The AHA and Federation of American Hospitals today urged President-elect Trump and congressional leaders to preserve health coverage gains as part of any effort to repeal the Affordable Care Act. However, in the event such protection does not occur, they urged them to restore reductions to payments for hospital services that were included in the ACA. “According to reports, it appears that the Congress is moving to reconsider the ACA in the early days of the new year without enacting accompanying legislation specifically guaranteeing similar coverage for those who will lose it,” wrote AHA President and CEO Rick Pollack and FAH President and CEO Chip Kahn. “If that approach is taken, we respectfully urge you to also include in such legislation the prospective repeal of funding reductions for Medicare and Medicaid hospital services for patient care that were included in the ACA for purposes of helping fund coverage for the insured. Specifically, we seek your support for the restoration of the Medicare hospital inflation update, as well as Medicare and Medicaid Disproportionate Share Hospital payments that support those facilities that take care of high volumes of uninsured, poor and disabled Americans. Restoring these cuts for the future is absolutely essential to enable hospitals and health systems to provide the care that the patients and communities we serve both expect and deserve.” The letter accompanied a new report from health economic firm Dobson | DaVanzo that finds that under H.R. 3762, the most recent repeal bill, hospitals would face a net negative impact of $165.8 billion from 2018-2026 regarding coverage losses. It also found that hospitals would suffer a loss of $289.5 billion in Medicare inflation updates if the payment reductions in the ACA are not restored. Finally, the authors calculate that failure to restore the ACA’s Medicare and Medicaid DSH reductions would amount to $102.9 billion. “Losses of this magnitude cannot be sustained and will adversely impact patients’ access to care, decimate hospitals’ and health systems’ ability to provide services, weaken local economies that hospitals help sustain and grow, and result in massive job losses. As you know, hospitals are often the largest employer in many communities, and more than half of a hospital’s budget is devoted to supporting the salaries and benefits of caregivers who provide 24/7 coverage, which cannot be replaced,” wrote Pollack and Kahn.