Impact of ACA Repeal on Medical Sector

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Republicans and President Trump have promised to replace and repeal the Affordable Care Act. Without a good replacement, billions of dollars in economic output and tens of thousands of jobs could be lost in Arizona alone. Hear from Arizona House Health Committee chair Representative Heather Carter, Arizona Chamber of Commerce president and CEO Glenn Hamer and Greg Vigdor, president and CEO of the Arizona Hospital and Healthcare Association, on the issue.

TED SIMONS: REPUBLICANS AND PRESIDENT TRUMP HAVE PROMISED TO REPEAL THE AFFORDABLE CARE ACT. BUT WITHOUT A PROPER REPLACEMENT, BILLIONS OF DOLLARS IN ECONOMIC OUTPUT AND TENS OF THOUSANDS OF JOBS COULD BE LOST IN ARIZONA ALONE. JOINING US NOW IS STATE REPRESENTATIVE HEATHER CARTER, CHAIR OF THE ARIZONA-HOUSE HEALTH COMMITTEE, ALSO WITH US IS PRESIDENT AND CEO OF THE ARIZONA CHAMBER OF COMMERCE AND INDUSTRY, GLENN HAMER, AND GREG VIGDOR, PRESIDENT AND CEO OF THE ARIZONA HOSPITAL AND HEALTHCARE ASSOCIATION. GOOD TO HAVE YOU ALL HERE. THANKS FOR JOINING US. REPEALING THE AFFORDABLE CARE ACT WITHOUT A REPLACEMENT. FULL REPEAL, NO REPLACEMENT. YOUR THOUGHTS, IMPACT ON ARIZONA?

HEATHER CARTER: WHEN LOOKING AT HEALTHCARE IN ARIZONA SPECIFICALLY, THE HEALTHCARE SECTOR IS AN ECONOMIC ENGINE TO THE STATE OF ARIZONA. THAT MEANS NOT ONLY PROVIDING HIGH QUALITY HEALTHCARE TO THE CITIZENS OF ARIZONA BUT ALSO SOME OF OUR LARGEST JOB PROVIDERS. BANNER HEALTH IS LARGEST EMPLOYER IN ARIZONA. THEY PROVIDE JOBS TO KEEP OUR COMMUNITIES ALIVE. TALKING ABOUT THE NEXT STEPS FOR HEALTHCARE IN THE UNITED STATES, WE NEED TO MAKE SURE WE ARE LOOKING AT WHAT IS THE IMPACT TO OUR STATE OF ARIZONA?

TED SIMONS: IF THE AFFORDABLE CARE ACT IS REPEALED BUT NOT REPLACED?

GLENN HAMER: IT'S CLEAR TO ME THESE ARE GOING TO MOVE TOGETHER. YOU CAN'T REPEAL IT WITHOUT A GOOD REPLACEMENT. THERE IS GOING TO BE A LOT OF REPAIR WORK. AS REPRESENTATIVE CARTER MENTIONED, THE ECONOMIC CONSEQUENCE IS ENORMOUS. FROM OUR CONVERSATIONS WITH OUR DELEGATION, PARTICULAR OUR TWO UNITED STATES SENATORS, IT'S CLEAR THAT ANY SORT OF REPEAL OF OBAMA CARE, WHICH I EXPECT TO HAPPEN, IS GOING TO HAPPEN IN TANDEM WITH A THOUGHTFUL REPLACEMENT.

TED SIMONS: IF THERE IS A THOUGHTFUL REPLACEMENT TO THE AFFORDABLE CARE ACT, WILL THIS MEAN THE JOBS ARE NO LONGER IN JEOPARDY? THE FOLKS COVERED NOW WILL STILL FIND A WAY TO BE COVERED?

GREG VIGDOR: THE DETAILS MATTER SO IT REMAINS TO BE SEEN WHAT GOES FORWARD. THERE ARE WAYS TO WORK WITH THEM. AS WE WORKED WITH THE OBAMA ADMINISTRATION, WE ARE WILLING TO WORK WITH THE OTHER SIDE TO MAKE THIS WORK.

TED SIMONS: WHEN YOU SAY YOU ARE WILLING TO WORK WITH THEM, WHAT DO YOU TELL THEM?

GREG VIGDOR: OUR PRIMARY CONCERN IS TAKING CARE OF PATIENTS, BUT THERE ARE ECONOMIC CONSEQUENCES TO ARIZONA IN PARTICULAR IF IT'S WRONG AND WE HAVE TO LOOK AT THE IMPACT AND BUILD FROM THERE.

TED SIMONS: WE WANT TO GET BACK TO THE ECONOMIC IMPACT BUT AS FAR AS HUMAN BEINGS ARE CONCERNED, HOW MANY ARE AFFECTED AND WHAT WILL THEY DO AND WHERE WILL THEY GO IF THERE IS NOT A PROPER REPLACEMENT FOR OBAMA CARE. THE APPLE CART WILL BE UPSET, WON'T IT?

HEATHER CARTER: THE GOOD NEWS IS THAT OUR GOVERNOR EXPRESSED CONCERN TO ENSURE THE RUG IS NOT PULL OUT FROM ANY CITIZEN IN ARIZONA. WE HAVE WORKED TO MAKE SURE WE ARE SHARING OUR CONCERNS WITH OUR DELEGATES IN WASHINGTON D.C. WE WANT TO MAKE SURE THEY UNDERSTAND IN TERMS OF IMPACT TO THE SYSTEM, ANY IMPACT ON OUR TOP PROVIDERS OF HEALTHCARE IN ARIZONA IMPACT THE PATIENT. WE ARE TRYING TO MAKE SURE WE HAVE AN OPEN DIALOGUE MOVING FORWARD SO THEY HAVE ALL OF THE INFORMATION THEY NEED.

TED SIMONS: RURAL HOSPITALS, COMMUNITY HOSPITALS, BIG CONCERN AS TO WHAT'S NEXT. WHAT DO YOU TELL THEM?

GLENN HAMER: WE TELL THEM FIRST OF ALL WE UNDERSTAND HOW IMPORTANT IT IS TO GET THIS RIGHT. EVERY SUMMER I TAKE A ROADSHOW ALL OVER THE STATE. I HEARD THE MEDICAID RESTORATION WAS VITAL IN TERMS OF CONTINUING TO OPERATE. WHAT GOVERNOR DUCEY HAS DONE, PUTTING TOGETHER A LETTER TO SAY CONGRESS MUST ENSURE THEIR REPLACEMENT PLAN DOESN'T INCREASE HOSPITAL UNCOMPENSATED CARE. WE SAY AMEN. THERE ARE HUGE PROBLEMS WITH OBAMA CARE, THE MOST COMMON THE EXCHANGES, THE OBAMACARE EXCHANGES HAVE BEEN AN UNMITIGATED DISASTER. IT'S HARD FOR ME TO IMAGINE A PROPOSAL THAT DIDN'T IMPROVE THAT SITUATION.

TED SIMONS: WOULD IT BE HARD FOR YOU TO IMAGINE A SITUATION THAT DIDN'T IMPROVE THE SITUATION? THERE ARE A LOT OF FOLKS COVERED WITH OBAMA CARE.

GREG VIGDOR: THERE ARE 500 PEOPLE COVERED AS A RESULT OF ACT. THERE ARE OTHER WAYS TO FIND COVERAGE. AND WE'RE GONNA FIND THEM. I AGREE WITH GLENN, AT LEAST OUR DELEGATION IS RALLYING TO FIND A REPLACEMENT.

TED SIMONS: MEDICARE REIMBURSEMENTS. WHERE DOES THAT STAND NOW AND HOW BIG A DEAL IS THAT AS FAR AS A REPLACEMENT?

GREG VIGDOR: HERE'S THE DEAL WITH MEDICARE GOING BACK TO PASSAGE OF THE ACT. CONGRESS AND OBAMA NEEDED MONEY TO PAY FOR THE MEDICAID EXPANSIONS AND SUBSIDIES TO BUY INTO THE INSURANCE MARKET. A BIG CHUNK OF WHAT THEY FOUND IN REVENUE IS MEDICARE CUTS TO HOSPITALS, 155 BILLION NATIONALLY. AS WE CONSIDER THE QUESTION OF REPEAL, IF IT DOESN'T INCLUDE COVERAGE FOR THOSE PEOPLE, THE EXCHANGE FOR HOSPITALS, WE HAVE TO REVISIT THE CUTS OR OUR HOSPITALS WON'T BE ABLE TO MAKE IT WORK.

TED SIMONS: FROM A- GO AHEAD PLEASE.

HEATHER CARTER: IT'S ALSO TIME TO ADDING A THIRD WORD TO THE CONVERSATION ABOUT THE AFFORDABLE CARE ACT. YOU HEAR REPEAL AND REPLACE BUT WE HAVE TO LOOK AT RESTORING FUNDING CUTS AND THEN LOOK AT REPEAL AND REPLACE. BECAUSE THAT'S GOING TO BE A GAME CHANGER FOR OUR HEALTHCARE SYSTEMS IN ARIZONA.

TED SIMONS: EXAMPLE OF FUNDING CUTS.

HEATHER CARTER: MEDICARE BEING THE PRIMARY CONCERN IN TERMS IF THE CUTS REMAIN IN PLACE AND REPEAL AND REPLACE POLICY DECISION DOESN'T INCLUDE THE ISSUES, THEN WE ARE CONCERNED. CARE IS PROVIDED TO THE INDIGENT AND THE DISPROPORTIONATE AMOUNT HOSPITALS RECEIVE IS ALSO ANOTHER CUT.

TED SIMONS: IF THE AFFORDABLE CARE ACT IS MEANT TO INSURE THOSE UNEMPLOYED, YOUNG PEOPLE, THOSE WITH PREEXISTING CONDITIONS, IS IT JUST GOING TO BE OBAMA CARE BY ANOTHER NAME? HOW DO YOU CHANGE THIS?

GLENN HAMER: THERE IS A LOT OF WORK TO BE DONE SO WHEN IT IS CHANGED, IT FUNCTIONS. WHEN YOU LOOK AT THE OBAMA CARE EXCHANGES, NOT MEDICAID, WE WENT FROM A SITUATION IN THE STATE TO HAVING A LOT OF PROVIDERS TO NOW IN MOST OF ARIZONA WE HAVE ONE PROVIDER WITH DRAMATIC COST INCREASES FOR A LOT OF ARIZONA FAMILIES IN TERMS OF PREMIUMS. THAT TO ME, IS THE MOST BLINDINGLY OBVIOUS PLACE TO START IN TERMS OF REPAIRING AND CREATING A SYSTEM THAT DOES MORE THAN GET THE MARKETS RIGHT, BUT TO REALLY PROTECT AND HELP PEOPLE, MORE CONSUMER CHOICE. THINGS LIKE THAT.

TED SIMONS: I HAVE HEARD PEOPLE SAY IF THERE IS NOT A PROPER REPLACEMENT, A HEALTHCARE RECESSION COULD HAPPEN. IS THAT POSSIBLE?

GLENN HAMER: I DON'T BELIEVE THAT'S GOING TO HAPPEN. OBAMA CARE WAS JAMMED THROUGH, NO REPUBLICAN SUPPORT, AN ABOMINATION OF A PROCESS. I BELIEVE IT IS PAINFUL FOR THOSE REPUBLICANS THAT HAVE BEEN SAYING FOR A NUMBER OF YEARS THAT WANT TO REPEAL OBAMA CARE. I WANT TO GIVE THEM CREDIT FOR MOVING FORWARD IN A METHODICAL WAY, REACHING OUT TO HOSPITALS, MAKING SURE WHAT THEY DO WILL RESULT IN A BETTER SYSTEM. THEY SHOULD BE COMMENDED FOR THAT.

TED SIMONS: WOULD BLOCK GRANTS MAKE BETTER SENSE? PER CAPITA FUNDING MAKE BETTER SENSE?

GREG VIGDOR: THOSE ARE JUST LABELS. THE REAL QUESTION IS THE FUNDING BENEATH IT AND THE POLICY CHANGE. IF THERE IS A WAY TO MAKE OUR SYSTEM MORE PROFICIENT, GREAT, BUT IT'S REALLY JUST CUTTING THE FUNDING WE'LL GET. THAT'S WHAT'S IMPORTANT TO US. ONE OF THE OTHER THINGS TO NOTE IS WE'VE ACTUALLY BEEN DOING A LOT OF THIS WORK IN ARIZONA THROUGH OUR AXIS PROGRAM. IT'S ACTUALLY RECOGNIZED AS A LEADER AMONG MEDICAID PROGRAMS THROUGHOUT THE NATION. WE HAVE BEEN DOING THIS THROUGH WHAT IS CALLED WAIVERS. WHETHER THAT WILL ADVANCE CARE THROUGH ARIZONA IS DOUBTFUL. WE WANT TO CONTINUE ON THE PATH WE ARE ON AND EXPLORE THE POLICIES FURTHER.

GLENN HAMER: THAT POINT IS IMPORTANT. WE SHOULD NOT BE PENALIZED BECAUSE WE HAVE BEEN IN MOST EFFICIENT. WE HAVE THE BEST MEDICAID DIRECTOR IN THE COUNTRY. OTHER STATES LIKE NEW YORK ARE GAMING THE SYSTEM FOR A LONG TIME. WE HAVE TO BE CAREFUL THAT ARIZONA IS NOT PENALIZED FOR DOING THE RIGHT THING.

TED SIMONS: YOU AGREE WITH THAT?

HEATHER CARTER: ABSOLUTELY. ARIZONA IS THE GOLD STANDARD IN MEDICAID SYSTEMS AND WE HAVE DONE IT IN PARTNERSHIP WITH THE PRIVATE SECTOR. WHEN YOU'RE LOOKING AT A REPLACEMENT FOR THE AFFORDABLE CARE ACT, A ONE SIZE MODEL DOE NOT FIT ALL. WHAT WORKS IN CALIFORNIA AND WHAT WORKS IN NEW YORK WOULDN'T WORK IN ARIZONA, BUT THE CONVERSE IS TRUE, OTHER STATES CAN LEARN FROM WHAT WE HAVE DONE TO PROVIDE THE MOST COST EFFECTIVE AND EFFICIENT SYSTEM IN THE COUNTRY.

TED SIMONS: CAN WHAT WE HAVE DONE IN ARIZONA SURVIVE SOMETHING THAT IS NOT THE AFFORDABLE CARE ACT.

HEATHER CARTER: I BELIEVE IT CAN. I BELIEVE IT WILL BE A PROCESS OF ALL THE ELECTED OFFICIALS FROM THE STATE TO THE FEDERAL GOVERNMENT WORKING TOGETHER TO FIGURE OUT WHAT THE COMPONENTS ARE.

GLENN HAMER: SURE, WE'RE GONNA GET A BETTER PRODUCT. I MENTIONED THE HEALTHCARE EXCHANGES, THERE'S ALSO OTHER AREAS WHERE THERE'S BIPARTISAN SUPPORT. ELIMINATING THE CADILLAC TAX, THE HEALTH INSURANCE TAX. THERE IS BI-PARTISAN SUPPORT IN ARIZONA. IT MAY NOT BE AS FAST AS PEOPLE THOUGHT, BUT I BELIEVE IT WILL COME OUT A BETTER PRODUCT THAT WILL BE GOOD FOR THE STATE OF ARIZONA AND MORE IMPORTANTLY OUR CITIZENS.

TED SIMONS: A BETTER PRODUCT CONSIDERING WHAT WE WERE EXPERIENCING BEFORE OBAMA CARE?

GREG VIGDOR: WE'LL FIND A WAY. THE AMERICAN HEALTHCARE SYSTEM, THE ARIZONA HEALTHCARE SYSTEM IS RESILIENT. WE HAVE TO MAKE SURE THERE IS NOT CONSEQUENCES TO PATIENTS. WE PUT THEM IN CENTER, WE'LL MAKE IT HERE

TED SIMONS: ALRIGHT GOOD DISCUSSION, GOOD TO HAVE YOU ALL HERE. THANKS FOR JOINING US. WE'LL BE BACK IN A MOMENT WITH A LOOK AT SPRING TRAINING BASEBALL AND THE UPCOMING CACTUS LEAGUE SEASON.
 

Heather Carter: Arizona House Health Committee chair Representative
Glenn Hamer: Arizona Chamber of Commerce president and CEO
Greg Vigdor: President and CEO of the Arizona Hospital and Healthcare Association

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