Maine Hospital Assoc urges Pingree, Poliquin to vote 'no' on ACA replacement bill

File photo / Amber Waterman Steven Michaud, president of the Maine Hospital Association

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By James McCarthy

With a showdown vote scheduled later today in the U.S. House of Representatives on Republican legislation to repeal and replace the Affordable Care Act, the Maine Hospital Association wants U.S. Reps. Chellie Pingree and Bruce Poliquin to reject the bill.

“In its current form, the American Health Care Act doesn’t address the affordability and access problems in the Affordable Care Act — in fact, it makes things much worse,” MHA President Steven Michaud said in a written statement sent to Mainebiz.

Michaud said both President Donald Trump and House Speaker Paul Ryan were mounting a full-court press on House Republicans to ensure passage of the House’s health care plan. Politico reported that it would only take 22 Republicans to block passage of the ACA replacement bill and quoted Rep. Mark Meadows, R-N.C., saying that 25 members of the conservative House Freedom Caucus were planning to reject the plan.

“Our hope, clearly, is that both of our representatives vote ‘no,’” Michaud said. “We respect that there are other points of view and that there’s a lot that can and should be done to improve the ACA. But this goes the wrong way: It swings away from covering more people, it swings away from stabilizing the market. The ACA wasn’t perfect, but this is a lot worse.”

In a telephone interview late Wednesday, Pingree told Mainebiz she was voting against the Republican’s ACA replacement bill, noting that besides the Maine Hospital Association, her office has been contacted by the Maine Medical Association, behavioral health specialists, hospice organizations and a host of other Maine-based health care organizations who said the bill was a step backward from the ACA.

Poliquin’s office provided the following statement today, without indicating how he might vote: “The congressman is concerned about any potential impact on those nearing retirement who are not yet on Medicare. This week, he urged the White House and House leadership to improve provisions of the bill for those near retirement as it relates to health care costs. He was encouraged with two specific provisions in the original bill that retain coverage for those with pre-existing health conditions and give the option for young adults to stay on their parents’ policies so they can become established in the workforce.”

It also provided a link to its website detailing his meeting on Tuesday with the White House and House leadership.

What's at stake for Maine's hospitals

In a separate Jan. 18 letter to Pingree, Michaud noted that Maine hospitals’ operating margins have averaged roughly 1% for the past five years and that they are the largest employer in half of Maine’s counties, employing more than 30,000 workers throughout Maine.

“Our members have weathered a lot of storms,” he wrote. “They are nothing if not resilient. However, there are limits to that resilience. It won’t take cuts of hundreds of millions of dollars to dramatically undermine Maine hospitals.”

Michaud said MHA has three objections to the House bill:

1.) It perpetuates cuts in Medicare rates to hospitals that were used to finance the ACA but reduces benefits, which is likely to increase the burden of uninsured patients being unable to pay for their care at Maine’s 33 nonprofit general acute-care hospitals, its two private psychiatric hospitals and one acute rehabilitation hospitals.

He also noted that three other sources of financing the ACA — namely, penalties imposed on people who failed to buy health insurance; fees and taxes on insurance companies and employers and taxes on higher-income individuals — were cut in the House Republican bill.

“This is absolutely unfair, unbalanced and unacceptable,” he said in a written statement. “If the federal government is going to cut its ACA-related revenue by $800 billion over the next 10 years, some of that savings should be returned to hospitals. Hospitals shouldn’t be the only group locked out of relief.”

2.) The House bill includes a radical overhaul of the Medicaid program, without providing adequate time for stakeholders to review and comment on the reforms.

3.) AHCA’s proposed tax credits are skewed in favor of increasing market coverage for younger and healthier people at the expense of older enrollees. "It raises costs to all of us, insured or not,” he said.

“It is not much of a help to Maine hospitals if coverage increases among the younger and wealthier and healthier (who consume relatively less care) at the expense of coverage among the older and sicker," he added. "In addition to needlessly subjecting Mainers to more suffering, it’s just bad health care business. It raises costs to all of us, insured or not.”

On the plus side, Michaud noted the AHCA does preserve some beneficial ACA provisions — notably, maintaining children on parents’ plans until age 26 and providing a system to allow those with pre-existing conditions to be guaranteed coverage.

If the Republican bill fails to pass, Pingree told Mainebiz she hopes House members from "both sides of the aisle" would work together on crafting a bill that would improve the ACA without creating new problems for all the various stakeholders.