Jack Ende, MD, MACP
President, American College of Physicians
May 4, 2017
The American College of Physicians (ACP) is extremely disappointed that the U.S. House of Representatives passed the American Health Care Act (AHCA) today. This vote makes coverage unaffordable for people with pre-existing conditions, allows insurers to opt-out of covering essential benefits like cancer screening, mental health, and maternity care, and cuts and caps the federal contribution to Medicaid while sunsetting Medicaid expansion. As a result, an estimated 24 million Americans will lose their coverage, and many more will be at risk of paying higher premiums and deductibles.
The House action is by no means the end of the story, however. ACP will continue to do all that it can to ensure continued coverage and access for the millions of patients who have benefited from the Affordable Care Act. In a strongly worded letter to the United States Senate also sent today, ACP urged Senators to reject this harmful legislation and begin anew to craft bipartisan solutions to improve coverage and access for all Americans. Specifically, the Senate must reject the following policies that were included in the AHCA, as passed by the House:
- The AHCA will make radical changes to the Medicaid program’s structure and financing, resulting in the rollback of coverage for many millions of the most vulnerable Americans. Specifically, ACP opposes capping, block granting and cutting the federal contribution to Medicaid, ending federal funding for Medicaid expansion, and eliminating the requirement that Medicaid cover essential health benefits.
- The AHCA will allow states to opt-out of federal requirements that insurers cover essential health benefits; and that premiums be based on community rating rather than an individual’s health status. After analyzing the potential impact of the AHCA, The Brookings Institute concluded that “As a result, community rating would be eviscerated—and with it any meaningful guarantee that seriously ill people can access coverage.”
- The AHCA will replace income-based premiums and cost-sharing subsidies with regressive age-based tax credits that result in higher premiums and deductible for most people, especially older, poorer and sicker patients.
Because of these and other ill-advised policies, the House-passed bill violates the fundamental principle so important to the ACP, which is First, Do No Harm . The College feels strongly that the Senate must reject this legislation as it will result in catastrophic harm by eroding coverage and essential consumer protections for the most vulnerable: older, sicker and poorer patients. Instead, we urge Congress to start over and seek agreement on bipartisan ways to make health care better, more accessible, and more affordable for patients rather than imposing great harm on them as the AHCA would do.
The American College of Physicians is the largest medical specialty organization in the United States. ACP members include 148,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.
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