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you may not admit it, columnist e.j. montini says, but you like the affordable care act.

our turn: cutting medicare years ago hurt hospitals. not restoring that funding now would be disastrous for cities and patients.

obamacare repeal replace

some republicans want to repeal obamacare now and replace it with something else later.(p o: getty images/istockp o)

teddy roosevelt once observed that life’s true joys come from the “chance to work hard at work worth doing.”

in arizona, there are more than 80,000 people who get up each morning to do work that’s unquestionably worth doing — providing high-quality patient care and running our state’s hospitals in communities regardless of patient’s ability to pay.

unfortunately, hospitals in the united states are set to lose more than $400 billion in funding from 2018 to 2026 if the anticipated affordable care act (obamacare) repeal does not include changes to medicare hospital payments. when the aca was p ed, hospital medicare payments essential for ensuring treatment of medicare patients were cut heavily to defray the costs of other parts of the law.

without help, some hospitals may shutter

how do americans get their health insurance and who’s

how do americans get their health insurance and who’s covered? we went to the national center for health statistics for answers based on a 2015 survey. 

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in 2015, an estimated 28.6 million americans, or 9.1

in 2015, an estimated 28.6 million americans, or 9.1 percent of the population, did not have health insurance. that’s an improvement. in 2014, 7.4 million fewer americans had health coverage. 

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for those under 65 who are insured, 65.6 percent had

for those under 65 who are insured, 65.6 percent had private coverage and 25.3 percent had public coverage. 

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among those under age 65, 3.4 percent or 9.1 million

among those under age 65, 3.4 percent or 9.1 million people obtained coverage through affordable care act exchanges. 

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when looking at racial and ethnic breakdowns, the percentages

when looking at racial and ethnic breakdowns, the percentages without health insurance are: 27.7 percent of hispanics, 14.4 percent of blacks, 8.7 percent of whites and 7.9 percent of asians. although hispanics remain the largest ethnic group without coverage, there has been dramatic improvements. the uninsured rate for hispanics was 40.6 percent in 2013. 

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because of these cuts, hospitals have been having trouble making ends meet due to lower reimbursement payments for treatment provided to medicare recipients. this is especially the case with community hospitals, which typically rely more heavily on medicare (and medicaid) for their funding.

if congress p es an obamacare repeal that does not restore medicare funding for reimbursement to hospitals, many arizona medical facilities will need to limit their services or shut down. this will in turn mean many of our fellow citizens having limited or no access to needed medical services.

one of the most important parts of our jobs as mayors is to look out for the fiscal health of our cities and to ensure adequate services for our citizens.

more: arizonans experience obamacare angst as congress speeds toward repeal

many municipalities in arizona count on hospital networks and other health care providers as top employers. this pattern holds true across the state, as jobs from hospitals account for more than 7  percent of total employment. in scottsdale and mesa, for example, honorhealth and bannerhealth are the no. 1 employers.

and yuma regional medical center employs nearly 2,000 staff members. these jobs provide a living for families, strengthen our state and deliver crucial services to those who need them — as well as ress our local economies.

in terms of public health, our hospitals are vital in ensuring that residents have access to the quality care they deserve. rural areas of our state are often underserved and lack access to specialty care, a trend that has been exacerbated by cuts to medicare reimbursements.

three rural hospitals already have closed

in the last decade alone, three rural arizona hospitals have shut their doors because they are unable to cope with these changes, and many other arizona hospitals struggle day-to-day. if obamacare’s replacement doesn’t make hospitals whole by restoring the cuts, our hospitals stand to lose nearly $5 billion in reimbursements from medicare — putting them even more at risk.

mayors make difficult decisions that directly affect the lives of their citizens each and every day. as leaders in our own communities, we are calling on our counterparts in washington to make what we view as an easy decision — restoring medicare hospital reimbursements, so all arizonans have access to quality health care, and those who deliver it can keep their jobs.

related: medicare 'accountable care' reforms bring mixed results

we respectfully call on our federal delegation to stand up for arizonans by voting to strengthen medicare. cutting medicare funding was an error made years ago that wreaked havoc on arizona hospitals. it would be an even bigger mistake for our lawmakers not to act now.

the piece was co-signed by mayors jim lane (scottsdale), doug nicholls (yuma), john giles (mesa), harry oberg (prescott), and jay tibshareny (chandler). email them at [email protected][email protected]mayor@mesaaz.gov[email protected] and [email protected]; twitter, @mayorjimlane, @yumafirst@mayorgiles and @jaytibshraeny.

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