Affordable Care Act 

Senate Republicans, who have promised a repeal of the Affordable Care Act for seven years, took a major step toward that goal on June 22, 2017, unveiling a bill to make deep cuts in  Medicaid and end the law's mandate that most Americans have  health insurance.

 

According to the New York Times, the  142-page bill would create a new system of federal tax credits to help people buy health insurance, while offering states the ability to drop many of the benefits required by the Affordable Care Act, such as maternity care, emergency services, and  mental health treatment.

The Senate bill would allow insurers to charge older people five times as much as younger ones; the limit now is three times. The Senate measure, like the House bill, would phase out the extra money that the federal government has provided to states as an incentive to expand eligibility for Medicaid. And like the House measure, it would put the entire Medicaid program on a budget, ending the open-ended entitlement that now exists.

 

According to several sources, California's public health care systems together could lose more than $2 billion per year in revenue if the Medicaid expansion is repealed, and billions more over time because of the cap on federal Medicaid spending. The State of California estimates that by year ten under the spending cap, these cuts would leave a statewide budget hole of more than $18 billion.   Click here for a helpful breakdown of how the cuts will impact California's health care system. 

 

Each of our Healthcare Districts will need to determine the impact of this proposed legislation on their District and community.  Now is the time to communicate with your members of Congress and perhaps even visit their offices.  But please let them know, in very real terms, how this legislation might impact your Healthcare District and the community that you serve.  ACHD will continue to work closely with our members in this regard.

 

Value of Association 

The staff and I are often asked to articulate to our Healthcare Districts, "What is the value of 

ACHD?"   I thought I might share some insights regarding this question as well as address more specific topics going forward.

 

ACHD is the only Association representing Healthcare Districts; we have no other mission.

Our focus has been on addressing large issues, such as: employment of physicians, capital planning and construction (such as design build), licensure, taxes, insurance, labor relations, professional manpower training and shortages, health and wellness, and governance and accountability.  For example, this year, ACHD has advocated on behalf of all Healthcare Districts with the Little Hoover Commission to guard against onerous new regulations that would impede Districts' ability to operate and compete; as well as prevent proposals that would erode the authority of Districts to govern themselves.  ACHD has been working diligently with the Assembly Local Government and Senate Governance & Finance Committees to guard against regulations that would eliminate Healthcare Districts or erode their self-governance authority.  We have advanced legislation in support of specific Healthcare Districts; legislation to expand design-build authority and maintain institutional licensure; and have worked with other Legislative committees to expand professional practice acts and improve access to care.  In addition, ACHD has forged new partnerships (Stanford Health Improvement Program is one example) to enhance the ability of Healthcare Districts to expand their health and wellness programs.  Additionally, we have been diligent in fending off legislation that would have dramatically limited the current wide scope of authority of local Healthcare Districts.  We also continue to enhance the value and content of our Educational Programs, ensuring that the information presented is relevant to all the issues our Healthcare Districts face.

All the above has been accomplished within a dues structure that has remained largely unchanged for nearly a decade.  Remarkably, the ACHD Board implemented a new dues structure for 2017-2018 that provides for either no increase or significant reductions in dues for our Members.  In turn, the structure means that ACHD is providing a benefit/value to our Members in 2017-18 that is literally the same or less than the cost of Membership ten years ago; and we know of no other organization that can make that claim. 

 

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