As Obamacare Repeal Looms, Hospitals Brace For Job Losses
By Bruce Japsen
A repeal of the Affordable Care Act could cost more than 3 million jobs, and many would come from the nation’s hospitals and health systems, new reports and industry lobbies say.
The ACA’s subsidized private individual coverage and expanded Medicaid benefits have turned patients who couldn’t afford care into paying customers, allowing hospitals to hire more nurses, medical technicians, doctors and other caregivers to treat millions of newly insured Americans.
But the Republican Congress and the incoming Trump White House are promising to repeal the ACA with no detailed plan on how to replace it. That has hospitals worried that unpaid bills and bad debt will rise should the number of uninsured begin to rise again.
“Given that our hospitals already operate with no margin on average, it’s hard to see how they could avoid layoffs if repeal increases uncompensated care,” says Beth Feldpush, senior vice president of policy and advocacy at America’s Essential Hospitals, which represents public health systems across the country.
A hospital is often the largest employer in a community, and healthcare facilities have been an economic engine that have helped reduce unemployment under President Obama . January's jobs report again showed major growth in health industry jobs, “with most of the increase occurring in ambulatory healthcare services and hospitals.”
“For hospitals, like most businesses, labor constitutes the largest cost of providing services,” Feldbush said.
In 2013, public hospitals alone generated more than $165 billion in “economic activity for their respective state economies” and contributed more than 1.25 million jobs.
A highly publicized report last week from the Milken Institute School of Public Health at the George Washington University and the Commonwealth Fund said 2.6 million people could lose their jobs in 2019 alone if the ACA is repealed . The jobs lost would occur in all 50 U.S. states and rise to “nearly 3 million positions in healthcare and other sectors,” including real estate, construction, finance and insurance, by the year 2021.
Hospital operators across the country, including for-profit firms like Tenet Healthcare and HCA Holdings, have reported record revenue and profits since the ACA was passed. Health insurers including Aetna, Anthem and UnitedHealth Group have also done well from expanded Medicaid coverage and Medicare reforms even as they’ve lost money on individual coverage sold on public exchanges.
Nowhere in the U.S. would be immune to job cuts. Illinois could sustain a potential loss of more than $11.6 billion in “economic” activity that includes a loss of more than 84,000 jobs if the ACA is repealed and not replaced.
“In many counties across Illinois, hospitals are among the top three employers,” the Illinois hospital association said in a statement. “They are critical economic engines and job creators for their communities and the state, employing more than a quarter of a million people, generating nearly $89 billion in annual economic impact and nearly half a million direct and indirect jobs. Over the past 15 years, while total Illinois employment declined by 1.5% (89,900 jobs lost), the number of healthcare jobs increased 26% (127,600 jobs).”
Articles in this issue:
- I Am Not A Male Nurse. I Am A Nurse.
- As Obamacare Repeal Looms, Hospitals Brace For Job Losses
- Paul Ryan Confronted by Man Who Says He Would Be Dead Without Obamacare
- Can A Nurse Practitioner Replace A Physician?
- Goops Vagina Rocks, Explained.
- Travel Nurse Blacklists
- California Nurses Scramble For Education Records After State Board Demands Them
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