Last week, the nation was shocked to see U.S. Senator John McCain vote against the proposed Health Care Freedom Act (or “skinny repeal”), effectively ending the Senate’s multi-month effort to repeal and replace the Affordable Care Act (ACA).

At Phoenix Children’s Hospital, McCain’s vote evoked a sigh of relief. The result affords our nation exactly what was needed to find a stronger solution for effective health care reform – more time to discuss the importance of protecting critical services to the more than 636,000 Arizona children who rely on Medicaid.

In the U.S., children’s hospitals provide everything from routine care for pediatric patients to specialized treatment for the sickest 20 percent of kids. Medicaid helps low income children receive preventative care and helps kids with private insurance who have chronic, long term conditions that require expensive treatment not covered by commercial insurance plans.

Locally, Medicaid provides more than 50 percent of funding for Phoenix Children’s, since much of our population is disabled or medically complex. Without federal funding, our ability to care for the state’s most vulnerable residents is at dire risk.

At Phoenix Children’s, we believe that the national discourse about health care costs should – and must – continue. The ACA is far from perfect, and rising costs are a concern for consumers and health care providers alike. Likewise, we firmly believe that health care organizations must be responsible and accountable to patients and taxpayers. Moving forward, there are two crucial issues that we believe must be addressed:

Children are a unique Medicaid population: Medicaid covers four major groups: the disabled, the elderly, childless adults and children. Each of these populations is distinctly different, and a solution that fits childless adults is unlikely to work for the other populations. Children should be considered as a separate, unique population within Medicaid. This is especially important considering Medicaid spending on children is highly efficient – kids comprise 50 percent of the program, but only 20 percent of the spending.

Creating competition in the marketplace: In 2017, costs for Arizona’s “benchmark” marketplace plan increased 116 percent, pricing many residents out of health care. When individuals cannot afford an insurance plan, we have seen them forego preventative care and end up in the emergency room, where they receive the highest cost treatment. Hospitals are often not compensated for this care, forcing them to increase payments from other patients and insurers to cover uncompensated treatment. In 2018, only two insurers will offer plans on the exchange, and it is unclear how premiums will be affected. Our marketplace is suffering higher costs because of a lack of competition, while promises made to insurers in the form of reimbursements have been neglected, and insurers nationwide continue to pull their plans from state exchanges.

We’re proud of McCain for standing up to support a more thoughtful approach to health care reform, affording our elected officials the time to step back and evaluate the complex issue at hand. We are also thankful to our entire congressional delegation, our governor, and their respective staffs for their willingness to understand our concerns, perspectives, and the problems that the many versions of repeal and replace have posed to children’s health care.

Moving forward, we hope to see states take a leadership role in reforming our nation’s health care. Bipartisan efforts by the nation’s governors give us hope that the lessons states have learned regarding Medicaid can be applied to the national debate. Arizona boasts one of the most efficient programs in the nation, operating at costs more than 35 percent below those of states like New York. And at Phoenix Children’s, our cost structure is
16 percent lower on average than any other children’s hospital in the country – and our outcomes remain exceptionally high.

With an individualized approach led by the groups that live and breathe the effect of health care policy each day, success will come for all Americans.

— Robert L. Meyer is president and CEO of Phoenix Children’s Hospital.

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The views expressed in guest commentaries are those of the author and are not the views of the Arizona Capitol Times.