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ACP: New amendments to AHCA ‘even less acceptable’
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ACP recently sent a letter to the Congressional leadership in strong opposition of the manager’s amendments to the American Health Care Act, arguing that several new proposals fail to improve access, quality and cost of health care for patients.
Moreover, Nitin S. Damle, MD, MS, MACP, president of ACP, noted in the letter that the modifications worsen the negative impact of the bill, making it “even less acceptable than it was before it was modified.”
“We have already expressed to you our view that the [American Health Care Act (ACHA)] violates the principle that Congress must ensure that any possible changes to current law, including to the Affordable Care Act (ACA), the Medicaid program and the Children’s Health Insurance Program should first, do no harm to patients and ultimately result in better coverage and access to essential medical services,” Damle wrote in the letter. “While ACP continues to advocate for improvements to the [Affordable Care Act] ACA, the AHCA, especially as modified by several of the proposals released last night, would go in the wrong direction, eroding coverage and essential consumer protections for the most vulnerable patients: those who are older, sicker and poorer.”
The manager’s amendment includes technical and policy changes, but still contains many of the original provisions, according to a Health Affairs blog.
“Our legislation includes ideas from Republican members who are committed to improving health care for patients and families across the country,” Chairman of House Ways and Means Committee, Rep. Kevin Brady, R-Tex., said in a statement. “We’re confident these changes will set AHCA up for success in the House. We look forward to working with our Senate colleagues to get this bill over the finish line and send it to the President as quickly as possible.”
The ACP emphasized that the amendments to the AHCA will harm, not improve, health care. The amendment would offer states a block grant financing option, according to ACP. This provision, along with the federal contribution limit per Medicaid enrollee in the original bill, would cause millions of vulnerable Americans to lose coverage and benefits, ACP stated. The manager’s amendment will further contribute to the decline in access to affordable coverage by prohibiting enhanced federal funding — as of March 1, 2017 — for states wanting to expand Medicaid, according to ACP. In addition, the provision would eliminate the Essential Health Benefits for Medicaid expansion enrollees, including behavioral and mental health and substance use disorder services that currently require coverage, thus intensifying the opioid misuse epidemic, ACP stated. ACP also opposed amendments made to the AHCA that would offer a financial incentive to states for requiring that certain Medicaid enrollees perform work or job searches.
In his letter, Damle acknowledged that one of the amendments aims to increase the value of premium subsidies; however, he noted that there is no assurance the regressive nature of tax credits would be eradicated.
“We are also extraordinarily concerned that a new Congressional Budget Office (CBO) cost estimate of the amended bill will not be made available, with the necessary time for full consideration of its impact on coverage, out-of-pocket costs, premiums and the deficit, until right before the floor vote in the House of Representatives occurs on Thursday,” Damle said. “This information is crucial to evaluating its impact on patients.”
The ACP previously issued a statement expressing concerns about the president’s skinny budget proposal due to a CBO report that projecting the AHCA will cause millions of Americans to lose vital access to health care — as many as 14 million within the first year, with the total number of uninsured climbing to 52 million by 2026.
“We sincerely hope that Congress would still be willing to slow down the legislative process, obtain a CBO score in time for thorough consideration before it is voted on, and work with us on ways to improve current law without undermining essential coverage and consumer protections for millions of patients as the AHCA and these potential proposals do,” Damle concluded.
According to House Speaker Paul Ryan, R-Wis., the amendments made to AHCA will assist in passing the bill in a vote on March 23.
“With the president’s leadership and support for this historic legislation, we are now one step closer to keeping our promise to the American people and ending the Obamacare nightmare,” Ryan said in a statement. – by Alaina Tedesco
Disclosure: Healio Internal Medicine was unable to confirm relevant financial disclosures at the time of publication.