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ACP, AMA not satisfied by proposed changes to AHCA

In a letter to the House of Representatives, ACP argued that the new provisions intended to gain support among House Republicans for the American Health Care Act that increase funding to states for “high risk” pools by $8 billion over 5 years would not make coverage more affordable for patients with pre-existing conditions. In a separate statement, AMA noted that these amendments would still result in millions of Americans losing health insurance coverage.

“None of the legislative tweaks under consideration changes the serious harm to patients and the health care delivery system if AHCA passes,” Andrew W. Gurman, MD, president of AMA, said in the statement. “Proposed changes to the bill tinker at the edges without remedying the fundamental failing of the bill – that millions of Americans will lose their health insurance as a direct result of this proposal.”

A recent analysis by the Brookings Institution found that the AHCA, through the MacArthur-Meadows amendment, would allow states to eliminate community rating protections for all Americans seeking individual market coverage, thus denying access to coverage for seriously ill individuals, according to the letter. The community rating provision prohibits insurers from charging higher rates based on a consumer’s health background. The MacArthur-Meadows amendment would also allow states to opt out of the benefits insurers are required to provide.

“This new amendment’s addition of an average of $1.6 billion per year doesn’t come close to” making up the $20 billion shortfall needed to sustain the proposed high risk pools that had previously been identified in an analysis, Jack Ende, MD, MACP, president of ACP, noted in the letter. “We also know that high risk pools are no substitute for the ACA’s ban on insurers charging more to patients with pre-existing conditions.”

In the letter, Ende emphasized that the ACP’s concerns are not limited to the harm that the AHCA will do to patients with pre-existing conditions; the organization is also concerned about how the bill would cap and cut the federal contribution to Medicaid by 25% over the next 10 years and allow insurers in waiver states to opt out of providing essential health care benefits, among other changes.

“There is nothing moderate about the AHCA,” Ende wrote. “Rather, it is an extreme attack on access and coverage for millions of Americans, and especially, older, sicker, and poorer patients who are most in need of help.”

The ACP previously urged Congress to “find a new way forward” and develop meaningful legislation that improved the current law, rather than eliminate coverage and benefits for millions of Americans after the vote in the House on AHCA was postponed in March.

“America should not go backward to the time when our fellow citizens with pre-existing health conditions faced high costs for limited coverage, if they were able to obtain coverage at all,” Gurman said. “The AMA urges congressional leaders and the Administration to pursue a bipartisan dialogue on alternative policies that provide patients with access and coverage to high quality care and preserve the safety net for vulnerable populations.”

Disclosure: Healio Internal Medicine was unable to confirm relevant financial disclosures are the time of publication.