Medicaid expansion is the likeliest long-term solution for hospitals in Florida, Texas and the 19 other states that have resisted broadening coverage under the government healthcare program, the incoming president of the nation’s most influential hospital lobbying group, the American Hospital Association, said Friday.
Noting that only six states adopted Medicaid when the program first launched in January 1966 — all states joined by 1982 — Rick Pollack, who will become AHA president in 2016, said the forward march of healthcare reform will make coverage expansion unavoidable if hospitals are going to thrive. Included in that reform is a scheduled reduction of government payments to hospitals that care for large numbers of uninsured patients.
“History may be repeating itself here,’’ Pollack said, at the South Florida Hospital and Healthcare Association’s annual summit in Davie. “It may take certain states like Texas, Florida and Louisiana longer, but there is a little bit of a precedent here … the switch doesn’t get flipped, and it doesn’t necessarily occur overnight.”
The Affordable Care Act continues to face legal tests, Pollack noted, most immediately the Supreme Court’s ruling expected this month on King v. Burwell, which could unravel the government subsidies that make health insurance affordable for 6.4 million Americans in the 34 states that rely on the federally-run exchange, including 1.3 million people in Florida.
The central question in the Supreme Court case, Pollack noted, is the same one dividing Florida’s Legislature, which was forced to meet in a special session this month after failing to reach agreement on a state budget, largely over Medicaid expansion.
“Coverage, and how do you pay for it,’’ Pollack said. “That’s where we’re at all over again this month.”
He noted that most Republicans and Democrats agree on many of the ACA’s provisions, such as insurance reforms, incentives for coordinated care and healthy outcomes, and price transparency.
But while the question of coverage and how to pay for it remains an ideological sticking point, he said, most of the AHA’s 4,500 member hospitals are moving ahead with the Affordable Care Act’s other reforms — becoming or joining large health systems that can coordinate patient care; affiliating with more physicians who can provide a broad spectrum of treatment; reducing patient infections and other conditions to avoid costly penalties; and adopting electronic health records to meet reporting requirements.
While hospitals and states are at varying stages of adapting to the new landscape of healthcare reform, Pollack said, the stakes are pretty clear to all in the hospital industry.
“We don’t want to be Blockbuster here,’’ he said in closing. “We want to be Netflix.’’