BUSINESS

State health systems and other stakeholders speak out against health care bills

Guy Boulton
Milwaukee Journal Sentinel
Staff respond quickly to the Surgical Intensive Care Unit at Froedtert Hospital.

Aurora Health Care, the state’s largest health system, is clear and straightforward: It opposes the House and Senate bills to replace the Affordable Care Act.

So, too, do Froedtert Health, Marshfield Clinic Health System and Children's Hospital of Wisconsin.

The same goes for the Wisconsin Hospital Association and Wisconsin Medical Society.

LeadingAge Wisconsin, which represents nonprofit organizations that provide nursing home care, assisted living and other services for people who are elderly, also is among the opponents. So are the Wisconsin Primary Health Care Association, which represents community health centers, and the Rural Wisconsin Health Cooperative.

The bill passed by the House and the bill now before the Senate have prompted an array of organizations that try to work with Republicans and Democrats alike to take clear stands.

A vote on the Senate bill, scheduled for Wednesday, was delayed Tuesday by GOP leaders after both moderate and conservative members spoke out against it.

Both bills would hurt the state’s most vulnerable people, including senior citizens, patients with behavioral health conditions and people with low incomes, Rachel Roller, senior vice president of community and government relations for Aurora, said in a statement. And under both bills, fewer people would have access to coverage.

The nonpartisan Congressional Budget Office estimated on Monday that the Senate bill would increase the number of people without health insurance by 22 million by 2026.

That’s 1 million fewer than the CBO estimate for the bill passed by the House.

The CBO also said premiums and out-of-pocket expenses, such as deductibles, could increase sharply for some people with low incomes and particularly for people 55 to 64.

Other changes could destabilize the market for insurance sold directly to individuals and families, according to the CBO.

The law also would phase out the additional federal funding available to states that expanded their Medicaid programs under the Affordable Care Act. That resulted in 11 million people gaining insurance coverage.

Those and other provisions are reasons for Marshfield Clinic’s opposition.

"We are concerned both the House and Senate bills would cause premiums and out-of-pocket costs to increase significantly for our patients who tend to be older, poorer and more rural,” Susan Turney, a physician and chief executive officer of Marshfield Clinic Health System, said in a statement.

Rural areas are projected to be hurt more by the changes than urban areas.

“We believe both bills take us in the wrong direction, and while bad for Wisconsin as a whole, they are particularly bad for rural Wisconsin,” said Tim Size, executive director of the Rural Wisconsin Health Cooperative.

The Wisconsin Hospital Association also opposes the bills.

“You have to look at the bills and the impact on Wisconsin,” said Eric Borgerding, president and chief executive officer of the association, “and I find it very hard to get to a place other than opposition at this point.”

The bills fall far short of protecting the association's core issues, he said, of maintaining access to affordable health care coverage, stabilizing the market for insurance sold directly to individuals and families and protecting the state’s Medicaid program.

The House and Senate bills both would cap future increases in federal funding of Medicaid and over time increasingly shift costs to states.

The Senate bill, for instance, would limit increases in federal funding to a rate well below the historical increase in medical costs.

That particularly worries Children’s Hospital. Slightly more than half of its patients are covered by Medicaid.

In a statement, Peggy Troy, president and chief executive officer of Children’s, said the Senate bill contains some improvements from the House bill. But, she said, “The bill continues to put access to health care at risk for the vast majority of children enrolled in Medicaid.”

Other health systems and organizations also noted that the bills would limit access to care.

“They do not do enough for our patients,” said Noel Deep, president of the Wisconsin Medical Society and a physician with Aspirus Clinics in Antigo.

The Wisconsin Medical Society, he said, does not want to see the gains in people with health insurance through the Affordable Care Act reversed.

Fewer people with health insurance also would undercut the move to provide more preventive care, Deep said.

Cathy Jacobson, president and chief executive officer of Froedtert Health, cited similar concerns, noting in a statement the health needs ranging from chronic disease to behavioral health in Milwaukee County.

“These needs remain and require significant resources and consistent attention,” Jacobson said. “Erosion of health coverage either through Medicaid or the individual marketplace will exacerbate these problems.”

Aurora, Froedtert Health and Marshfield Clinic also noted that the House and Senate bills would penalize states such as Wisconsin that did not accept the additional federal dollars available under the Affordable Care Act to expand their Medicaid programs.

Wisconsin instead expanded its program to include adults who don’t have dependent children and who have incomes below the federal poverty level.

The state was the only one in the country to expand its Medicaid program — adding about 100,000 people to the program — but reject the additional federal dollars.

The Wisconsin Hospital Association estimates that the state's unique approach is costing it $280 million a year in lost federal dollars, Borgerding said.

“That is the ongoing penalty that Wisconsin is paying,” he said.

Some health systems and organizations, including ProHealth Care and Bellin Health, declined to comment on the House and Senate bills. And others, such as the Medical College of Wisconsin, raised concerns but are not taking a public position.

Ascension, the parent company of Wheaton Franciscan Healthcare and other health systems, also has stopped short of opposing the bills.

But in a statement, Bernie Sherry, the Ascension Healthcare senior vice president who oversees the Wisconsin market, said, “We are hoping our leaders in Washington will go back to the drawing board, because if this bill goes forward, it will cause millions of the most vulnerable people in our country to lose health coverage.”

Sherry also praised Sen. Ron Johnson (R-Wis.) for calling for the Senate to move more slowly on the bill.

That happened on Tuesday with the decision to postpone a vote on the bill until after July 4.

Johnson also has called for lawmakers first to stabilize the insurance market and then return to crafting a bill.

“I continue to think that makes loads of sense,” Borgerding said. “But that doesn’t seem to be where we are going.”