“We are looking at everything from changing our eligibility systems, bringing new vendors on board, new staffing models… Then you have to build a new data and privacy infrastructure, because as you implement work requirements, you have to make sure that the documents that prove you are actually working can be uploaded securely,” he said.
The only states that have previously enacted similar rules – Arkansas and Georgia – have experienced high prices To implement them, there was no increase in employment and significant insurance losses.
Figueroa predicts a similar outcome in his state.
“At some point, people will lose coverage because of this law,” he said. “So I wouldn’t mind that we’re investing $60 million if it’s being invested in covering people and making that coverage more comprehensive and more affordable, but we’re doing that on work requirements instead.”
He added that whether the policy would pay out was “a matter of debate at this time.”
Health care providers across the country have warned that the new rules will take a huge toll on their already precarious finances.
Dr. Mark Boom, president and CEO of Houston Methodist and president of the American Hospital Association, said at the POLITICO summit that he is ready for work requirements to increase the number of uninsured Americans who can’t afford primary care and rely on clinics and hospitals in emergencies.
“We’re seeing people lose coverage. And, well, when you lose coverage … guess what happens? Those patients don’t stop being sick,” he said. “They just come to our emergency rooms, and they get the care they need when they’re much sicker than they probably would have if we actually had a longitudinal health care process to take care of them.”
This increase in uncompensated care, he added, will force his hospital and others to ask themselves: “What services can we continue to provide or not provide?” Top of the list to be sacrificed will be mental health and maternal health care, especially in rural areas, he said.
Both Bloom and Figueroa also emphasized that the $50 billion Rural Health Transformation Fund that Congress included in the One Big Beautiful Bill Act won’t come close To offset states’ losses in Medicaid funds in coming years.
“This is in the context that on one hand we are losing billions of dollars and on the other hand we are getting $189.5 million,” he said. “So it’s not intended to be dollar for dollar. As my sister used to say, math isn’t math.”
The lack of resources, he said, forces the state to “think more creatively about the delivery of care.” But no matter how much creativity and collaboration Virginia adopts, he warned, “there’s going to be some disruption in care given the fact that we’re losing a lot of other financial resources on the other side of the house.”
The failure of Congress to expand the enhancements is also critical of all stakeholders in the health care system, from state officials to providers to insurers. Obamacare Subsidies for millions of Americans, which has led to an increase in the number of patients who are uninsured or switching to less high-deductible health plans.
“People still bought coverage, even though they did it with lower subsidies,” said Kathy Grasson, vice president, associate general counsel and head of government affairs for Oscar Health. “We were challenged to design products that meet people where they are, at an affordable price. But frankly, for a lot of people, that’s a high deductible, and that’s not good enough.”
A recent survey Health policy research group KFF found that more than half of those surveyed said they planned to deal with premium increases due to lapsed subsidies by cutting spending on food and other basic household needs.
There are about a dozen states trying to save its residents Those impacts can be offset by some or all of the lapsed subsidies being repaid, but they cannot fully cover the lost federal funding or afford to do so over a long period of time. Meanwhile, most states have taken no action — including both conservative states where leaders oppose the Affordable Care Act and states with progressive leaders who support the program.
