Repealing Obamacare is going to be a disaster on just about every level: for individuals, for state and local governments, for healthcare providers and insurers, and thus for the politicians who are doing it. That's the message that the insurance industry has been giving President-popular-vote-loser-elect Trump and congressional Republicans. Now the nation's hospitals are putting a number on it: at least $165 billion in losses, just to hospitals, in the next decade unless something equally as good replaces it.
The two main trade groups for U.S. hospitals dispatched a letter to the incoming president and Capitol Hill’s top four leaders, saying that the government should help hospitals avoid massive financial losses if the law is rescinded in a way that causes a surge of uninsured patients.
The letter, along with a consultant’s study estimating the financial impact of undoing the Affordable Care Act, makes hospitals the first sector of the health-care industry to speak out publicly to try to protect itself from a sharp reversal in health policy that Trump is promising and congressional Republicans have long favored. […]
[T]he American Hospital Association and the Federation of American Hospitals (FAH) convened a news conference Tuesday to release the study’s findings and draw attention to their concerns. […]
Joann Anderson, president of Southeastern Health, a financially fragile rural hospital in Lumberton, N.C., one of that state’s most economically depressed areas, said the prospect of repealing the health law without a replacement to keep people insured is “gut-wrenching. . . . We cannot take additional cuts.”
The study used the only thing available for its analysis, the repeal bill Republicans pushed through this January, vetoed by President Obama. Since in the intervening year, Republicans haven't come up with a scrap of anything else, this is what they're going with. That bill, since it had to pass through budget reconciliation to avoid a filibuster from Senate Democrats, stayed on the taxing and spending parts of the law and eliminated the federal subsidies for people purchasing private insurance on the exchanges, the penalties for individuals and employers who don't comply with its coverage mandates, and the Medicaid expansion in 31 states.
Without any of that, the entire thing crumbles and we go back to a situation at least as bad as pre-law, and for hospitals even worse. That's because the law also enacted cuts to hospitals treating uninsured patients on the assumption that there wouldn't be huge numbers of people without insurance needing treatment. If those cuts are restored (and fat chance they would be with Paul Ryan in charge) there's an addition $102 billion in losses, just to hospitals.
And there's a lot of hospitals closing, particularly rural ones. Which means lots more people—both insured and uninsured—without a place to go when they get sick or injured. The scope of the looming disaster with repeal is hard to fathom, and it's not going to be contained to the 20 million who are going to lose coverage. It's going to be everybody. If you throw in Medicare privatization and Medicaid being turned into a block grant, there won't be very many people who can afford health insurance, and a lot of employers who won't be able to provide it affordably either. And Republicans have absolutely no idea of how to fix that.