American Hospital Association CEO Explains His Opposition To Graham-Cassidy Bill

NPR's Robert Siegel talks with Rick Pollack, president and CEO of the American Hospital Association, about his opposition to the Graham-Cassidy health care reform bill. He says the bill risks losing tens of millions of people's insurance and does nothing to stabilize the insurance market.

ROBERT SIEGEL, HOST:

The Graham-Cassidy bill has been opposed by most of the stakeholders in the health care debate. And now we're going to hear from one group that opposes it, the American Hospital Association, and its president, Rick Pollack. Good afternoon. Welcome to the program.

RICK POLLACK: Thank you for having me.

SIEGEL: The central idea of this version of health care reform is the block grant. Washington sets some parameters, but it gives states the money and then they run their own systems. Given the difficulty of getting the national system fixed or repealed, is it possible that a state-by-state plan could be the best that could be achieved at this point?

POLLACK: Well, we're very concerned that the approach of cutting $275 billion over six years and then providing a block grant to the states is going to result in dramatic cuts in terms of coverage. In fact, over 20 million people would lose coverage under this proposal. And people would lose coverage in every single state. We're also concerned about eliminating consumer protections that protect people with pre-existing conditions. So the amount of funding reductions that go with this new block grant is very problematic.

SIEGEL: Your group, the American Hospital Association, has faulted this bill for doing nothing to stabilize the insurance market. What should Washington do to stabilize the health insurance market?

POLLACK: Well, you know, senators Lamar Alexander and Patty Murray were working in a bipartisan manner to address this whole issue of private market stabilization.

SIEGEL: This is the Republican chair and the Democratic ranking member of the health committee in the Senate.

POLLACK: Correct. And they had a series of hearings with a lot of different public officials and stakeholders. And they were actually making progress. But the Graham-Cassidy bill essentially sidetracked that whole effort. It ought to be on a bipartisan effort to stabilize the private markets.

SIEGEL: But what does that mean? Does it mean, for example, committing to enforce the individual mandate, to keep young, healthy people in the insurance - getting health insurance? What would stabilize the market at this point?

POLLACK: Well, what would stabilize the market right now is funding the cost-sharing reductions that are at issue. And those are subsidies that are provided to insurance companies to cover co-payments and deductibles of low-income people. In the absence of those subsidies being provided, insurers are reluctant to sell policies in the exchanges. And that's why we've seen a lot of them withdraw. That's why we've seen premiums increase. This problem can be fixed. It could be accompanied by different forms of reinsurance to further stabilize those markets. And that's where we think the immediate focus ought to be.

SIEGEL: An aim of health care legislation has been, in addition to making coverage available to more Americans, bringing down the cost of health care, which accounts for about a sixth of our economy. It's a bigger share than for most countries. Are your hospitals, your member hospitals, prepared to make cuts and change practices so as to bring down the cost of a hospital visit?

POLLACK: We're already doing that. The Affordable Care Act made some pretty significant reductions in payments to hospitals under the Medicare program. We are changing the way we deliver care through - using innovative models, some of them referred to as accountable care organizations, different types of projects associated with creating medical homes. We're absolutely committed to moving toward a system that rewards preventative care, that rewards wellness, that is focused on coordinating care so that people get the best care at the right time and in the right place. And a lot of that work is underway.

SIEGEL: Rick Pollack, president and CEO of the American Hospital Association, thanks for being on the program today.

POLLACK: Thanks for having me.

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