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AAFP, ACP, others to Congress: ‘Find a new way forward' after AHCA failure

With plans to revoke the Affordable Care Act stalled, leaders of the AAFP, ACP, AAP, American Congress of Obstetricians and Gynecologists and American Osteopathic Association are encouraging lawmakers to craft new health care legislation that builds on successes of the Affordable Care Act.

For now, the Affordable Care Act (ACA) remains the law following the Republicans' decision to pull the vote on the American Health Care Act (AHCA) that would replace it.

“As primary care physicians on the frontlines of patient care, we are grateful that many Representatives heard our concerns and did not vote to pass the AHCA, and we turn now to Congress to find a new way forward,” the leaders said in a joint statement. “We urge our elected leaders to consider our joint principles for health care reform in any new proposal they pursue, and that any efforts to change or amend current law should ‘first, do no harm’ to our patients.”

The groups stated that those principles include: making sure that every individual that currently has insurance coverage be allowed to keep it; keeping consumer and benefit protections, as well as essential benefits covered; and system reforms that would enhance the health care system for both patients and their physicians.

“Congress now has an opportunity to refocus on the shortcomings of our current health care system, especially the issues of affordability and access to primary care," John Meigs, Jr., MD, AAFP President, said in a separate statement. "The AAFP calls on Congress to develop legislation that ensures meaningful, affordable and comprehensive health care coverage for patients in both the employer-sponsored and individual markets."

"Congress has another chance to ensure that they 'first, do no harm' to patients and make changes that actually result in improvements over current law," Nitin S. Damle, MD, MS, MACP, ACP President, said in a separate statement. "The goal must be to expand existing coverage and consumer protections available under [ACA], rather than taking them away as the AHCA would have done."

Robert B. Doherty, senior vice president, governmental affairs and public policy, ACP, said at a press conference at this year’s ACP Internal Medicine Annual Meeting that some parts of the plan pushed by Rep. Paul Ryan (R-Wis.) would have made things worse, not better.

“The irony here is that the Republican bill, on average, would have made deductibles even higher than the ACA does and the support you get from premiums would have been inadequate [compared to] what you get under the ACA , particularly if you’re older and sicker,” he said. “So this whole argument that I’ve been hearing for 7 years now is that the deductibles are too high, the premiums are too high, their answer to that was to make [these things] even higher so that’s a concern.”

AAFP and ACP encouraged lawmakers to seek input from as many entities as possible in developing the new legislation.

"We would urge the House and Senate to work with the AAFP, other health care organizations, and patient stakeholders to develop legislation that will immediately stabilize the health care market and meet the needs of their constituents." Meigs said.

ACP agreed, and added any new legislation should be thoroughly vetted.

"Our sincere hope is that Congress will join with physicians, nurses and other health professionals; consumer and patient advocacy groups; hospitals; insurers; states; employers; and others ... " Damle said.

"It is also imperative that Congress approach health care legislation in a deliberative, transparent and bipartisan way, with full hearings and debate," he said. "Coming back with a warmed over, somewhat revised version of the fatally flawed policies in the AHCA is not an option."

In the weeks leading up to Friday's pulled vote, AAFP and ACP had repeatedly criticized the AHCA, with AAFP saying it had 'significant concerns' and ACP calling it 'unacceptable.'

The New York Times and NPR are among the media outlets reporting that Republicans have shifted their primary legislative focus to tax reform. – by Janel Miller

Disclosures: Meigs works for AAFP; Damle works for ACP.  Healio Family Medicine was unable to determine Doherty's relevant financial disclosures prior to publication.

Further reading:  Joint Recommendations of the American Academy of Family Physicians, American Academy of Pediatrics, American Congress of Obstetricians and Gynecologists, American College of Physicians, and American Osteopathic Association on Priorities for Coverage, Benefits and Consumer Protections Changes. Accessed March 27, 2017.