Welcome to Practice Rounds, our weekly column exploring what's being covered in the larger world of healthcare.
House GOP Releases Controversial ACA Replacement Plan
Late Monday, Republican Congressmen released a 123-page bill dubbed the American Health Care Act was released as a way to repeal and replace the Affordable Care Act (ACA). The controversial bill has been met with significant resistance from prominent medical groups.
The bill would keep some aspects of the ACA including the ban on preexisting conditions, allowing young-adults to remain on their parents' coverage plans until the age of 26, and banning lifetime limits on health insurance. It replaces the subsidies that the ACA provided for low-and-middle-income families with a tax credit, ends the Medicaid expansion program in 2020, and increases the amount insurers can charge older consumers compared to younger ones from three times the amount to five times. The AHCA would also eliminate the ACA mandate that all Americans purchase health insurance or face a fine. It does however ask insurers to charge a 30-percent increase in premiums for consumers who allow their healthcare coverage to lapse for two consecutive months.
Opponents to the AHCA
Many medical interest groups including the AMA, American Association for Retired Persons (AARP), and the American Hospital Association, have come out against the AHCA and its proposals. AARP senior vice president Joyce Rogers wrote a letter the day following the bills release:
"Our members and older Americans believe that Medicare must be protected and strengthened for today’s seniors and future generations. We strongly oppose any changes to current law that could result in cuts to benefits, increased costs, or reduced coverage for older Americans," Rogers said in a statement. The AMA followed suit, soon after.
"While we agree that there are problems with [Obamacare] that must be addressed, we cannot support the AHCA as drafted because of the expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient populations," Dr. James Madara, AMA's CEO, wrote in a letter to Congressional leaders this week.
Opposition has even come from right-wing sources as well. Kentucky Republican Senator Rand Paul, an Obamacare opponent, took to Twitter to point out AHCA flaws and call for the "total repeal" of Obamacare. Sen. Tom Cotton from Arkansas said House Republicans should pause and start over.
Small business owners nationwide are signing a letter urging lawmakers to halt the repeal of the ACA in fear that it will be bad for their businesses. The letter states that the ACA has helped many entrepreneurs with pre-existing conditions leave large companies, with employer-sponsored coverage, and pursue their dreams of owning their own business. But, with the AHCA, the group argues that small businesses would no longer receive tax credits to help offset the cost of providing employees coverage.
"Repealing the ACA will eradicate hard-won benefits that were decades in the making for entrepreneurs," said Small Business Majority Founder & CEO John Arensmeyer in a press release dated March 9.
The AHCA does have President Trump's support. According to news reports, Trump said he will work with conservative leaders of Congress to get the bill passed.
It is unknown how many Americans the AHCA would ultimately affect. The bill has a long road ahead before any of its proposals are approved. House committees began markup on the bill Wednesday and moved the bill forward. It will have to receive more markups and committee votes before moving to a floor vote. The nonpartisan Congressional Budget Office has yet to release its score, which would estimate how many would potentially lose coverage on the AHCA. Until then, a lot of questions and speculation will continue to surround the AHCA.
Quote of the week:
"Our goal is absolutely to make certain that individuals have the opportunity to select their physician," – Secretary Tom Price on the AHCA.