Executive staff from NJHA held a media briefing on potential effects of repealing without replacing the Affordable Care Act, providing specific modeling of impacts at the hospital and county levels.

NJHA President and CEO Betsy Ryan said any plan to repeal the ACA must be accompanied by a replacement plan that extends coverage to the 22 million Americans – and nearly 800,000 New Jerseyans – who are covered under the law. She told reporters she is concerned that “coverage” is being conflated with “access to care” under some of the replacement plans being discussed. For patients as well as providers, insurance coverage that provides access to healthcare services in the appropriate healthcare setting is essential.

Hospitals and health systems in New Jersey have already absorbed nearly $1.5 billion in funding cuts since the ACA was enacted in 2010, with the promise of expanded healthcare coverage to mitigate these losses. The healthcare sector is concerned the cuts will remain despite the coverage of 796,291 state residents being jeopardized by repealing the law. 

New Jersey’s post-acute facilities have also seen more than $430 million cut from their funding, according to NJHA. NJHA’s modeling also showed the cuts yet to come if Congress and the new Administration do not pass an appropriate replacement plan. New Jersey hospitals will see added cuts totaling $1.1 billion through 2019, while post-acute care providers will sustain another $325 million in cuts.

A listing of funding cuts by hospital, as well as ACA enrollment by county, is available on the NJHA website. 

Other key issues for New Jersey include:

• The state could lose federal matching dollars under Medicaid expansion, to the tune of $4.4 billion annually.
• New Jersey residents could lose $795 million in federal subsidies that helped them pay for their insurance premiums.
• A stark reduction of insured New Jerseyans would create a dramatic increase in the demand for charity care services. That would be a double blow to hospitals that have seen state charity care funding cut by $350 million in the last two state budgets.
• More residents of New Jersey would access care through the emergency department, which is not effective for patients, increases wait times for all and increases healthcare costs.
• Further impacts include reduced investment in population health, quality improvement and health information technology; an unraveling of the healthcare safety net; and deep payment cuts to nursing homes and other post-acute providers that care for the most vulnerable and frail New Jerseyans.
• The additional strain on hospital budgets of caring for more indigent patients would force extremely difficult – and often unpopular – choices about availability of services, staffing and reinvestments and modernization.

Ryan reiterated her desire to work with New Jersey’s congressional delegation to ensure stability and appropriate funding for the state’s healthcare providers. NJHA is holding an advocacy day in Washington, D.C., Feb. 7, to further communicate the concerns of stakeholders.