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"Repeal and defund Obamacare." What happens to PCORI?

This topic contains 5 replies, has 3 voices, and was last updated by Profile photo of Cherie C Binns RN BS MSCN Cherie C Binns RN BS MSCN 6 months ago.

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  • #1062
    Profile photo of Hugo Campos
    Hugo Campos
    Participant

    Folks have been asking me what happens to PCORI if the Patient Protection and Affordable Care Act is defunded or repealed.

    I have been explaining that nothing will happen to PCORI—at least not until 2019, when Congress must pass legislation reauthorizing funding for the PCOR Trust Fund. I add that funding comes from three separate streams: appropriations from the general fund of the Treasury, transfers from the Centers for Medicare and Medicaid trust funds, and a fee assessed on private insurance and self-insured health plans (the PCOR fee). Given that agreements are signed, contracts are in place, and research work is going on, I believe nothing would happen to PCORI even if the ACA is repealed.

    Others have insisted that a repeal would mean that all commitments would disappear overnight and all PCORI-funded work would come to a screeching halt.

    Am I sharing wrong information? Can someone help clarify?

    #1092

    Here is a link to the full wording of the Executive order signed on January 20, 2017.  http://www.cnn.com/2017/01/20/politics/trump-obamacare-executive-order/

    You will note, upon reading, that everything is based on intent and is not yet in place and will not be soon.  The two main areas that may be impacted are the fees assessed on Private and Self insured plans and the IRS penalty for those who did not obtain insurance.  PCORIs funding ends in September 2018 and not in 2019.  In a letter from Joe Selby to the members of PCORnet, he noted that all funds had been transferred from the Trust Fund and deposited them into PCORIs private account, thus insuring that we should be able to follow through on funding the projects that have been committed.

    Does this help?

    For another point of view, this article http://www.medpagetoday.com/Washington-Watch/Reform/62667?xid=nl_mpt_SRRheumatology2017-01-22&eun=g378374d0r  Was published in MedPageToday on Monday of this week.

    #1097
    Profile photo of Sharon Terry
    Sharon Terry
    Participant

    Hi Hugo,

    Good question, and one you can imagine the funded PPRNs and CDRNs have been worried about. The unofficial answer is this: PCORI has received the necessary funds to meet its commitments and will not be affected by a repeal of ACA for already awarded contracts. My guess (me, not official) is that this is true if there is no way to claw back funds once they have left the treasury – so I see this as a 90% assurance. There is some risk.

    The second part of the answer is that PCORnet was only expecting to be funded until PCORI sunsetted – albeit had a different president taken office we would have seen a renewal perhaps. Therefore, we have already begun an important deliverable that was part of all of our funding: become sustainable. We are exploring a number of options for keeping at least PCORnet alive beyond the committed funding.

    Sharon

    #1098

    Thank you for your input Sharon.  I know of more that is happening to assure that we remain active, vital members of this network that has been created as we continue to grow and move forward but do not wish to say too much too soon.   I think it is a necessary step at this juncture to make it a point to speak to our senators and representatives and let them know how we stand on the issues that are being considered for removal.  In our State, there are no Republicans in Washington but a friend is a mayor near me who is Republican and he is very concerned that the “baby is being thrown out with the bath water” if ACA is repealed without something at least as comprehensive in place.  “We the People” need to use our voices now more than ever.

    #1099
    Profile photo of Hugo Campos
    Hugo Campos
    Participant

    Thank you Cherie and Sharon. This is helpful. Thanks for taking the time.

     

    #1100

    There is so much “alternate” information out there that I think it is so very important for us not to share what is not something with which we are personally familiar or have not researched a bit through reputable sources.  PCORI, as we know it, will most likely cease to exist in a year and a half while the work all of us have been doing through the PCORnet channels is going to continue in some form.  There are too many patients, researchers, and other stakeholders who have been touched in positive ways by  that which began as PCORI that I am not sure things could ever fully “go back to what they were” at this point.  That is….IF all of us who have seen a better way to do research continue on the path we have envisioned.

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