Health care moves into a period of uncertainty next year, with the Patient Protection and Affordable Care Act facing repeal or replacement under incoming President-elect Donald Trump, who takes office along with a Republican-controlled Congress. Enactment of the ACA meant that starting in 2010, Michigan hospitals would forgo $7 billion over a decade in Medicaid and Medicare payments from the federal government in exchange for expanded coverage, said Laura Appel, senior vice president and chief innovation officer at the Michigan Health & Hospital Association. Appel expects the coming debate over the ACA to dominate health care in 2017.
"The new threat to health care funding with the challenge of continuing the coverage expansion of the Affordable Care Act could significantly change the outlook for health care. The Healthy Michigan Plan (Michigan’s expanded Medicaid program) carries an appropriation of just over $4 billion annually. In addition, Michigan residents receive an estimated $769 million in annual tax credits for the purchase of health care benefits and insurance through Michigan’s federally-facilitated ACA marketplace. That has a sizable, positive economic impact. Ending or reducing these amounts is equally likely to have a sizable, negative economic impact. ACA changes won’t happen in the first few months of 2017, but as the uncertainty grows, health care systems will need to adjust their outlook to accommodate for a wide variety of potential scenarios. Our concern is expansion could be lost, yet hospitals will continue to pay for coverage that doesn’t exist. It is a financial risk that is not yet quantified." - Laura Appel, Senior Vice President and Chief Innovation Officer, Michigan Health & Hospital Association