Latest ACA Repeal Effort Soundly Rejected by AMA, Others

Welcome to Practice Rounds, our weekly column exploring what's being covered in the larger world of healthcare.

Republicans Try To Revive Healthcare with MacArthur Amendment

Earlier this week, just days before President Trump's 100th day in office, Republican members of the House proposed an amendment to the American Health Care Act (AHCA) bill. The MacArthur amendment, created by the moderate Tuesday Group leader Tom MacArthur, (R-N.J.) and conservative House Freedom Caucus Chairman Mark Meadows, (R-N.C.), would allow states to explore waivers to weaken some of the Obamacare insurance reforms that protect those with pre-existing conditions. This includes the benefits insurers must cover in their policies and the ban on allowing carriers to charge more based on a person's health background. The bill is the next bid to bring together moderate Republicans and more conservative members of the GOP party.

MacArthur and Meadows consulted the White House and House leadership. It remains to be seen if this amendment will be the breakthrough the GOP seeks in their quest to repeal the ACA, and there is currently no vote scheduled. Despite this, medical groups such as the AMA and AARP, both of which opposed the original AHCA bill, have come out strongly opposed to the amendment.

"Although the MacArthur amendment states that the ban on pre-existing conditions remains intact, this assurance may be illusory as health status underwriting could effectively make coverage completely unaffordable to people with preexisting conditions," wrote James L. Madara, MD, and CEO and Executive Vice President of the AMA in a letter Thursday to House Speaker Paul Ryan and Minority Leader Nancy Pelosi.

Poll: Public Wants Administration to Make ACA Work

The latest Kaiser Health Tracking poll found that three fourths (74 percent) of Americans want to see President Trump and the administration do what they can to make the ACA work. The poll, conducted between March 28 and April 23 to a nationally represented audience of 1,171 people, found 48 percent were in favor of the ACA, while 41 percent were not (11 percent didn't answer). Despite this, more Americans want President Trump and Republican lawmakers to continue working on a plan to repeal and replace the ACA than want them to stop working on healthcare (51 percent vs. 43 percent).

Additionally, 64 percent of responders, including 53 percent of Republicans, say that because President Trump and Republicans in Congress are in control of the government, they are responsible for problems with the ACA. The poll also found that for most people, repealing the ACA falls behind other healthcare priorities including lowering the cost people pay for healthcare and for prescription drugs.

Is The Opioid Epidemic Worse Than We Think?

A new study conducted by researchers at the Centers for Disease Control and Prevention (CDC) found that 3.5 percent of the 1,676 deaths in Minnesota's Unexplained Death Surveillance System (UNEX) were due to opioids. Fifty-nine of the unexplained deaths, which took place from 1996 to 2015, were linked to opioids, but more than half of those deaths never showed up on the state's official total for overdose deaths.

UNEX is just one death surveillance system in a state that only had a bit more than 300 reported opioid overdose deaths in 2015. CDC researchers say it's possible that these dozens of overlooked deaths speak to a much bigger problem. These findings suggest that the terrifying numbers for opioid-related deaths represent the minimum. One potential reason for this is there is no national standard for what counts as an opioid overdose, meaning that if someone has multiple conditions at their time of death, the death may not be ruled a drug overdose. It's left to local medical officials to decide whether a death was caused by an overdose or not.
 

Quote of the Week

"We know all too well when someone says, 'Send me a bill', it's rare we actually get paid. We are out thousands (literally) of dollars. Some providers are hopeful, they keep sending you a bill, and you keep shredding it. You justify it by saying things like, 'The service wasn't that great.' Or 'How can they charge so much?' Providing healthcare to you is expensive." - P.J. Cloud-Moulds in an open letter to patients