The focus of Tuesday’s Annual Conference of Hospital Boards at Garden City’s Clarion Inn was on the changing climate of health care in America.
Sponsored by the Pioneer Health Network, the event featured two keynote speakers: Michael Hubble, managing director of the Advisory Board Company, a for-profit, publicly traded research, technology and consulting firm that serves more than 4,400 of America’s hospital and health systems; and Tom Bell, the president and CEO of the Kansas Hospital Association.
The event was catered toward hospital trustees, CEOs, administrative and management staff, physicians and people interested in the health care industry.
Hubble used his expertise to address health care in the federal sphere within the context of the Republican efforts to repeal and replace the Affordable Care Act, and Bell addressed health care on the state level, which has become especially pertinent in the wake of a failed attempt to expand Medicaid by the majority of the state Legislature that was ultimately vetoed by Gov. Sam Brownback.
With the ACA, otherwise known as Obamacare, hot on the agenda in Washington, and the expansion of Medicaid continuing to pose questions in the Kansas Legislature, the health care industry is at the focal point of federal and state policy right now.
Despite the uncertainty of the status quo in federal health care policy, Hubble said he thinks letting the ACA collapse would not be a good thing.
“Right now, of course, the big question is: With the ACA continuing to be the law of the land, will the GOP let it collapse, as President Trump has said he might? Or will they do something to prop it up?” Hubble said. “I think the implosion or collapse of the ACA would be a bad thing for the country, would be a bad thing for our industry. No one likes that level of uncertainty.”
Hubble expects to see four fundamental things from the GOP as they fight to change establishment health care policy: a hesitance to increase entitlement spending and a resultant pressure on Medicare reimbursement; a continued push for state control of health care policy; free markets and consumer choice across the board; and an effort to improve the transparency health care cost and quality.
“President Trump has talked about the need for better health care transparency for a few months now,” Hubble said. “And in general, we completely agree. One of the areas where health care is behind other industries is in this issue of transparency.”
Speaking about the state level of health care reform, Bell noted that Rep. Roger Marshall has already stated that he would vote for the repeal and replacement of the ACA with the establishment of the AHCA.
Bell also said he believes states should be given equal compensation regardless of whether or not they expand Medicaid, alluding to the ostensibly unequal benefits given to states that expand Medicaid before the implementation of the AHCA.
“Expansion states tended to have their gains ‘baked in’ under the law,” Bell said. “This is an oversimplification, but it’s generally true, while non-expansion states like Kansas tended to be offered a kind of consolation prize, so in Kansas we would have gotten about 10 times less under this bill than we would have had we expanded Medicaid.”
The fact that Kansas was being “punished” instead of “rewarded” for its hesitancy to expand Medicaid was to Bell the biggest problem the health care industry in Kansas generally had with the new bill.
“I’m just saying that, if you’re going to treat states equally and equitably, you give Kansas a big pile of money to use on health care or whatever, the same as what you would give these expansion states,” Bell said. “I’m not saying you have to expand Medicaid. You can make the argument: The non-expansion states did what they were supposed to do. They ignored that. They didn’t take the expansion bait. We should be rewarded, as opposed to being punished.”
Bell said the governor’s concern over the added cost of Medicaid expansion was a warranted one, but he noted that if one looks at other states that have spent more with added enrollment, their costs have actually diminished per capita, resulting in less money spent overall.
Regardless of the prospects, though, legislators shouldn’t brace themselves for an imminent repeal of the ACA because, “Congress is already having trouble repealing the ACA, and they aren’t going to be able to go back and tell a state that has already expanded Medicaid that they can’t do it,” Bell said.
“Where we go with this in Kansas, I don’t know,” he said. “I think there are a number of legislators that are unhappy with the veto and would maybe like another chance to get this in maybe a different way.”
He added that it would be “really hard” to put together a Medicaid expansion bill that Gov. Brownback would sign.
Pulling up a map of state districts that voted for and against the veto override, Bell pointed out that rural counties in western Kansas were vastly in favor of the override. Just one isolated district in the western third of the state, represented by Rep. Shannon Francis, R-Liberal, who said Medicaid expansion would be bad for rural hospitals, was in opposition to the override.
“I think a big part of that is because people in rural America tend to value their hospital,” Bell said. “I’m not saying they value them more, but they understand what a hospital is to a community, and they’re very concerned about the future of their community hospitals in rural America.”
Contact Mark Minton at email@example.com
Health care reform dominates hospital conference | Local News