As the debate rages on in Washington about revisions to the Affordable Care Act, local health care providers are prepared to make adjustments.

Indications are that some participants covered under the ACA could be in for steep premium increases in 2018 as Congress tries to reach a consensus on changes to the law enacted seven years ago.

Officials from New Hanover Regional Medical Center, Novant Health and Wilmington Health recently offered perspectives on the ACA’s uncertain future.

“We’re planning as though there will be changes in how we will be reimbursed or how the health care market will look, regardless of potential changes to the Affordable Care Act. In the short term, we are working on how to reduce the cost of care while still continuously improving quality,” said Scott Whisnant, NHRMC’s administrator of community relations and government affairs.

“A longer-term effort is working in communities to fix the underlying causes of poor health, such as underlying social issues and disparities, among those we serve,” he added.

Novant Health, the health care system that operates Novant Health Brunswick Medical Center, “is not waiting for Washington or Raleigh to move us forward,” said Shelbourn Stevens, president of the Bolivia- based hospital.

“Long before the Affordable Care Act, Novant Health has been transforming to meet the needs of our consumers and to make health care more affordable and accessible,” he said.

Changes in the U.S. health care system have been a constant for many years, and organizations like Wilmington Health have learned to adapt while continuing to provide quality care.

“The health care system has been changing so rapidly over the last decade that not knowing what will be next is part of our planning process. We continue to develop our providers, staff and leadership to be flexible and adjust quickly to change in the best interests of the patient and the health care system,” said Jeff James, Wilmington Health CEO.

“Our goal remains simple: reduce cost, improve population health and positive patient experience. The [legislation] under which those are performed may require us to do some things differently, but remaining true to those goals will never change.”

Health groups said they were keeping an eye on potential coverage impacts from proposals to tweak the ACA – whether from Congress or through executive orders from President Donald Trump – now that attempts for a full overhaul of the law stalled in the Senate.

“Any plan that reduces the number of those who have access to health insurance, or reduces what health insurance plans cover, is a potential issue for NHRMC or any hospital. Insured or not, patients will still have health care needs, and more of the cost should not be shifted to hospitals and health systems,” Whisnant said.

NHRMC would also have to make accommodations if a restructured health care system is introduced by the Trump administration.

“The amount of care we provide without reimbursement essentially has not changed under Obamacare. While more patients have some form of insurance, more patients are also having trouble paying high deductibles or copay under many of the ACA plans, so hospitals end up writing it off anyway,” Whisnant said.

James said that Wilmington Health administrators believe “certain aspects” of the ACA “and the overall direction of health care won’t change regardless of the outcome of the current debate.”

“Improving the health of our populations of patients and the community while reducing the per capita cost of care will continue to be the foundation of our health care system into the future,” James said. “Our biggest concern is that as the debate continues, there is honest discussion as to the merits of the current [ACA]. Let’s focus on positive recognition of what is working while addressing those items which are not.”

For more on how area small businesses are coping with rising health insurance costs, click here.