RMC emergency room

RMC emergency room is shown in this 2016 file photo. 

As Republicans in the Senate rework their plan to repeal and replace the Affordable Care Act, hospitals and patients face uncertainty, Alabama health care advocates said Tuesday.

“I think a lot of hospitals are holding off on their future plans,” said Danne Howard, executive vice president of the Alabama Hospital Association. “They will be looking at their business models to see what cuts will have to be made to sustain what they have now.”

The Senate’s revised health care bill will be released Thursday after the first draft failed to garner a majority in the Senate, Sen. Mitch McConnell, R-Ky., said in a statement on Capitol Hill Tuesday. The Congressional Budget Office will release its findings on the bill next week, McConnell said.

McConnell delayed the Senate recess to Aug. 7 to work on the Senate Republicans’ health care bill. The announcement came after a lunch with Senate Republicans to discuss revisions to the bill introduced in June.

Howard said the current Senate bill will have a significant impact on Alabamians, with around 100,000 people losing private insurance due to rising premiums and subsidy cuts.

The bill in its current form will also lead to a $12.9 billion cut to Alabama Medicaid funding in the next 10 years, Howard said. These proposed cuts would make hospitals uncertain about their future, she said.

Individual Alabamians are affected by the uncertainty as well, according to Jim Carnes, policy director of the Montgomery-based nonprofit Arise Citizens' Policy Project. He said that negative television ads about the Affordable Care Act, widely known as Obamacare, during the election could have suppressed enrollment.

“We can attribute the slight downturn in enrollment to the uncertainty,” Carnes said, referring to the people getting health coverage through exchanges set up under Obamacare. “People are wondering if the marketplace will be around and what do these changes mean for the people?”

According to the Kaiser Family Health Foundation nationwide enrollment in ACA decreased by 500,000 this year, but Blue Cross Blue Shield of Alabama officials said their enrollment increased by 50,000 over the same period.

Glen Browder, a political science professor at Jacksonville State University, foresees problems for Republicans if they don’t pass a bill.

“If they are not able to pass their bill, there will be great confusion among the public and the health care bureaucracy,” Browder said.

University of Alabama political science professor Joseph Smith sees advantages for Republicans in leaving the Affordable Care Act mostly untouched.

“If the Republicans were to give up on repealing or drastically cutting back on Obamacare, insurance companies would get more certainty that the system would stay the same going forward,” Smith wrote in an email to The Star. “That would entice insurance companies to participate in the insurance marketplaces set up under Obamacare.”  

Repeated attempts to contact Alabama Sens. Richard Shelby and Luther Strange since the unveiling of the bill have been unsuccessful.

A spokesperson for Gov. Kay Ivey’s office said the governor did not have an opinion on the health care bill as it was still being drafted.