On behalf of our practically 5,000 member hospitals, well being programs and different well being care organizations, our clinician companions — together with greater than 270,000 affiliated physicians, 2 million nurses and different caregivers — and the 43,000 well being care leaders who belong to our skilled membership teams, the American Hospital Association (AHA) appreciates the chance to submit this assertion for the file.
America’s hospitals and well being programs play a central position in delivering well being care on this nation and are dedicated to the objective of reasonably priced, complete well being protection for each American. We imagine we must always construct upon and enhance our current system to enhance entry to protection of complete well being advantages.
The Importance of Health Coverage
Meaningful well being care protection is vital to residing a productive, safe and wholesome life. Studies verify that protection improves entry to care; helps optimistic well being outcomes, together with a person’s sense of their very own well being and wellbeing; incentivizes applicable use of well being care sources; and reduces monetary pressure on people and households.i Coverage has broader neighborhood advantages as nicely, from making certain sufficient sources to sustaining vital well being care infrastructure to being related to decreased crime. We, due to this fact, respect Congress’ give attention to alternatives to shut the remaining protection gaps and obtain complete well being protection for each American.
Despite current protection positive aspects, roughly 9% of the U.S. inhabitants stays uninsured. Many of the uninsured are seemingly eligible for, however not enrolled in sponsored protection, together with by way of Medicaid, the Health Insurance Marketplaces or their employers. For instance, thousands and thousands of the bottom revenue uninsured might be coated if all states expanded Medicaid.
While the AHA shares the target of reaching well being protection for all Americans, we don’t agree {that a} government-run, single-payer system is true for this nation. Such an strategy might upend a system that’s working for the overwhelming majority of Americans and throw into chaos one of many largest sectors of the U.S. economic system.
Results from a 2019 examine give some concept of the monetary impression a public choice program primarily based on Medicare charges might have on the well being care system. The examine discovered {that a} proposal to create a government-run, public choice Medicare-like well being plan on the person change might create the most important ever minimize to hospitals – practically $800 billion – and be disruptive to the employer-sponsored and non-group medical insurance markets, whereas leading to solely a modest drop within the variety of uninsured as in contrast to the 9 million Americans who would acquire insurance coverage by profiting from constructing upon the present public/non-public protection framework. This protection proposal would enroll considerably fewer folks than a single-payer mannequin, and but the reimbursement cuts can be catastrophic.
Even if the proposed single-payer program elevated reimbursement charges above Medicare’s charges, our members’ expertise means that the federal government doesn’t all the time act as a dependable enterprise companion. Delays in fee and retroactive adjustments to reimbursement insurance policies depart suppliers prone to insufficient fee. Politicization implies that suppliers can’t all the time belief that the foundations of right this moment would be the guidelines of tomorrow, which presents a difficult – if not inconceivable – atmosphere for big, complicated organizations. Recent examples of the uncertainty of working with authorities.
We are also deeply involved {that a} single-payer mannequin would significantly distract from the necessary supply system reform work underway. Hospitals and well being programs have invested billions of {dollars} in expertise and supply system reforms to enhance care, improve high quality and scale back prices. Moving to a single-payer mannequin might stymie these efforts by, at finest, diverting consideration and, at worst, being deemed irrelevant if the federal government can merely ratchet down supplier charges to obtain spending aims.
Ways to Promote Better Care for America
Health protection is simply too necessary to danger such ranges of disruption. The higher path to reaching complete protection for all Americans lies in persevering with to construct on the progress revamped the previous decade. To advance our goal of masking all Americans, we help:
- Continued efforts to broaden Medicaid in non-expansion states, together with offering the improved federal matching price to any state, no matter when it expands. This would give newly expanded states entry to three years of 100% federal match, which might then scale down over the following a number of years to the everlasting 90% federal match.
- Providing everlasting federal subsidies for extra lower- and middle-income people and households. Many people and households who should not have entry to employer-sponsored protection earn an excessive amount of to qualify for both Medicaid or market subsidies and but wrestle to afford protection.
- Strengthening the marketplaces to enhance their stability and the affordability of protection by reinstituting funding for cost-sharing subsidies and reinsurance mechanisms.
- Robust enrollment efforts to join people to protection. The majority of the uninsured are seemingly eligible for Medicaid, sponsored protection within the market or protection by way of their employer. We want an enrollment technique that connects them to – and retains them enrolled in – protection. This requires sufficient funding for promoting and enrollment efforts, in addition to navigators to help customers in purchasing for and choosing a plan.
We stand prepared to work with Congress as we search for methods broaden protection to sufferers and households.
- American Hospital Association, “The Importance of Health Coverage,” October 2019. https://www.aha.org/system/files/media/file/2019/10/report-importance-of-health-coverage_1.pdf