Billions could be lost for Missouri hospitals with ACA repeal

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JEFFERSON CITY -  A new report from the Missouri Hospital Association shows Missouri hospitals could lose up to $9 billion over the next 10 years if certain parts of the Affordable Care Act are repealed.

This comes as House Republicans released their plan to repeal and replace the Affordable Care Act on Monday.

Spokesperson Dave Dillon of the Missouri Hospital Association said if Title III of ACA is repealed and not replaced, it could create problems for everyone in the marketplace.

"Everyone will be affected because the system acts as a whole, and when hospitals or healthcare providers lose money on patients that have Medicare or Medicaid they have to find a place to make that up, and generally speaking the only place to do that is through the people who are commercially insured," Dillon said.

The report put out by MHA is called "Realities of Repeal," and in District 4, which includes Boone County, hospitals stand to lose up to $679 million from Medicare payments and pay-for-performance measures that help to ensure patient protections.

The ACA consists of 10 different titles, each one highlighting different amendments, like coverage for people with pre-existing conditions and allowing children to stay on their parents' plan until 26.

Title III is the most important section for healthcare providers. It details changes in Medicare and moves health insurance from a fee-for-service system toward payments based on quality of delivery.

Dillon said Title III of ACA has a tremendous affect on hospitals, and if Congress does not repeal ACA as a whole and only certain sections, it can be detrimental.

"It's going to be very expensive, and it's unlikely that the coverage expansion would be enough to make up the difference of those losses to the states' hospitals," he said.

Dillon said repeal of the ACA could also mean more than 250,000 Missourians lose their health insurance, totaling $1.23 billion in lost coverage. He said this means it would be financially damaging to hospitals because they would have to provide more free care.

"Coverage doesn't come to back fill the loss of those payments, and hospitals will be forced to cost shift to the people who have insurance, so that the currently insured might end up paying more because hospitals are paid less," he said.