Today we’re getting our first close look at House Republicans’ proposal to replace the Affordable Care Act. There’s a lot to pore over, but our first and overriding concern is that access to healthcare through safety net providers does not equal coverage – and coverage is essential to good health, a strong healthcare delivery system and reduced healthcare costs.

President Trump had assured the country that no one would lose coverage under his plan, but this proposal does not provide that guarantee. The proposal to change Medicaid from a federal-state partnership to a program that simply provides per-capita lump sum payments to the states raises serious worries about the future coverage of the 553,474 New Jersey residents who are covered under Medicaid. Medicaid beneficiaries have access to a primary care doctor and preventive care under that coverage. It would be a very harmful step backward if a portion of those New Jersey residents lose coverage and return to the days when they used the hospital emergency room for all of their healthcare. That’s not good for those New Jersey residents, and it’s just not a smart way to deliver healthcare services.

Less planned and preventive care will raise healthcare costs for all. It also raises real worries about the future of hospitals. As more people gained health insurance coverage, the state significantly reduced funding for hospitals that provide charity care for the poor and uninsured. Those cuts totaled $373 million over the last three years, and Gov. Christie has proposed even deeper cuts in the next state budget. Those cuts, coupled with the proposal we see here, could gut funding for our hospitals.