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At hospital, Hudson, Caldwell talk Obamacare repeal

By Josh Bergeron
josh.bergeron@salisburypost.com

SALISBURY — During a meeting with Rep. Richard Hudson, Novant Health Rowan Medical Center President Dari Caldwell advocated for a careful and methodical process as Congress considers repealing and replacing Obamacare.

Caldwell spoke with Hudson, a Republican who represents the 8th Congressional District, as he began a listening tour focused on repealing and replacing the Affordable Care Act or Obamacare. His first stop was Monday morning in Salisbury. Later, he was scheduled to meet with staff at Carolinas HealthCare System NorthEast in Concord.

Hudson sits on the Energy and Commerce Committee’s Subcommittee on Health, which he says will be at the center of Obamacare’s repeal. On Monday, Hudson said a vote to repeal will come with a delay in effective date. In the period between the vote and the effective date, Congress will craft a replacement, he said. Hudson mentioned 2020 as the effective date he prefers.

Hudson also said he favors making Medicare reforms and Obamacare reforms at the same time.

Exact details of a replacement haven’t been decided. Hudson says the Health Subcommittee will question health care providers, patients and various other people as it comes up with a solution. He will also solicit input from constituents in his district.

Noting the negative effects of health care regulations, Caldwell proposed a potential worst-case scenario.

“The greatest fear of all is that we repeal Obamacare and the folks that are insured now are no longer insured, but none of that other stuff goes away,” Caldwell said, referring to health care regulations. “Then, we still have all of the downsides.”

She said there are good and bad parts of Obamacare, some of which may be worth keeping in place.

“We are hopeful that you’ll be able to sort through and identify the elements that are good, like you mentioned preexisting conditions and being able to keep a kid on your insurance up until age 26,” Caldwell said. “Those are really critical.”

Although not directly related to Obamacare, items Caldwell listed as negatively affecting Novant Health Rowan Medical Center included recovery audits and a piece of legislation from 2015 that established new ways to pay physicians caring for people covered by Medicare.

The recovery audits result in third-party contractors checking expenses to find errors and take back Medicaid dollars, Caldwell said. The hospital has two, full-time employees only working to respond to the audits.

The 2015 legislation known as MACRA often doesn’t evaluate the quality of care as intended, she said. Instead, it actually evaluates patient compliance, she said. As an example, Caldwell said a patient may be prescribed blood pressure medicine and not follow a doctor’s orders about eating. If the patient “eats a bag of Cheetos and their blood pressure goes up,” the doctor may be held responsible, she said.

Caldwell and staff at Novant Health Rowan Medical Center said they don’t have an opinion about whether Medicare and Obamacare should be reformed at the same time.

The “bottom line” Caldwell said is that anything Congress does might destabilize health care. She said it’s important that the implications of any potential change are considered before repeal and replacement occurs.

“It’s a lot like flying a plane,” she said. “If you adjust one flap, it’s going to make it go a different direction, and we’ve got to make sure we’ve covered all of that.”

Hudson responded by saying he’s pushing for the 2020 effective date because of the complications in the health care law.

Although there’s still work to do, Hudson says he favors a measure introduced years ago as an alternative to the Affordable Care Act as a potential replacement. Introduced by Rep. Tom Price, R-Md., the bill is known as the Empowering Patients First Act. Whatever the solution, Hudson says the process will be transparent.

“We aren’t gonna say ‘here’s a 2,500-page document and this is the reform,'” he said. “We’re going to go into subcommittee hearings and having hearings to bring in providers and bring in insurers and bring in individuals and hash it out. We’re going to actually write the bill in subcommittee.”

Contact reporter Josh Bergeron at 704-797-4246.

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