March 9, 2017: Advocacy spotlight on Outcome of House health reform bill uncertain

An AMA Viewpoints from AMA President Andrew W. Gurman, MD

The American Health Care Act (AHCA), released by Congress this week, is intended to repeal and replace the Affordable Care Act (ACA). But as introduced, it does not align with the health reform principles that the AMA set forth in January to protect patients. While the ACA is imperfect, the current version of the AHCA is not legislation we can support.

The replacement bill, as written, would reverse the coverage gains achieved under the ACA, causing many Americans to lose the health care coverage they have come to depend upon.

In a letter sent this week to leaders of the House committees that will mark up the AHCA, AMA CEO and Executive Vice President James L. Madara, MD, wrote that the proposed changes to Medicaid would limit states' ability to respond to changes in service demands and threaten coverage for people with low incomes. Dr. Madara also noted that the proposed changes in tax credits and subsidies to help patients purchase private health insurance coverage are expected to result in fewer Americans with insurance coverage.

Policymakers and stakeholders are awaiting budgetary and coverage projections from the nonpartisan Congressional Budget Office. The ratings and analytics firm S&P Global Ratings has estimated that as many as 10 million Americans could lose coverage if this bill becomes law, saying that between 2 million and 4 million people could lose the insurance they purchased in the individual health exchanges under the ACA, and between 4 million and 6 million could lose their coverage under Medicaid.

That just won't do.

We all know that our health system is highly complex, but our core commitment to the patients is firm. As the AMA has previously stated, members of Congress must keep top of mind the potentially life-altering impact their policy decisions will have.

We physicians often see patients at their most vulnerable moments, from the first time they set eyes on a newborn child to the last time they squeeze a dying loved one's hand. We don't want to see any of our patients, now insured, exposed to the financial and medical uncertainties that would come with losing that coverage.

That is, above all, why physicians must be involved in this debate.

Editor's note: In the coming weeks, a series of AMA Wire® articles will explore policies that form the basis of the AMA's advocacy on health reform. Read parts one ("Protecting insurance gains is priority No. 1") and two ("No going back on key market protections").

• March 9, 2017: National Advocacy Update 
• March 9, 2017: State Advocacy Update 
• March 9, 2017: Judicial Advocacy Update