1. Now What? The ACA, the New Administration, and Impact on Health Care Consumers
Karen Kelly, EdD, RN, NEA-BC
Associate Professor
SIUE School of Nursing
Let’s start with some of the myths and misinformation about the Affordable Care Act.

2. The Affordable Care Act
Imperfect legislation but a good first start from perspective of many health care professionals and their organizations.
Surrounded by myths:
Socialized health care/universal health care
Death panels
The ACA is better than Obamacare
Costs of health care rising because of Obamacare
Healthcare organizations will be taken over by the federal government
Government will decide your treatments, not your provider
You will be assigned a provider by the government, no choices by consumer
Who was the first US president to call for reform of the US healthcare system?

3. The AHCA 1.0 did not make to a vote in the House….
But…
Let’s assume that the ACHA 2.0 will be back soon with some of the same elements.

4. Five Ways Repeal/Replace Bill Reverses Course of ACA : Kaiser Health News
1. Tax credits to buy insurance when there is no employer plan; based on age, not income. Older persons could be charged up to 5 times more than younger people in the same healthcare plan. Tax credits are based on flat rate with no COLA rates.
2. Rolls back Medicaid expansion for working poor. Funds only with flat rate and would be capped, leaving states to make up the differences.
3. Would increase amount allowed in flex plan accounts.
4. Insurance mandates: no mandates for employers larger than 50 people; eliminates individual requirement to carry healthcare coverage; returns uninsured to the use of ERs for primary care.
5. Unclear how this plan will be paid in the first bill.

5. Health Affairs, the Commonwealth Fund, Kaiser Family Foundation…
ACA repeal may result in the loss of coverage for thousands in Illinois;
24 million expected to lose coverage in the US by 2020, returning the US to about million uninsured in the US (as in 2010, pre-ACA);
$40 billion in Medicaid lost across the states;
For Illinois hospitals, $1.7 billion lost in ACA Medicare payments over ; $10.2 billion in Medicare cuts to hospitals

6. Standard & Poor’s View of the Bill….
S & P predicted that if the AHCA became law, hospitals will experience a significant drop in revenues, with likely reductions in service.

7. Ground rules for discussion groups:
Each table will have two questions (one will be address by all tables);
15 minutes for discussion; appoint a reporter
20 minutes for report to the group

8. Consider----
Your organization’s current level of services to the community;
Any reductions or modifications of services provided to the community that “repeal and replace” may create;
Needs and expectations of community for health care services;
Your organization’s strategic plan to address the health and wellness needs of your community; and
The political climate of your community.

9. Question for all tables-----
What is your organization doing to increase advocacy efforts with members of Congress who represent your region in Washington? What is your organization doing to engage the Governor and the General Assembly in protecting health care services in Illinois in light of the state’s continuing budget crisis?

10. How will these potential revenue cuts with a possible increase in the number of uninsured in Illinois affect your organization and your community?
How will potential decreases in Medicaid payments and the loss of expanded Medicaid coverage affect your organization and your community?

11. How will potentially reduced Medicare reimbursement affect your organization and your community?
How would potential job losses, in your community and within your organization, impact your organization’s mission to provide safe and effective health care services?
How would potential Medicaid cuts and a change in the funding model affect your organization and your community?

12. How would your organization and your community be affected by the loss of essential health benefits, including: cancer screenings, immunizations, inpatient & outpatient care, emergency services, mental health services, prescription drugs, laboratory services, habilitation/rehabilitation services, pregnancy care (prenatal through postpartum care), wellness services, and chronic disease management?
How would budget cuts in health sciences and health policy research and services from federal agencies (especially the CDC and NIH) impact your community and your health care organization?

13. Consider these points----
Your organization’s current level of services to the community;
Any reductions or modifications of services provided to the community that “repeal and replace” may create;
Needs and expectations of community for health care services;
Your organization’s strategic plan to address the health and wellness needs of your community; and
The political climate of your community.