D-Day for the ACA?

This article was originally published here

If you are a sports fan, March is your month. The past week has been filled with near non-stop coverage of the NCAA tourney, and there are still a few more weeks to go.

However, if you are apathetic toward sports and filled out a bracket at the last minute only out of office-pool guilt (like I did), then March is your month for a whole other reason. Not only have SCOTUS confirmation hearings happened this week, but the very fate of the Affordable Care Act (ACA) is up for a vote in the House of Representatives today as well.

Regardless of where you sit on the political spectrum, and whether you have found this week exciting of terrifying, you have to admit that it has been captivating. But even with all of this Kardashian-esque drama, frankly I am ready for it to be over!

That is not a political statement, nor is this a political post.

Repeal and replace the ACA versus amending and improving? I will leave it to you to turn to your favorite cable news channel for the latest on that debate. Rather, as in-house for a hospital network, I am ready for the whole debate to be done so a little certainty can return to our business operations and give our patients some peace of mind.

I have been fielding “what if the ACA goes away” hypotheticals since Trump won the Republican nomination last summer. I have been contemplating what a post-ACA life would look like for our hospital network with renewed vigor since Trump won in November. I have worked Biglaw-like hours since the House introduced its repeal bill a couple of weeks ago. And frankly, I am tired.

I am tired of monitoring CNN and Fox News simultaneously for the latest breaking news or theories on the repeal measure.

I am tired of explaining to my non-legal colleagues that reconciliation in Washington, D.C. has nothing to do with being a Catholic.

And I am tired of reviewing hastily drafted bills and amendments and evaluating their potential impact on our organization and our patients.

I understand this sort of work comes with the territory of being in-house, and I am happy to do it. Sadistically, as a self-professed political nerd, I even enjoy it. However, any real appreciation the present ACA debate is having on thousands of hospitals and millions of patients across the nation seems to be absent from the current political debate in Washington.

If you are a patient currently covered by expanded Medicaid coverage or if you are a family with insurance paid for by a subsidy, the fact that the AHCA would not take effect until 2020 is likely of little solace to you. Similarly, if you are an insurance company or a hospital attempting to forecast your financials for the coming years, the current political instability may cause you to rethink your future staffing model.

While I have my own opinions as to what health reform in America should look like I understand, just like March’s sports fans, there are winners and losers. And I am happy to respect whatever sort of outcome our elected officials in D.C. do, or do not, implement. However, our health care system is already shaky enough as is, without the political interjections every few years.

Whatever happens in D.C. today, I and my fellow in-house counsel in the healthcare sector will prepare for it. But please recognize this is not a fire drill we can engage in every four to eight years.

Yes, it may be painful, but reach across the aisle and find a solution both parties can live with for many years to come.

Not only will I thank you on behalf of my in-house colleagues, but on behalf of the millions of patients across the country who can now focus on getting  better, not on whether their health insurance coverage is still valid.


Stephen R. Williams is in-house counsel with a multi-facility hospital network in the Midwest. His column focuses on a little talked about area of the in-house life, management. You can reach Stephen at stephenwilliamsjd@gmail.com.

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