- The lead advocacy groups for U.S. hospitals and physicians slammed an amendment to the Republican-backed American Health Care Act, saying it would leave millions of Americans without adequate or affordable health coverage.
- The amendment, offered by Rep. Tom MacArthur (R-NJ) and Rep. Mark Meadows (R-NC), has the backing of the conservative Freedom Caucus, which helped to upend an attempt to pass the ACHA in March.
- Among other things, it would let states waive essential health benefits such as emergency services, maternity and newborn care and mental health services, and weaken the ban on preexisting conditions.
In separate reactions, the American Hospital Association and American Medical Association said the amendment does nothing to remedy flaws in the original bill. Of particular concern is how it would affect older and sicker patients as well as those with preexisting conditions.
“Although the MacArthur Amendment states that the ban on preexisting conditions remains intact, this assurance may be illusory as health status underwriting could effectively make coverage completely unaffordable to people with preexisting conditions,” James Madera, CEO of the AMA, said in a Thursday letter to House Speaker Paul Ryan (R-WI) and Minority Leader Nancy Pelosi (D-CA).
“There is also no certainty that the requirement for states to have some kind of reinsurance or high-risk pool mechanism to help such individuals will be sufficient to provide affordable health insurance or prevent discrimination against individuals with certain high-cost medical conditions,” he added.
In a Thursday statement, AHA President and CEO Rick Pollack said the proposed changes would “dramatically worsen” the ACHA and noted that the Congressional Budget Office has yet to score the amendment. “CBO previously projected that the ACHA would result in 24 million fewer people covered in 2026,” he said. “It is unlikely this amendment would improve these coverage estimates.”
The proposed amendment also lacks a long-term strategy for stabilizing and strengthening the individual insurance market to ensure that moderate and lower income patients can get affordable care, and there are no assurances that Medicaid and other safety net programs will be adequately funded and maintained, Madera says.
Their statements are backed by a recent report from the Center on Budget and Policy Priorities, which stated the amendment does not fix underlying flaws in the AHCA and would lead to unaffordably high premiums and a return of medical underwriting.
While conservative members of Congress are applauding the amended AHCA, it’s still not certain the GOP’s more moderate members will support it. Many of them support essential health benefits and protections for preexisting conditions and could be hard to bring on board.
Republicans had hoped for a vote on the AHCA this week, before President Donald Trump hits the mark of 100 days in office, but House Majority Leader Kevin McCarthy (R-CA) confirmed Thursday evening that wasn't going to happen.