President Donald Trump has spent the last few days promoting the possibility of eliminating the Affordable Care Act altogether, and replacing it with a plan that has not yet been revealed.

President and CEO of the Montana Hospital Association, Rich Rasmussen, speculates on the impact of the loss of the ACA to Montana.

“If you look for a minute at what this might mean to our hospitals, but most importantly to our patients,” he said. “Under our Medicaid expansion and our ACA Exchange population here in Montana, almost 150,000 people, that’s 15 percent of the population of Montana would lose health insurance immediately. Imagine for a moment that the federal government in the middle of the day that they would shut down the entire air traffic control system, the havoc that would create. That is very similar to what we would experience if the ACA is taken down immediately, then hospitals, physicians, patients, insurers, businesses would all be scrambling how to figure out how to provide healthcare coverage to their employees and family members.”

Rasmussen said emergency rooms all over the state would be flooded with patients almost immediately.

“Experience has shown us that when people are at their sickest, they come to the emergency department,” he said. “The value of the ACA or Medicaid expansion is that patients have had major access to physicians and other services not having to use the emergency room as their primary care provider.”

Rasmussen mused over what he would say to President Trump about this issue if he had a face to face visit.

“I would say that what we need to do is seek a bipartisan solution to improve the situation we have,” he said. “Certainly, there are ways we can make modest adjustments to the system, but for the most part it is working, and we can see that here in Montana as a primary example. Medicaid expansion is a prime example. We have high engagement among our enrollees that are covered under Medicaid. People are seeking care in the most appropriate setting, so let’s look at what is working and build upon that, and I think a bipartisan effort to do that like is being sought here in Montana is what I would suggest to the President.”

Rasmussen said the American Hospital Association will be gathering in Washington, D.C. next week, and this issue will be at the top of the agenda.