Local hospitals are bracing for major changes after President-elect Donald Trump said he wants U.S. Rep. Tom Price, R-Roswell, to be his health and human services secretary.
Trump also plans to nominate healthcare consultant Seema Verma of Indiana to head up the Centers for Medicare and Medicaid Services.
“Both of these individuals have markedly different philosophies toward health reform than what’s in the (Affordable Care Act),” said Kurt Stuenkel, president and CEO of Floyd Medical Center.
Republicans in Congress say they are gearing up to quickly repeal and replace the ACA, known as Obamacare, but Stuenkel said it’s too early to do more than keep an eye on the proposals floating around.
He and Redmond Regional Medical Center CEO John Quinlivan both touted the current law’s provisions that gave coverage to about 20 million formerly uninsured Americans.
According to the CMS, nearly 107,000 Georgians signed up through the health insurance exchange in the first four weeks of open enrollment this year, ending Nov. 26. The deadline is Dec. 15 for coverage that starts Jan. 1.
“Our biggest concern under a repeal and replace scenario is that the expanded health insurance coverage accomplished under the ACA be continued in some form,” Quinlivan said. “If we don’t do this, millions of citizens who’ve gained coverage will find themselves once again uninsured.”
Trump has said he favors making block grants to the states, and that could provide the flexibility Georgia needs, Stuenkel said.
The state is one of 19 that did not expand Medicaid, which was meant to take in people who don’t get coverage through work but are ineligible for a subsidy. The issue appeared to be heading for a resolution in the upcoming Georgia General Assembly session but local lawmakers have said plans are on hold.
“We’re a large Medicaid provider and would like to see more coverage there,” Stuenkel said. “The Georgia Chamber of Commerce) had proposals we had hoped would be considered this year. Now, we’ll have to wait to see how that unfolds.”
Quinlivan said he’s hopeful state lawmakers will find a way to extend coverage to people who fall into the so-called “Medicaid gap.” Of the 32 states, including the District of Columbia, that do offer the coverage, eight received waivers to use a method other than Medicaid expansion.
A number of expected changes under the new administration could prove beneficial. Stuenkel said there is a push to address the rise in insurance premiums, although it’s unclear what direction that might take.
There also have been some advances under the ACA that are unlikely to be rolled back.
“Coverage for people with preexisting conditions, keeping young adults up to the age of 26 on their parents’ insurance — those are elements people like and depend on now,” Stuenkel said.
An eight-year initiative of penalties and incentives encouraging healthcare providers to switch to electronic medical records appears to have already done its job.
“I don’t think it matters if you’re a Democrat or a Republican. Everybody knew the medical industry needs to digitize,” Stuenkel said.
He also said a “payment for value” provision, which ties reimbursements to certain quality-of-care indicators, is likely to continue since it affects government spending.
Neither FMC nor Redmond is planning immediate changes in their operations.
“We’re watching everything like everybody else is, to see what’s going to happen,” Stuenkel said.