The GOP's proposed legislation to repeal and replace the ACA was made public a week ago, and continues to be met with controversy. The bill, dubbed the American Health Care Act (AHCA), is being marked up in the House and dissected on the internet and in the media.
On Monday afternoon, the CBO score was released for the AHCA, finding that twenty-four million Americans would lose insurance by 2026 under the House Republican health care bill compared to the ACA, including 14 million by next year. Although the bill has a ways to go before it's approved, medical organizations have wasted no time weighing in. Amid all of the controversy, what are they saying physicians can take away from this proposed legislation?
"There are still roughly 30 million people in this country without insurance…..we made great gains with the ACA from an uninsured number of about 50 million. We know that people without health insurance live sicker and die younger. If we go back and if we have fewer people insured as a result of the new proposal, that’s a step backwards," said David Barbe, MD AMA president-elect and practicing family physician in Mountain Grove, Mo., during an exclusive interview with Physicians Practice.
Barbe's thoughts are hardly a surprise and echo the AMA's overall sentiment toward the proposed AHCA bill. The AMA has been a staunch supporter of the ACA since it was first implemented in 2010. They see the AHCA as a step backwards from a coverage perspective.
"It appears to us and I think most that have looked at [the proposal] critically…it threatens to undermine the coverage gains from the ACA. There would be fewer people with insurance, and fewer on Medicaid, if these proposals are implemented, and that concerns us greatly. Therefore we are not in a position to support the proposal in its current form," says Barbe.
The coverage expansion was the main reason the AMA supported the ACA in the first place. "We have appreciated the gains in coverage and the expansion of Medicaid that occurred under the ACA. Those were the primary reasons we supported the ACA back in 2010," says Barbe.
It is unknown if the repeal of the Medicaid expansion program or any of the AHCA's other proposals will see the light of day. The bill has faced opposition not just from medical groups, Congressional Democrats, but some prominent Republicans as well. Kentucky Senator Rand Paul initially called the bill "dead on arrival" and "Obamacare Lite" on Twitter. This uncertainty has lead organizations like the MGMA to refrain from coming out with a reactionary stance on the proposed bill.
"For the most part, the initial reactions were somewhat negative or express some concern. I think that indicates some trouble on the horizon, my sense is that this is going to be a far lengthier process than is being conveyed. The fact is it’s a lot harder to work in reverse with the key stakeholder groups," said Anders Gilberg, Senior Vice President, Government Affairs at Medical Group Management Association (MGMA).