is taking a wait-and-see approach. He expects hiring to slow down because of the uncertainty with whatever may replace Obamacare.

"If in fact the Trump administration or the Congress combined savage the ACA, then one of the things it's going to do is hurt the Inland Empire very badly," Husing said.

Not all business experts agree.

Jay Prag, professor of economics and finance at the Claremont Graduate University, believes any change to ACA won't be that great.

"The state has said they are going to try and maintain the same level of coverage that the ACA was providing the state to make up the difference," Prag said. "They can certainly do it for a while with health insurance, but I don't think California, at least in the short term, is going to see any substantial change."

The Associated Press contributed to this report.

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