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The Iowa Hospital Association is pleased that the American Health Care Act was not pushed through the House on a wave of political pressure. There is far too much at stake – and too many unanswered questions – to force through a bill that would jeopardize health insurance coverage for more than 20 million Americans, including 200,000 Iowans.

The Affordable Care Act is not perfect, but Iowa’s hospitals are committed to working with elected officials and agency administrators on addressing those problems and making it better, just as we have been for the last seven years.

However, the AHCA was not the answer. It endangered the health of thousands of Iowans – senior citizens, children and families, the disabled, veterans and others – who have received health coverage under the Affordable Care Act. It threatened the Medicaid program that serves 630,000 Iowa residents. And it would have been an economic disaster for our state budget as well as hospitals and other health care providers that all Iowans depend on.

Iowa’s hospitals will continue to work with our congressional delegation as advocates dedicated to improving the health and lives of Iowans.

Featuring hospital and health care headlines from the media and the Web.

Iowa News

LRH creates $19 million in economic impact
Lakes Regional Healthcare (LRH) generated 452 jobs that add more than $19 million to Dickinson County’s economy, according to the latest study by the Iowa Hospital Association. “Given our mission of improving the health and well-being of the Iowa Great Lakes, we often think about that only in terms of the care we provide and not economic impact,” LRH President and CEO Jason Harrington said. “However, being a large employer, we also impact the economic well-being of the area and in many communities, health care makes up the largest sector of employment.” (Dickinson County News)

Broadlawns Medical Center opens $22 million addition
Many patients at Polk County’s public hospital will start seeing doctors, dentists and counselors in a new building next week, partly thanks to Obamacare. Leaders of Broadlawns Medical Center celebrated the new, four-story addition Thursday. It will house an expanded dental clinic, outpatient mental-health services, addiction treatment, a pain-treatment clinic and a family-practice clinic whose goals will include training young doctors. Part of the reason for the hospital’s success has been that many Iowans who used to lack health insurance now have coverage due to the Affordable Care Act. (Des Moines Register)

More cancer projected in Iowa this year
Researchers project 17,400 new cancer diagnoses in Iowa this year — up from an estimated 16,600 last year, according to a new State Health Registry of Iowa report released Wednesday. The number of Iowans expected to die from cancer this year, however, is projected to dip from the 2016 projection of 6,400 to 6,200 this year, according to the registry, located at the University of Iowa in the College of Public Health’s Department of Epidemiology. Cancer and heart disease persist in killing the most Iowans annually. The 6,200 deaths expected in 2017 is 18 times the number of auto fatalities, according to the report. (Cedar Rapids Gazette)

National News

House sets risky health care vote after trump demands it
In a gamble with monumental political stakes, Republicans set course for a climactic House vote on their health care overhaul after President Donald Trump claimed he was finished negotiating with GOP holdouts and determined to pursue the rest of his agenda, win or lose. House Speaker Paul Ryan set the showdown for Friday, following a nighttime Capitol meeting at which top White House officials told GOP lawmakers that Trump had decided the time for talk was over. In an embarrassing and stinging setback hours earlier, leaders abruptly postponed the vote because a rebellion by conservatives and moderates would have doomed the measure. (Associated Press)

Late move to dump ‘essential’ benefits could stand chronically ill
A last-minute attempt by conservative Republicans to dump standards for health benefits in plans sold to individuals would probably lower the average consumer’s upfront insurance costs, such as premiums and deductibles, said experts on both sides of the debate to repeal and replace the Affordable Care Act. But, they add, it will likely also induce insurers to offer much skimpier plans, potentially excluding the gravely ill, and putting consumers at greater financial risk if they need care. What might be desirable for business would leave patients vulnerable. (Kaiser Health News)

CBO says revised GOP health care bill still leaves 24 million uninsured
In the second round of bad news for the revised GOP health care bill, the Congressional Budget Office (CBO) reported Thursday that the faltering legislation would still leave 14 million people without health insurance next year and 24 million without coverage in 2026 – the same as the original bill. While the legislation wouldn’t reduce the federal deficit as much as the original bill – $150 billion over the next ten years compared with $337 billion – the identical coverage estimates are yet another blow to GOP leaders whose hopes for the bill’s House passage fizzled Thursday amid stubborn opposition from House conservatives led by the Freedom Caucus. (Miami Herald)

Cost of KanCare expansion debated ahead of key vote
A dispute about the cost and potential benefits of expanding Medicaid eligibility is heating up ahead of a Kansas Senate committee vote on a bill. In testimony Monday to the Senate Public Health and Welfare Committee, supporters of expanding eligibility for KanCare, the state’s privatized Medicaid program, said expansion would more than pay for itself. An estimated 300,000 Kansans would qualify for coverage under expansion, though only about half that number would enroll in the first year, according to estimates. (KCUR)

Recent events hearten advocates of Georgia’s rural hospitals
This week, the fortunes of rural hospitals in Georgia took a turn for the better. Voters in Monroe and Jefferson counties approved tax increases to help preserve their rural hospitals, which are in financial danger. And a proposed tax credit upgrade for donors to rural hospitals, an idea that had appeared dead in this year’s Georgia General Assembly session, is alive again less than two weeks before the legislators are expected to adjourn. Rural health care in Georgia has been financially endangered for several years. Five rural hospitals have closed in the state since the beginning of 2013, and many others are cash-strapped and looking for help. (Georgia Health News)

Featuring hospital and health care headlines from the media and the Web.

Iowa News

‘Repeal and replace’ easier said than done
Republicans have kept the Affordable Care Act in their crosshairs ever since then-President Obama and the Democratic majority in Congress pushed it through, over GOP objections, seven years ago. Donald Trump and most every Republican railed against Obamacare during last year’s campaign, vowing to “repeal and replace” it. And so, after Republicans won the White House and majorities in both chambers of Congress, they set about to make good on that campaign pledge. No one should be surprised by that. What might be surprising, at least to those politicians now in power, is that their “repeal-and-replace” promise is easier said than done. (Dubuque Telegraph Herald)

Dubuque ACA supporters rally in final hours before GOP health care vote
In the final hours before a crucial House vote on healthcare, white bags littered Dubuque’s Washington Park, Wednesday evening. All of them filled with a candle. Dozens of Affordable Care Act (ACA) supporters placed the 450 luminaries there, each represented 100 people expected to lose coverage in Iowa’s First District if the ACA is dropped. “Obviously, that’s too many,” said Helen Varner, an organizer of the rally. But that reality now seems less likely to this group as more and more Republicans have jumped ship, coming out against the Affordable Healthcare Act. (KCRG)

King lone ‘yes’ vote on health care bill among Iowa’s House members
With a key vote looming Thursday, Iowa’s entire congressional delegation has staked out positions on the Republican health care proposal aimed at repealing and replacing Obamacare. Three Iowa members, U.S. Representatives David Young, Rod Blum and Dave Loebsack — two Republicans and a Democrat — have announced they oppose the measure and will vote “no” on Thursday. The delegation’s other Republican, U.S. Representative Steve King, says he will support the bill. The ardent conservative from the state’s most conservative district was “undecided” and “leaning no” on the bill as recently as Wednesday morning. (Des Moines Register)

Another Iowa hospital closes psychiatric unit
Oskaloosa’s hospital has shuttered its inpatient psychiatric unit, compounding a chronic shortage of options for southeast Iowans suffering mental-health crises. The Mahaska Health Partnership hospital discharged its last psychiatric inpatient Monday, CEO Jay Christensen said Wednesday. The Oskaloosa hospital is the latest in a string of Iowa hospitals that have closed or trimmed their psychiatric units over the past several years, citing financial losses. Patient advocates say southeast Iowa is particularly short of such facilities, especially since the state closed its Mount Pleasant mental hospital in 2015. (Des Moines Register)

National News

Little agreement among GOP on health care bill next steps
House Republicans had hoped to vote on a bill to partially repeal and replace the landmark 2010 health care law on Thursday, seven years to the day after President Barack Obama signed it. Instead, they find themselves without the votes to do so and little agreement on their next move. The House GOP Conference’s regular Thursday weekly planning meeting, where lawmakers might have decided on next steps, was canceled Thursday morning. Progress on the bill may not be made until midday Thursday or later. (Roll Call)

High drama for Obamacare vote
President Trump and GOP leaders are pulling out all the stops to win over House conservatives to their ­ObamaCare replacement bill ahead of a crucial up-or-down vote scheduled for today. Recent developments suggested a deal that could win over House Freedom Caucus members was possible. Trump promised a group of 18 GOP lawmakers that he would support an amendment in the Senate that would repeal ­ObamaCare’s essential health benefits. That pledge, which also included a commitment from Senate Majority Leader Mitch McConnell (R-Ky.), lawmakers said, was enough to bring on board a key conservative, Representative Steve King (R-Iowa). (The Hill)

Obamacare repeal threatens a quiet revolution in how US cities care for poor
Over the last four years, Denver, Colorado has quietly transformed how it cares for its poorest residents. Republican legislation to roll back Obamacare threatens to not only strip Medicaid coverage from millions of poor Americans, but also to take away the funding that has allowed communities like Denver to build better systems to care for them. That is fueling rising alarm in cities such as Los Angeles, Cincinnati and Boston, where safety net hospitals have also used Obamacare’s insurance expansion to take on underlying challenges that make lower-income Americans sick, including unsafe housing, poor diet and untreated mental illness. (Los Angeles Times)

GOP lawmakers slammed Obamacare for Medicare cuts. Trumpcare doesn’t undo them
In letter after letter, Republican lawmakers have reminded their constituents: Obamacare cut Medicare. Implied, and sometimes stated outright, was that the GOP’s own plan should instead bolster the program. “Any reforms must protect Medicare,” Congressman Ted Poe, a Texas Republican, wrote in a letter last month to one of his constituents about the Affordable Care Act’s failures and his party’s own plans. But the bill now working its way through Congress does not reverse those cuts. Instead, Republicans for now appear committed to keeping this reviled part of the law. (Stat)

Virginians with disabilities and mental illness raise concerns over GOP health care bill
Governor Terry McAuliffe and advocates for Virginians with disabilities and mental illness have raised concerns about how the Republicans’ proposed health care bill would impact the state. The bill’s latest iteration could reduce Virginia’s Medicaid funding by $708 million over the next decade, Joe Flores, deputy secretary of Health and Human Resources, said late Wednesday afternoon. More than 11,200 people are on a waiting list for disability services funded through Medicaid as of this week, officials with the Department of Behavioral Health and Developmental Services said. People diagnosed with serious mental illness stand to lose access to doctors if the bill is approved. (Richmond Times-Dispatch)

Iowa hospitals are urging the state’s congressional delegation to vote against the American Health Care Act (AHCA), the bill designed to “repeal and replace” the Affordable Care Act (ACA) and which is expected to be voted on in the House today.

It’s estimated that this legislation would cause 24 million Americans to lose insurance coverage. In Iowa, it is estimated that 200,000 individuals who gained coverage under the ACA would lose their health care coverage. Because of this loss of coverage, Iowa’s hospitals would be called upon to care for more uninsured individuals through more expensive means, often in the emergency room.

Uncompensated and charity care will drastically rise again, causing concern for the viability of health care services in rural communities in Iowa and throughout the nation. Despite this loss of coverage and expectation for hospitals to shoulder the increased burden, the AHCA fails to restore billions of dollars in cuts to hospital payments that were part of the ACA.

Additionally, the proposal to change Medicaid from a federal-state partnership to a program that simply provides per-capita lump-sum payments to the states raises serious worries about the future coverage of 630,000 Iowa residents who depend on the program. Most notably, this fundamental change in Medicaid could eventually force the state, facing another tight budget year, to reduce care or tighten eligibility requirements, creating more uninsured, unhealthy Iowans.

The AHCA will not improve the health and well-being of Iowans. In fact, it will do the opposite. This legislation would return the nation to the dark days when the uninsured rate reached double digits and millions of families didn’t have access to primary and preventive care. That means a less healthy population and higher health care costs. It also means that health care providers will once again carry the burden of providing safety-net care. The impact will be borne by all health care consumers and taxpayers who will experience cost shifts to pay for that care.

AHCA will leave more Iowans without health insurance coverage and harm Iowa’s hospitals and communities.

IHA is asking hospital advocates to reach out to their US House members to vote “no” on AHCA. If you stand with Iowa’s hospitals, click here to send a message to Congress.

Featuring hospital and health care headlines from the media and the Web.

Iowa News

Johnson County law enforcement learns how to interact with mentally ill in crisis situations
Law enforcement are learning some alternatives for handling people experiencing substance abuse or mental health issues. Right now these people will go to jail or to the hospital, but that may not be the right place for them to go. “Whenever you train officers to be able to identify mental crises and de-escalate them without force everybody wins,” said Captain Mark Bullock with the University of Iowa Police Department. Johnson County’s Crisis Intervention Training is more about deescalating situations before they get out of hand. Officers said having better communication skills means they won’t have to use force, which means fewer situations ending with a trip to the emergency room. (KCRG)

SMCH contributes more than $19.79 million to Calhoun County economy
A recent study by the Iowa Hospital Association has revealed that the 404 jobs at Stewart Memorial Community Hospital (SMCH) in Lake City generate more than $19.78 million for the Calhoun County economy. The report also indicated that employees spend more than $2.4 million in retail sales and contribute more than $145,000 in state sales tax revenue. In total, Iowa’s health care sector contributes $16.6 billion into the state economy and provide just short of 325,000 jobs, or about one-fifth of the state’s non-farm employment. (KCIM)

Representative Blum opposes GOP health care plan
Iowa Republican Representative Rod Blum said Tuesday he will not support the House GOP’s health care plan in its current form. The 1st District congressman tweeted that the American Health Care Act “doesn’t do enough to lower premiums for hardworking Americans.” The repeal and replacement of much of Obamacare is supposed to get a vote on the House floor on Thursday. Dozens of Republican House members oppose the bill or have expressed major concerns. (Iowa Public Radio)

National News

GOP health care bill would kill 1.8 million jobs in 2022, says new analysis
The US economy would produce 1.8 million fewer jobs in 2022 if the Republican legislation to repeal the Affordable Care Act became law, according to a new analysis by the Center for American Progress. Two provisions in the legislation accounted for most of the projected job losses: repealing expanded eligibility for Medicaid coverage and cutting federal financial assistance for marketplace health coverage. Both measures were expected to eliminate 2.2 million jobs in 2022, according to the study by the left-leaning think tank. (McClatchy)

Gripes about Obamacare aside, health insurers are in a profit spiral
Over the last few years, big managed care companies like UnitedHealth Group have contributed to the furor over the fate of the Affordable Care Act by saying that important parts of it are fundamentally flawed. But overall it has been something of a blessing. The underlying businesses of the big managed care companies have actually done extremely well under Obamacare. They have run into some problems but are hardly in need of a rescue. The companies have notched profits — from expansion of Medicaid, for example, and from services aimed at cutting medical costs — while learning how to insulate themselves from parts of the law that have crimped their income. (New York Times)

House health care bill teetering on the brink of failing
The GOP health care bill appears poised for failure with at least 19 Republicans committed to voting “no,” absent additional substantial changes, and several more likely to join them in opposition. CQ Roll Call has confirmed in interviews and review of public statements that at least 19 Republicans will not vote for the GOP health care bill Thursday. Another handful said they were either undecided or were leaning toward opposing the bill, with most of those members still looking for changes. If the number of “no” votes surpasses 21, that’s enough to sink the bill. (Roll Call)

Trump warns House Republicans: Repeal health law or lose your seats
President Trump on Tuesday turned up the pressure on recalcitrant Republicans to support a sweeping bill to overhaul the health care system, threatening wavering lawmakers in his party with political payback if they failed to get behind a measure that has become an early test of his negotiating power. At a private meeting with House Republicans at the Capitol, the president also delivered a blunt warning that many of those present would lose their seats in next year’s midterm congressional elections if the effort failed. (New York Times)

Tapping telehealth for complex cases
For more than a decade, some hospitals and health systems have turned to telehealth to reach patients in areas squeezed by physician shortages. More recently, providers answered patients’ calls for convenience by offering on-demand video visits for routine health problems. Now the leading health systems are harnessing telehealth to treat patients with more complex conditions in ways that lower costs by preventing complications, reducing lengths of stay and, when used in home or post-acute settings, reducing readmissions. (Modern Healthcare)