Healio Special Report: Health Care and Politics

Healio Special Report: Health Care and Politics

March 08, 2017
3 min read

ACP, AMA: Proposed ACA replacement ‘unacceptable,’ ‘critically flawed’

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In the midst of the House Republicans recent announcement of their proposed ACA replacement plan, known as the American Health Care Act, the ACP and AMA, among many other health care organizations, have released statements in opposition of the plan, noting that it will negatively impact access, quality and cost of care for patients.

“This bill will result in many millions of Americans losing coverage; benefits and consumer protections ...,” Nitin S. Damle, MD, MS, MACP, president of ACP, said in a press release. “In sum, it will rollback and reverse the coverage gains from the ACA.”

Andrew W. Gurman, MD, president of AMA said, “The AMA supported health system reform legislation in 2010 because it was a significant improvement on the status quo at the time; and although it was imperfect, we continue to embrace its primary goal — making high-quality, affordable health coverage accessible to all Americans. As drafted, the AHCA would result in millions of Americans losing coverage and benefits. By replacing income-based premium subsidies with age-based tax credits, the AHCA will also make coverage more expensive — if not out of reach — for poor and sick Americans. For these reasons, the AMA cannot support the AHCA as it is currently written.”

In a letter to congressional leadership, the ACP stated that the American Health Care Act (AHCA) is “unacceptable,” as it fails to meet its “first, do no harm” criteria for modifications and/or improvements to the ACA.

The ACP and the AMA outlined their concerns with several provisions within the AHCA. The AHCA could cause the loss of coverage and benefits for tens of millions of patients enrolled in Medicaid by drastically limiting future federal contributions to Medicaid and phasing-out the higher federal match in states that have opted to expand Medicaid starting in 2020, according to the ACP. Coverage under the AHCA will be unaffordable for poorer, sicker and older persons, as well as for persons who live in high health care cost regions, due to regressive age-based tax credits and the ability of insurers to charge older individuals significantly increased premiums than permitted in the ACA, according to both the ACP and AMA. Continuous coverage requirements for patients with pre-existing conditions in the AHCA would make coverage unaffordable for these vulnerable patients, noted ACP. Repealing “actuarial value” requirements for essential health benefits could increase out-of-pocket costs for many essential health care services, including mental health benefits, substance abuse treatment, maternity care and contraception and preventive services, noted the ACP and AMA. In addition, legislative or regulatory restrictions proposed in the AHCA would deny or discriminate against funding to women’s health clinics, according to the ACP.


“The changes that the AHCA would make to our health care system would adversely impact tens of millions of our patients, especially older, sicker and poorer ones,” Damle said. “We sincerely hope that Congress would still be willing to slow down the legislative process to work with us on ways to improve current law without undermining essential coverage and consumer protections for millions of patients as this proposal does.”

The ACP previously examined the future of the ACA and noted that the repeal and replacement of ACA would negatively impact health care industry.

The American Academy of Family Physicians, American Academy of Pediatrics, American Congress of Obstetricians and Gynecologists and American Osteopathic Association are still individually reviewing the AHCA, but join ACP and AMA in expressing serious concerns with the bill. The organizations urge House Speaker Paul Ryan (R-WI) and the chairs of the Energy and Commerce and Ways and Means committees to halt mark-up and allow for a thorough review of AHCA to ensure that patients and providers are not adversely affected. The ACP also calls for a detailed release of modifications or improvements to the current law, as well as hearings on the proposals in advance of committee mark or floor vote.

The American College of Cardiology (ACC) and the American Heart Association (AHA) also released statements advocating to protect patient access to quality and cost-effective care.

“We stand ready to work with policymakers on both sides of the aisle to honor our shared responsibility to care for all Americans, especially for the most vulnerable among us,” Richard A. Chazal, MD, FACC, president of ACC said.

The AHCA could result in as many as 15 million individuals losing coverage, according to AHA.

“While we were encouraged that the legislation acknowledged the importance of preserving critical patient protections, like pre-existing conditions, our priority is the overall preservation of coverage for those insured under Medicaid and the ACA,” Nancy Brown, CEO of AHA, said. “At first glance, we are not convinced that this goal will be achieved by this proposal.”

“We urge Congress to develop a plan that provides affordable, accessible and adequate health care for our nation,” she concluded.by Alaina Tedesco





Disclosure: Healio Internal Medicine was unable to confirm relevant financial disclosures.