TUH officials uncertain about future if ACA repealed

Without a clear plan in place, the hospital could lose millions of dollars in revenue.

An executive order signed by President Donald Trump on Jan. 20, mandates that health insurance agencies stop implementing policies outlined in the Affordable Care Act. This  could impact Temple University Hospital, officials said.

If the ACA is completely repealed, the 20 million people for whom it provides insurance would lose their coverage completely and TUH could have losses of $45 million a year, said Robert Lux, the senior vice president and chief financial officer of Temple University Health System.

TUH is located in a federally designated “medically underserved” area, a distinction given to neighborhoods that have enough primary care providers or has high infant mortality rates, poverty rates or a large elderly population. This makes the hospital more dependent on Medicaid or the ACA to provide patients with health insurance.

Lux told The Temple News on Jan. 23 that he was unsure if TUHS would need to accommodate for the order.

Lux said he has trouble identifying exactly how a repeal of the ACA will affect TUH without “a clear path that says, ‘This is what it means to repeal and replace the ACA.’”

But John DiLeonardo, an adjunct economics professor, said he doesn’t believe there will be a “significant adverse impact” on health care providers like TUH if ACA is repealed, but other factors might change the landscape.

“There will be a lot of forces that are going to impact health care in general and health care providers … like TUH,” he added.

DiLeonardo, who has 22 years of experience in healthcare finance and operations, said the post-ACA health care market may be a challenging environment, but the ability of insurance companies and providers to respond to the different market structure will decide how hospitals’ profits are affected.

Regardless, Lux said the situation is unsettling for the TUHS.

“It’s just a lot of uncertainty,” he said. “We don’t know what’s going to be replacing or augmenting it.”

Many experts are warning that the repeal is an impending public health crisis, and many Americans also worry about the consequences of a repeal.

DiLeonardo said he thinks there must be a different outlook on the repeal and replacing of the ACA.

“Nobody will be left uninsured,” he said. “That’s just hysteria. If we migrate from a mandated program to a consumer-driven, competitive marketplace, then there will always be insurance companies around.”

“Consumers in North Philadelphia will be able to drive better, more accessible, and more timely health care,” DiLeonardo said.

But Lux said it’s going to be unsettling to the financial markets.

“It’s certainly unsettling to the health care industry, and it’s definitely unsettling to CFOs like me, whose institutions take care of a lot of people who obtain their coverage through the ACA,” he said.

“We care for some of society’s poorest and most vulnerable patients,” Lux added. “I would want the policymakers to always be reminded in their deliberations that these people need care.”

Noah Tanen can be reached at noah.tanen@temple.edu.

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