The election of President Donald Trump and the preservation of Republican majorities in Congress — avowed opponents of the Affordable Care Act — likely mean that South Florida hospitals will be forced to find ways to deliver medical care to more people with less money, a panel of hospital CEOs said Friday at a healthcare conference at the University of Miami.
With the future of the health law better known as Obamacare facing an uncertain future, South Florida hospital CEOs speaking at the conference, “The Business of Health Care Post Election,” said they expect to see more partnerships between competing hospitals, an emphasis on technology such as doctor visits via remote video conferencing, and greater financial risks for keeping patients healthy.
“While Obamacare was really about expanding coverage, it looks like what’s going to be happening under the new administration is cutting costs,” said Orlando L. Alvarez Jr., chief strategy officer for Cleveland Clinic Florida.
Alvarez added that with 1.7 million Floridians signed up for 2017 coverage through the ACA insurance exchange at healthcare.gov, including about 635,000 people in Miami and Fort Lauderdale, “any changes around coverage that doesn’t cover that population will have a negative impact financially to the healthcare infrastructure.”
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But Carlos Migoya, CEO of Miami-Dade’s taxpayer-owned Jackson Health System, the largest public hospital in Florida, struck an optimistic note.
That may be because lawmakers in Congress have been receptive to Florida hospital requests for larger federal payments to hospitals to care for the uninsured. Jackson has lost about $160 million a year since 2014 because of reductions in those payments — a loss that Migoya attributed to Florida’s refusal to expand Medicaid to nearly all low-income adults as provided under the ACA.
“Florida is the only state that nationally got negatively impacted by the fact that we did not come up with Medicaid expansion,” he said.
Migoya recently returned from a trip to Washington, D.C., where he and other hospital executives lobbied members of Florida’s congressional delegation for an additional $1 billion in federal funds for hospitals to care for the uninsured.
“They’re receptive to those kinds of conversations,” he said.
But Migoya, who admitted to being “very concerned” about future public funding for Jackson Health, said he also doesn’t see a replacement for the ACA coming anytime soon: “We’re talking 2019 before we see anything of that magnitude.”