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Colorado Hospital Association opposes Graham-Cassidy as another analysis shows losses for state

Posted September 21

— The Colorado Hospital Association said Thursday that the latest effort by Senate Republicans to repeal and replace the Affordable Care Act "has the potential to have a significant and harmful impact on the health of all Coloradans" as another nonpartisan analysis found the measure could cost Colorado billions in federal health care dollars.

The hospital association says that forecasted Medicaid cuts under the latest Republican proposal, Graham-Cassidy, "will likely impact hospital's ability to provide care for Colorado's most vulnerable patients."

"CHA has long been focused on preserving coverage and access to care in Colorado, and we believe the elements in this bill will likely have a detrimental impact on both of those issues," CHA's CEO and president, Steven J. Summer, said in a written statement.

The hospital association said it had shared its statement of opposition with both of Colorado's senators, Michael Bennet and Cory Gardner, and has entered it into testimony planned for next Monday in the Senate Finance Committee.

The association's opposition comes on the same day that the nonpartisan Kaiser Family Foundation released its analysis of Graham-Cassidy, which showed Colorado could face a 13 percent reduction in federal funding between 2020 and 2026 under Graham-Cassidy when compared to current law.

KFF's analysis is slightly less dire than analysis released Wednesday by Avalere Health, which showed funding losses of $6 billion over the same time period. Kaiser forecasts losses of around $2.3 billion.

But like Avalere found, KFF's analysis found that current ACA subsidies and funding for both traditional and expanded Medicaid programs would be lumped into block grants meant for states that are less than most states currently receive.

Both also found that Medicaid funding would be cut across the board because of a new per capita cap.

The analysis is also similar in that both found that states which opted not to expand Medicaid under the ACA would receive more money, while states that did expand Medicaid would see funding reductions when compared to current law.

KFF found that under current law, Colorado stands to receive around $17.7 billion in federal funding under the Affordable Care Act from 2020 to 2026, but that funding would be reduced to $15.4 billion under Graham-Cassidy, resulting in around $2.28 billion less money, a 13 percent difference.

That's slightly higher than the average cut of 11 percent for states that expanded Medicaid.

Meanwhile, states that opted not to expand Medicaid would get an average increase of 12 percent in federal funding, according to KFF. Also similar to Avalere's analysis, KFF says that there is no commitment to funding the programs after 2026 written into the proposal.

Proponents of the measure say Congress would appropriate funds for beyond 2026 over the next decade, but as the proposal stands, there is nothing currently committed.

The Center for American Progress also put out an analysis on Wednesday estimating that 468,000 fewer Coloradans would be insured in 2027 compared to estimates based on current law.

The Colorado Hospital Association pleaded in its statement of opposition for Congress to resume bipartisan health care discussions that seemed to have ground to a halt earlier this week with the revival of the Graham-Cassidy push, which has to be done before Sept. 30 before parliamentary rules force the reconciliation measure back to requiring a two-thirds majority vote and not a simple majority.

"CHA member hospitals and health systems strongly encourage Congress to engage in serious and sincere bipartisan efforts to work across the aisle to create a plan that will improve our nation's health care system," CHA wrote in its statement of opposition. "It is clear that many changes and refinements are needed for the ACA – and it is likely that Congressional colleagues work together with that type of approach, the result will be a better and more fiscally sound ACA that serves the needs of all Americans."

The CHA joins numerous leading medical associations, insurers and others opposing the proposal.

Colorado Gov. John Hickenlooper and his group of bipartisan governors also oppose the legislation and have called for a bipartisan solution and regular order. Republicans need at least 50 votes for the proposal, lest repeal efforts die once again.

Alaska's governor, Bill Walker, and New Jersey's governor, Chris Christie, both also came out against the measure on Wednesday. Senate Majority Leader Mitch McConnell said Wednesday he "intends" to bring the proposal to the floor for a vote next week, which President Trump said he supported.

But leading Republican Sen. Chuck Grassley of Iowa expressed some concerns, saying he thought his party was "one or two votes short" and that he didn't see those other votes coming.

Sen. Bennet, a Democrat, is adamantly opposed to the measure. He said earlier this week, "I can't decide whether this is Groundhog Day or the definition of insanity: every attempt is worth than the last."

"The bipartisan process in our [HELP] committee was making process. Why would we abandon it now?" he asked. "This is exactly why Coloradans have lost so much faith in Washington."

Bennet's fellow senator from Colorado, Republican Cory Gardner, is analyzing the proposal and "any other proposals that look at ways to improve our nation's health care," his spokesman, Casey Contres, told Denver7 Monday.

Contres told Denver7 Thursday that Gardner was still reviewing the measure and other proposals.

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