With ACA repeal looming, California’s hospital industry goes silent
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As one of the strongest and earliest supporters of the Affordable Care Act (ACA), it’s a cruel irony that California stands to suffer more than any other state if Congress and President Trump repeal the law. Repeal threatens to:

  • Put healthcare up for grabs for 13 million Californians who depend on Medicaid for their health insurance, and more than 1.5 million who have purchased healthcare through the state-run health exchange.
  • Blow a $20.5 billion annual hole in California’s state budget;
  • Result in 209,000 lost jobs in California, primarily in the healthcare industry;
  • Eliminate the requirement that insurance companies provide coverage even if patients have pre-existing conditions; and
  • Eliminate the ACA provision permitting young adults to stay on their parents’ health plans until age 26.

Despite the looming catastrophe for healthcare in California, what has been the response from healthcare giants like Kaiser Permanente, the California Hospital Association and Cedars-Sinai Medical Center, a nationally prominent hospital in Los Angeles?


Kaiser Permanente, which over the years took a lot of credit for passing the ACA and praised it repeatedly, has made it clear it has no intention of publicly opposing repeal of the law. It is skittish about alienating Republicans in Washington for fear of losing influence on crafting an ACA replacement. That’s a sad statement by a health provider that serves more than 10 million patients nationwide, including more than 8 million in California.

Meanwhile, the California Hospital Association – the voice of California’s hospitals – has offered no public opposition to ACA repeal. It appears content to sit back and let the devastation happen in hopes it may have some small influence down the road after the die has mostly been cast.

Contrast their response with that of the national hospital organizations. In December 2016, the American Hospital Association and the Federation of American Hospitals said in a joint statement: “This reversal of coverage would represent an unprecedented public health crisis as individuals would lose their insurance coverage and no longer be able to follow their prescribed regimen of care.”

Or, the equally strong response of the Texas Hospital Association, which just days after the November 2016 election, said: “Repeal without replacement of the ACA’s provisions that have reduced the number of uninsured would be problematic for any leadership be they Republican or Democrat. Any replacement needs to ensure that patients can get the care they need and providers are fairly paid for services provided.”

It’s unclear why the situation is so different in California. Yet, at one of the most perilous times for healthcare in our nation’s history, Kaiser Permanente and most of the hospital industry in California have decided to collectively bury their heads in the sand, abandoning any advocacy role on behalf of the very people they profess to care about. More than 70 percent of hospital beds in California are in not-for-profit hospitals and hospital systems. They are charities under federal law and, as such, have a responsibility to stand up for their communities and patients.

The people of California should not have to suffer. The dangers are too high, with millions of lives literally at stake. The powerful California hospital industry needs to actively and immediately join the debate and defend the interests of the men, women and children who are looking to them for leadership and protection.

Dave Regan is president of Service Employees International Union – United Healthcare Workers West, which has more than 90,000 members who work in hospitals in California.

The views expressed by this author are their own and are not the views of The Hill.