(l. to r.) Will Cromer and Clay Phillips
As states across the country look at the implications of the ongoing federal debate around health care legislation, Leadership Health Care hosted a Fundamentals series panel discussion on how providers, payers and legislators in Tennessee are preparing for what may happen with the passage of the American Health Care Act (AHCA).
Last week’s panel featured Will Cromer, deputy director and chief of staff, health care finance and administration for the State of Tennessee; Clay Phillips, vice president, network innovation for BlueCross BlueShield of Tennessee; and Mary Layne Van Cleave, executive vice president and COO for the Tennessee Hospital Association. Darin Gordon, president and CEO of Gordon & Associates, LLC, and former director of TennCare, moderated the discussion.
All of the panelists agreed that a lot is still uncertain when it comes to the AHCA and its passage. However, all agreed that the current ACA law is not perfect.
“There are some clear successes with the ACA, but there are also some major issues with the exchanges and access through the exchanges. In Tennessee alone we have 75 counties that only have one payer option available through the exchanges,” said Van Cleave.
Phillips highlighted that the ACA has done a good job at what it set out to do — avoid job block and expand access. But the country forgot to pay for it, which is why it’s run into issues.
Mary Layne Van Cleave
“I think the CBO is probably right that depending on what the complete calculus is, you will probably see some initial price increases with passage of the AHCA. But after that, the market will likely stabilize. We won’t really know what the financial implications are going to look like until about three years into the bill being law,” said Phillips.
Cromer discussed the AHCA’s implications when it comes to Medicaid financing, a part of the bill that directly impacts states. The House version of the AHCA passed in May looks to put a cap on how much states can spend on Medicaid, using 2016 as a state’s base year per capita cap.
“The biggest concern from the state perspective is that it’s looking to shift risk to the states, but not control. If you are going to cap federal spending on Medicaid, states need more flexibility from federal requirements in order to manage the program successfully,” Cromer said.
The Senate version of the AHCA, which was released late last week, is expected to go to a vote in the coming weeks.
This Fundamentals series discussion is part of ongoing programming for the Council’s Leadership Health Care initiative, offering members insights into key industry-related topics. For more information about Leadership Health Care, visit www.leadershiphealthcare.com.