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City’s hospital leaders warn health law changes could lead to job cuts

Mayor Walsh met with leaders of the city’s biggest hospitals at City Hall, including Carney Hospital president Walter Ramos (left).Craig F. Walker/Globe Staff/Globe Staff

Mayor Martin J. Walsh sat down Friday with leaders of the city’s biggest hospitals to talk about the potential impact of a repeal of President Obama’s signature health care law. What he heard wasn’t comforting.

The executives told Walsh that policies Republicans in Washington are considering to replace the Affordable Care Act could destabilize their organizations and lead to job cuts. Hospitals are among the city’s largest private employers and a powerful engine driving the local economy.

President Donald Trump and Republican leaders in Congress are moving to dismantle the national health law, also known as Obamacare. Their replacement plan could result in cuts to Medicaid, the federal-state program that funds health care for low-income Americans and accounts for a big share of hospital revenue.


“It will destabilize all of us,” said Peter Healy, president of Beth Israel Deaconess Medical Center. “We would all be having job losses.”

Sandra L. Fenwick, chief executive of Boston Children’s Hospital, said she’s worried Congress will “rush to get something done with a lack of knowledge about unintended consequences.”

Also meeting with the mayor were the leaders of Boston Medical Center, Brigham and Women’s Hospital, Carney Hospital, Dana-Farber Cancer Institute, Massachusetts General Hospital, New England Baptist Hospital, and Tufts Medical Center.

Walsh said he convened the group to understand their worries about an Obamacare repeal, and he promised to share those concerns with his counterparts in other cities through the US Conference of Mayors. Walsh chairs the conference’s health committee.

“What role do you want me to play?” Walsh asked the hospital chiefs. “I’m all in... All of your hospitals are an integral part of our city.”

Hospitals throughout the country have gained new business from the current health care law, which helped 20 million Americans gain health coverage, either through Medicaid or commercial insurers. But in some states, some insurers have stopped participating in the program, and the costs of many health plans have jumped.


Massachusetts hospital leaders have been following the news from Washington voraciously since the November election, trying to grasp what new health policies may be enacted. Much uncertainty remains.

Dr. Michael Wagner, chief executive of Tufts Medical Center, said Tufts — like many other hospitals — has been adopting new contracts with insurers that reward health care providers for coordinating patient care and trying to keep patients healthy, instead of rewarding them for every service and procedure. The Obama administration promoted this shift, but Wagner said he’s worried the new administration won’t do the same.

“There are assumptions we’ve been working under for a number of years to make care work better,” he said. “Basically, all of that work is being undone.”

Hospital leaders are also unsure about the future of an agreement between state and federal officials that secures more than $29 billion in federal funding over five years for the Massachusetts Medicaid program, known as MassHealth. The agreement was completed during the last months of the Obama administration, but the new administration could seek to rework the deal.

Boston Medical Center, which treats an especially high number of poor and low-income patients, would be among the hardest hit by such a change.

“The notion that this could be pulled out from under us abruptly by a new federal administration, even though it’s been approved for five years, is really what worries us the most,” said Kate Walsh, chief executive of BMC.


Priyanka Dayal McCluskey can be reached at priyanka.mccluskey@globe.com. Follow her on Twitter @priyanka_dayal.