|Joann Anderson (Photo by Rose|
Hoban, North Carolina Health News)
Hospitals are "the first sector of the health-care industry to speak out publicly to try to protect itself from a sharp reversal in health policy that Trump is promising and congressional Republicans have long favored," Goldstein notes. "When it was enacted in 2010, the health-care law was a product of a delicate balancing act among various parts of the health-care industry. Each essentially agreed to sacrifices in exchange for the prospect of millions of Americans gaining insurance to help cover their medical expenses."
The balancing act includes rural hospitals, which have special provisions in the law and other federal statutes. For example, the law expanded special funding for hospitals with relatively few patients, but that provision is scheduled to expire in October 2017. That would have a significant negative impact on rural hospitals, says a study just published by the Journal of Rural Health.
The exact nature of the repeal-and-replace strategy is unclear because Republicans will be in a position to make laws on their own after Trump replaces Obama Jan. 20. Until now, they have passed repeal bills with no replacement, knowing Obama would veto them. House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell have said they favor phasing out Obamacare and phasing in a replacement, but the time frame for that is uncertain.