Vermont Hospitals Say 65,000 Vermonters Could Lose Coverage Under Obamacare Repeal

Mar 15, 2017

Vermont hospitals are rallying in opposition to a proposal to repeal and replace the federal Affordable Care Act, saying the plan from Congressional Republicans could cause as many as 65,000 Vermonters to lose their health insurance coverage.

Republicans in the U.S. House of Representatives are trying to fast-track their plan to replace the Affordable Care Act, also known as Obamacare.

Health care providers across the country, however, are sounding the alarm over the proposal. And Vermont hospital officials say the legislation would deal a particularly devastating blow to health care in this state.

An independent analysis conducted by the non-partisan Congressional Budget Office concluded that 24 million Americans would lose coverage over the next decade if the Republican plan goes through.

There aren’t any official projections yet for how that loss of coverage might break down state-by-state.

“But my own belief is that we’ll Vermont drop from nearly 98 percent of our population being covered to somewhere between 85 and 90 percent,” says Tom Huebner, president of the Rutland Regional Medical Center. “That’s 64,000 or 65,000 people in Vermont who will lose their coverage. That’s something no health care provider I know would support.”

Tom Huebner, president of the Rutland Regional Medical Center, shown here in 2005, says the plan to repeal and replace the Affordable Care Act could drive up insurance prices even for people unaffected by the loss of federal subsidies.
Credit Toby Talbot / AP

On Wednesday morning, Huebner and other Vermont hospital officials joined Congressman Peter Welch for a conference call with reporters. Welch is looking to build political opposition to the Republican plan to repeal and replace the Affordable Care Act — often referred to as Obamacare.  

Huebner and his industry colleagues provided some compelling talking points.

Tens of thousands of Vermonters have come on the insurance rolls since the advent of the ACA. Dr. John Brumsted, CEO of the University of Vermont Medical Center, says “it’s no mystery” what will happen to people if they lose that coverage.

“They aren’t going to get the care that they need early in the process, and people are going to suffer,” Brumsted says. “And this is not an untested hypothesis.”

The consequences of that outcome, Brumsted says, are twofold. For one, it costs more to treat patients who defer care until their condition worsens. Secondly, Brumsted says, and more importantly in his mind, those patients will often suffer worse outcomes because they didn’t get timely care.

"These are not just statistics ... estimates we’re talking about. These are real people with real stories." — Jeff Tieman, Vermont Association of Hospitals and Health Systems CEO

Jeff Tieman, the CEO of the Vermont Association of Hospitals and Health Systems, says he hopes federal officeholders will weigh the human toll of their decisions.

“These are not just statistics and CBO estimates we’re talking about. These are real people with real stories — someone who’s in the middle of cancer treatment who’s now worried about what the politics in Washington mean for their continued treatment,” Tieman says.

Vermont embraced the Affordable Care Act more tightly than most states, and might therefore see disproportionate effects if it’s repealed.

Vermont took full advantage of the Medicaid expansion offered under the ACA, for instance, and also tried to maximize the number of people availing themselves of federal premium assistance in Obamacare.

Rep. Peter Welch is among the Congressional Democrats mobilizing opposition to Republicans' plan to repeal and replace the Affordable Care Act.
Credit Toby Talbot / AP File

The Republican plan under consideration in the U.S. House of Representatives right now would roll back that Medicaid expansion, and replace the premium assistance with less general tax credits.

“Vermont could see a $200 million hit in reduction in federal health care dollars in fiscal year 2020,” Welch says. “The threat to hospitals in Vermont with increased uncompensated care is enormous.”

U.S. House Speaker Paul Ryan calls the repeal-and-replace plan a $1 trillion tax cut that will end up lowering insurance premiums for many Americans. The Congressional Budget Office projects that plan would reduce the national deficit by about $350 billion over 10 years.

But Welch says those tax cuts would fall disproportionately to the country’s wealthiest residents. And Huebner says the impact of reduced federal health care dollars would put a financial hit even on people who aren’t directly affected by the loss of premium assistance or Medicaid subsidies, “because that loss of funding … means that we will have to do one of two things: We will either have to cut programs, or increase prices to everybody else to offset that.”

Welch says he hopes growing opposition from Republican governor and lawmakers will stymie the House proposal; he and other Democrats will find out soon if it does. The legislation could go to the full House floor in as little as two weeks. If that vote is delayed, Welch says it likely signals dissension in the GOP ranks.