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Over the past several months as Congress and the new Administration have worked toward a bill to repeal and replace the Affordable Care Act, hospitals have been clear that while changes are needed, we must maintain coverage for the millions of Americans, including the tens of thousands of residents here in New Hampshire, who were finally able to obtain the health insurance coverage they needed.

Unfortunately, the American Health Care Act appears to go backwards on that commitment to coverage, leaving more people without health insurance.  Further, while it repeals or eliminates many of the taxes that helped to fund the coverage gains that were part of the ACA, the American Health Care Act does not eliminate the significant Medicare spending reductions for hospital services that were also part of the ACA’s funding equation. Hospitals in New Hampshire are estimated to receive approximately $1.5 billion less in Medicare reimbursements between 2018 and 2026 from these Medicare changes, reductions that would be devastating to their ability to serve the patients and communities who depend on them if people lose their coverage.  Further, the American Health Care Act would replace the Medicaid program with per capita block grants that underfunds the actual cost of providing care to Medicaid patients, would down-shift costs to the state and undermine New Hampshire’s successful Medicaid expansion program.

Our priorities remain unwavering:  advancing the transformation of health care, preserving adequate resources for health care, protecting patient access to care, enhancing the quality of care and patient safety, making health care more affordable and ensuring access to coverage, especially for those who were previously uninsured. 

This is the first step in what will undoubtedly be a longer and more extensive debate over the future of the ACA and health care policy. We are committed to working with Congress, the Administration and others on legislation that improves our health care system through patient-centered care, but given the troubling impact this bill would have on our patients, our hospitals and our state, we cannot support the American Health Care Act in its current form.


Steve Ahnen is the president of the New Hampshire Hospital Association