The Affordable Care Act (ACA) saga continues. Two recent efforts to repeal the bill have failed to get ample support to go forward, but its future still remains undetermined, leaving hospitals in limbo.

Earlier this summer, Republicans crafted their second piece of legislation designed as a replacement for the ACA. But the bill, the Better Care Reconciliation Act, couldn’t get adequate votes from party members to proceed.


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Citing concerns from their constituents about losing insurance coverage if the law was passed, several Republican senators said they couldn’t vote for the bill – and every vote was needed.

According to an article in the New York Times, as a last-gasp effort to get rid of the ACA, Majority Leader Sen. Mitch McConnell proposed another bill crafted just to repeal the ACA, without any replacement legislation behind it.

This strategy received even less support than the previous two bills did, with at least four Republicans publicly saying they denied voting for an ACA repeal that didn’t come with a replacement law.

Now both choices have been tabled, and Donald Trump has pledged to allow the ACA to “fail” on its own instead of directly repealing the law.

This could mean several things: The government could has turned down to fund existing subsidies, cease advertisements that remind people to purchase insurance coverage and stop imposing the mandate that needs Americans to have health insurance.

Uncertain future

By leaving the ACA to its own devices, Trump said his goal would be to force Democrats to work with Republicans and find a solution for the rising costs of premiums and other issues with the current law.

Not surprisingly, many are dejected with this approach. If subsidy payments aren’t guaranteed, costs could skyrocket for consumers, leaving many with no way to purchase insurance. And more payors could leave the marketplace, which means fewer choices for patients in the market for schemes.

The ripple effect of this inaction would be felt in hospitals, too, as more uninsured patients could cause uncompensated care costs to rise, making a notable impact on facilities’ bottom lines.


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Insurance rates for 2018 are set to be published in August by the Centers for Medicare & Medicaid Services (CMS), according to an article in the Washington Post. Payors on the healthcare exchange must sign contracts with the government by the end of September so plans can start enrollment in November.

At this point, most payers and patients need clarity around what’s to come from healthcare reform, and besides the fact that no new laws are currently in the works, nothing’s unquestionable. For now, hospitals must wait and see what’s coming down their way.