The AMA sent a letter to Senate leaders stating its overwhelming disapproval with the U.S. Senate’s proposal to repeal and replace the Affordable Care Act.
The Senate Better Care Reconciliation Act of 2017, released to the public last week, maintains much from the version the House passed May 4, but presents some critical changes, such as a slower phase out of Medicaid expansion and funding cost-sharing exchange plans for 2 years.
AAFP, ACP and AAP all cited their concerns with the bill in statements last week.
“Throughout the health system reform debate, the AMA has urged that reforms not result in individuals with health insurance losing access to affordable, quality coverage; that Medicaid, CHIP and other safety net programs be adequately funded; and that key market reforms, such as pre-existing conditions, be maintained,” the group stated in a press release. “The Senate draft, however, violates many of those principles.”
James L. Madara, CEO and executive vice president, AMA, expressed concern that the proposal would change Medicaid into an operation that hinders the federal obligation to care for needy patients on to a predetermined formula based on per capita caps.
“[These] caps fail to take into account unanticipated costs of new medical innovations or the fiscal impact of public health epidemics, such as the crisis of opioid abuse currently ravaging our nation,” he wrote. “The Senate proposal to artificially limit the growth of Medicaid expenditures below even the rate of medical inflation threatens to limit states’ ability to address the health care needs of their most vulnerable citizens. It would be a serious mistake to lock into place another arbitrary and unsustainable formula that will be extremely difficult and costly to fix.”
Madara also expressed concern that the proposal would remove many of the original bill’s preventive medicine components, and indicated he was pleased that the Senate bill extends cost sharing reductions payments, which he said are intended to bring short-term stability to the individual market.
He concluded by stating that legislators should work to come up with a health care plan that is more inclusive to all.
“We sincerely hope that the Senate will take this opportunity to change the course of the current debate and work to fix problems with the current system. We believe that Congress should be working to increase the number of Americans with access to quality, affordable health insurance instead of pursuing policies that have the opposite effect, and we renew our commitment to work with you in that endeavor,” Madara wrote.
Disclosure: Madara is CEO and executive vice president of AMA.