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CPH CEO says substance abuse treatment program would be hard to maintain if ACA repealed

Posted 3/24/17

By MATT LINDSEY POTSDAM – St. Lawrence Health Systems CEO David C. Acker says that cuts to Medicare and Medicaid would have a significant impact on the hospital’s ability to provide care and …

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CPH CEO says substance abuse treatment program would be hard to maintain if ACA repealed

Posted

By MATT LINDSEY

POTSDAM – St. Lawrence Health Systems CEO David C. Acker says that cuts to Medicare and Medicaid would have a significant impact on the hospital’s ability to provide care and services, including chemical dependency.

If the Affordable Care Act, also known as "Obamacare," is replaced with the American Health Care Act, Acker says the number of people able to maintain or acquire insurance coverage through the state exchange or expanded Medicaid would decrease.

The House of Representatives could vote on the bill today.

If enacted, the AHCA would cause financial issues at area hospitals, which Acker says, most already are facing.

“All North Country hospitals are small and economically fragile – many run on negative margins and some may make a little,” he said.

“What little we get cannot be taken away,” Acker said.

Lawmakers have not offered a replacement for the lost incomes CPH could face.

A repeal of the ACA would have a direct impact on patient care and services.

Today’s scheduled House of Representatives vote on a Republican health care bill to replace “Obamacare” is expected to be extremely close, but Acker says the new bill would likely have sweeping impacts for the county that is struggling to fight a growing chemical abuse problem.

CPH is the only hospital north of the thruway that offers inpatient care chemical dependency. The majority of those patients are Medicaid, Acker said.

“The program already loses money but we feel it is important to maintain,” he said. “A repeal would make it very hard to keep the program.”

Acker, in speaking with North Country Congresswoman Elise Stefanik on Wednesday, said she is working to get provision changed.

“When you are running the red it will take away from the scope of care we can provide,” he said.

Acker said if Stefanik is able to get more opioid funding included in the bill “it would be helpful.”

“Stefanik is sincerely attempting to understand the complex problems and she is listening to North Country health officials,” he said. “The last time we spoke she was not prepared to state her position, but she had concerns.”

CPH has not discussed what actions they might take if the ACA is repealed.

“We are a long way from done – we will see what happens with the House vote and Senate is another issue.” Acker said. “Expending time to a law or something that might not become a law is not a good expenditure of institutional resources.”

Acker said that although the ACA is a “very imperfect act” and that modifications are needed, those are not the issues front and center.

Acker said some changes were made in response to the ACA but that CPH has been growing at a good rate for about 10 years, even before Obamacare.

The main positive from Obamacare was that every patient had some ability to pay something, which Acker says “was helpful” to Canton-Potsdam Hospital.

The ACA was made to solve issues in the individual insurance market, which is made up people not covered through workplace insurance or government programs.

Under the old system, insurance companies could deny coverage to people with pre-existing conditions or charge higher premiums. Obamacare (ACA) requires insurers to accept everyone, regardless of health and charge the same price.

Everyone is required to buy insurance or pay a penalty. To help people afford their plan, the law pays out subsidies to people making up to 400 percent of the federal poverty line. It also offers states more Medicaid dollars to cover adults at lower incomes.

The House was expected to vote Thursday but did not do so as changes were being made. The new bill, nick-named “Trumpcare,” would likely cover far fewer people than the ACA, allow insurers to raise deductibles and out-of-pocket costs, and cut Medicaid by large amounts, analysts say.

Acker says 20 percent of their patients are Medicaid. Although a repeal would have a negative effect, Acker was not able to provide an estimated financial impact.

“I have no idea – there are all sorts of numbers flying around,” he said. “It’s too hard to speculate.”

A report released by Gov. Cuomo in January says that over 11,000 St. Lawrence County residents would lose insurance if the ACA is repealed. The report says over 2.7 million residents statewide would lose their insurance.