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AAFP, AMA: Congressional Budget Office report shows AHCA needs work

The presidents of AAFP and AMA have unleashed a new round of criticism regarding the American Health Care Act, the bill initiating the repeal of the Affordable Care Act that narrowly passed the House earlier this month.

The groups’ comments come after the Congressional Budget Office (CBO) and Joint Committee on Taxation released a report on Wednesday that indicated the House-passed version of the American Health Care Act (AHCA) would leave 14 million more people uninsured than under the present law. According to the CBO report, that number would increase to 19 million by 2020 and to 23 million by 2026. The total number of uninsured in 2026 under the age of 65 would be 51 million based on CBO projections.

AMA expressed dismay that the House-passed version offered nothing new to patients, and also its concern for those who will be without health insurance.

“Estimates from the nonpartisan Congressional Budget Office show last-minute changes to the AHCA made by the House offered no real improvements,” Andrew Gurman, MD, president and CEO, AMA, said in a statement. “Millions of Americans will become uninsured — with low-income families on Medicaid being hit the hardest.”

In a separate statement, AAFP president John Meigs, Jr., MD, also referenced his concerns about what AHCA would do to Medicaid; specifically, how the proposed law would restrict the federal financial commitment to the program, stop its expansion and decrease benefits for the newly enrolled.

Meigs also noted that in addition to those without insurance, AHCA will leave millions more Americans with inadequate coverage.

“[The report] also verifies that a significant proportion of Americans — one-sixth of the U.S. population — face the loss of meaningful coverage because they live in states expected to obtain waivers on coverage for essential health benefits and community ratings requirements,” Meigs stated. “Such states could return to medical underwriting and allow insurers to discriminate against individuals based on their gender, age and health status. These practices would also threaten the financial stability of millions of individuals and families, if, for example, protections against annual and lifetime spending caps are waived.”

Both AMA and AAFP expressed hope the Senate would address their concerns, with the AAFP specifically asking lawmakers to lower pharmaceutical treatments costs; to ensure primary, preventive, and mental health and substance use services are more readily available to all Americans; to stabilize the individual market; and to expand health insurance coverage and ensure that it remains affordable.

At the time of the AHCA’s narrow passage earlier this month, the ACP expressed disappointment in the plan and specifically asked the Senate to restore components that eliminated coverage of essential health benefits and replace income-based premiums and cost-sharing subsidies with regressive age-based tax credit.

The CBO’s analysis of AHCA came a day after the details of President Donald Trump’s federal budget were revealed. Representatives from several medical societies, including AAFP, have raised concerns the plan would decimate scientific research and innovation while jeopardizing millions of Americans’ access to essential health care and preventive services.

Earlier this week, both AAFP and ACP took their concerns about the future of health care to Capitol Hill.

During meetings with lawmakers from both sides of the aisle, AAFP stressed the importance of preserving patients’ access to care and getting affordable, meaningful health insurance; ensuring patients are protected from diseases that can be prevented with timely vaccines; and reauthorization and appropriate funding for teaching health centers; ACP used its meetings with legislators to discuss its new policy agenda containing several recommendations for Congress to improve American health care, including expanding access to health care coverage, optimizing value for the dollar spent, as well as supporting and advance scientific research and public health. – by Janel Miller

Disclosures: Gurman is president of AMA, Meigs is president of AAFP.