In a joint letter today to President Trump and the Congress, the AHA and 71 state, regional and metropolitan hospital associations outlined their top priorities as the administration and Congress deliberate the future of the Affordable Care Act. “If the ACA is to be repealed, the potential repeal and replace should be done simultaneously, and ensure that the 22 million people receiving coverage continue to receive adequate coverage,” the organizations said. “If repeal and replace cannot be accomplished simultaneously, the reductions to hospitals and health systems included in the ACA should be restored to ensure there are sufficient resources to provide care to the uninsured. Further reductions to hospitals and health systems should not be considered during either reconciliation or the replace debate. Any Medicaid restructuring should continue the federal-state partnership that ensures beneficiaries and providers continue to have access to high-quality health care coverage, provides sufficient funding, and treats expansion and non-expansion states in an equitable manner. Significant regulatory reform to address the burden faced by hospitals and health systems needs to be implemented by both the legislative and executive branches. And continued efforts to improve the health care system and make care more affordable should be supported by moving to fee-for-value based payment that provides incentives for clinically integrated coordinated care.”