Carilion’s Nancy Agee’s View of the Healthcare Bill

Carilion’s Nancy Agee

Carilion CEO/President Nancy Agee will shortly become chairwoman of the board of trustees of the American Hospital Association and has been named one of the 25 most influential women in healthcare nationally.

The AHA has 5,000 health care organizations as members and another 43,000 individual members.

Carilion is the largest healthcare organization in Western Virginia and operates seven hospitals, the VTC Medical School and Research Insitute, Jefferson College of Health Sciences, Carilion Wellness, the Institute for Orthopaedics and Neurosciences, Velocity Care, Carilion Children’s Hospital and Lifeguard (helicopter ambulance service).

The healthcare bill being argued in the U.S. House will have a direct effect on hospitals nationally, as well as the uninsured and the insured. The Congressional Budget Office estimates the bill–as written–could eliminate 24 million Americans from the health insurance rolls. Costs for their care–when it is given at all–would likely fall to the hospitals.

A new poll suggests Americans oppose House Speaker Paul Ryan’s bill by  21 points (45 percent to 24 percent), with 31 percent offering no opinion. Five percent of respondents strongly favor the bill, and 32 percent are strongly opposed to it.

Agee was asked to comment on the bill. She responded via email late last night on the way home from a conference in Phoenix. Here is her response:

“About 20 million people have attained coverage since the beginning of the Affordable Care Act, either through Medicaid expansion or the exchanges. We know that people who have health insurance are generally healthier, seek healthcare earlier and don’t get into a catastrophic situation as readily.

“So, obviously, affordable healthcare is important. Perhaps the operable word there is “affordable.” And that’s really a problem, because coverage has expanded, health care premiums have risen, [as] have out-of-pocket expenses for healthcare, which has impacted others … [That] is concerning.

“Health care costs are crowding out what people would pay for food, housing, etc. If the current bill stands ( and I have no doubt that there will be modifications), the Congressional Budget Office suggests that over the next 10 years many Americans would no longer have health insurance.

“The bill doesn’t really speak to the issue of out-of-pocket cost. The administration has made some improvements on attempting to stabilize the exchange market. And this needs to be furthered.

“About 20 states didn’t expand Medicaid, including Virginia, so,in some ways, the new bill has more limited impact on those states. That said, all hospitals took major cuts to facilitate Medicaid expansion.
“As a matter of fact, Carilion has experienced cuts in the neighborhood of $100 million or more since implementation of the ACA with virtually no reimbursement advantages. So, the American Hospital Association (and I agree with its stance) is trying to assure equity going forward for expansion and non-expansion states.”

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