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AAFP, AAP, ACP criticize Senate Health Care bill

The AAFP, ACP and AAP have stated their opposition to the U.S. Senate’s proposal to repeal and replace the Affordable Care Act, with the AAFP indicating it would have a “profoundly negative impact on Americans.”

The Senate Better Care Reconciliation Act (BRCA) of 2017, released to the public yesterday, maintains much from the version the House passed May 4, but presents some critical changes, such as a slower phase out of Medicaid expansion and funding cost-sharing exchange plans for 2 years.

“[This bill] reflects many of the same flawed concepts that are in the American Health Care Act,” John J. Meigs, Jr., AAFP president said in a statement. “We cannot and will not support a bill that will cause harm to millions of patients. [It] poses a graver threat to millions of Americans, particularly children, people with disabilities and older Americans,” he said.

His concerns about the bill’s impact on America’s youth were closely aligned with those of Fernando Stein, MD, FAAP, AAP president.

"The bill fails children by dismantling the Medicaid program, capping its funding, ending its expansion and allowing its benefits to be scaled back. The bill fails all children by leaving more families uninsured, or without insurance they can afford or that meets their basic needs,” Stein said in a statement. “This bill fails children living in or near poverty, children in foster care and children with complex health care needs whose parents have private insurance – all of these children depend on Medicaid, and if this bill passes, Medicaid will no longer be there for them.”

Other components of the Senate bill also have Meigs worried.

“The possible damage goes deeper, because the bill allows states to opt out of important consumer protections that prevent discrimination against patients based on their gender, age and health status,” he said. “States choosing to opt out would no longer be required to adhere to essential benefits such as prescription coverage, ambulance services or maternity care.”

Stein said the AAP’s lack of input in the Senate plan shows in its details.

“The bill ... was crafted without the benefit of groups like pediatricians weighing in with what children need. The result is that the bill would tear down the progress we've made by achieving health insurance coverage for 95% of America's children. We cannot let that happen,” he said.

Meigs concluded by reiterating the AAFP’s commitment to assist lawmakers in developing a health care plan that addresses the group’s concerns, while Stein said the AAP is leading its membership in a day of action to protect Medicaid.

ACP also expressed their “strongest opposition” to the BCRA. As explained in an earlier letter urging the Senate to reject the House’s AHCA, ACP stated that this bill threatens millions of patients who depend on the coverage and protection established by the ACA, including Medicaid.

“We strongly urge that the Senate vote down the BCRA,” Jack Ende, MD, MACP, ACP president, said in a press release. “Radically cutting and restructuring Medicaid and ending federal funding for expansion, allowing states to waive essential benefits; discriminating in the awarding of federal funds to women’s health clinics; and replacing the ACA’s premium and cost-sharing subsidies with insufficient tax credits that make coverage unaffordable for those who need it most will not fix or improve the healthcare system. The BCRA will not preserve and improve essential coverage, benefits and consumer protections, and will reduce access to care for both currently insured and uninsured individuals, children and families.” – by Janel Miller and Savannah Demko

Disclosure: Meigs is president of AAFP; Stein is president of AAP; Ende is president of ACP.