Retreat Doctors' Hospital
January 09, 2017

In the New Year, Congress and President Trump have promised to repeal the Affordable Care Act (ACA). If they are successful, it is imperative that they also remove the Medicare payment cuts to hospitals and clinics that were embedded in the ACA.

If this does not happen, it will create major obstacles to people seeking care in Virginia and across the nation, especially among the poor, disabled, and elderly, and those in who live in rural areas.

As a hospital administrator with 20 years of experience in the health care industry, and the president of HCA Virginia Health System, I have the privilege of overseeing the talented teams that deliver more than 1.8 million patient experiences annually in our 14 hospitals and 30 outpatient centers across the commonwealth.

We work together to constantly improve the quality of our patient care, prepare our facilities for the future needs of our patients and physicians, and manage the Medicare and Medicaid programs to ensure we can continue to meet the needs of all members of our community.

But, because the ACA included steep cuts in payments to hospitals from Medicare and Medicaid, I am deeply concerned about the access-to-care crisis that will result from congressional inaction to restore this essential funding.

If the law is repealed and Congress does not act to restore the cuts, it will cost U.S. hospitals more than $400 billion, on top of the $150 billion in cuts we have already endured in recent years because of other government actions.

Rural hospitals will be especially hard-hit.

As a result, many community hospitals and clinics across the nation will be forced to shut their doors, or they will stop providing important specialty care like behavioral health or neonatal intensive care services. These facilities will find it almost impossible to make ends meet, since they receive about half of their funding from Medicare and Medicaid — and rural hospitals will be especially hard-hit.

In every community where this happens, patients will lose access to the medical care they need. For ongoing treatment, it means patients will need to travel farther for care — and in emergency situations, it can mean the difference between life and death for patients who don’t have the time to travel long distances for acute injuries or illnesses.

In many communities, these cuts could also mean the loss of good, high-paying health-care jobs. This is as unacceptable as it is unnecessary. Congress must take action to protect access to quality health care in our communities.

If the ACA is going to be repealed, Congress must ensure hospitals are made whole by reversing the deep Medicare cuts. Let’s make sure our members of Congress keep their promise to protect Medicare — our community is counting on it.

Tim McManus serves as the president of HCA Virginia Health System, the fifth-largest private employer in the commonwealth.

This article originally appeared in the Richmond Times Dispatch at