NEJM: Most physicians want changes to the ACA, not a repeal
- In a recent survey of primary care physicians, only 15% said favored repealing the ACA in its entirety, while 73.8% said the law should be revised.
- Nearly all of the respondents (95.1%) supported requirements to bar insurers from denying coverage to or charging higher premiums for people with preexisting conditions.
- Meanwhile, Republican lawmakers in Congress gathered in Philadelphia for a three-day retreat aimed at setting their legislative agenda for the coming months, and House Speaker Paul Ryan (R-WI) said it includes repeal of the ACA by March or April, Fortune reports.
The survey results showed greater support for the ACA than two years ago, when a similar survey showed PCPs for and against the law to be closely split. Responses in the new survey, conducted from December into January 2017, fell somewhat along self-reported political party lines, the authors note. Of those claiming GOP allegiance, 32.4% supported repeal. No Democrats did.
In addition to those addressing preexisting conditions, ACA provisions with strong physician support included: allowing young adults to remain on their parents’ insurance plan until age 26 (87.6%); making tax credits available to small businesses (90.8%); providing tax credits to individuals (75.2%); and expanding Medicaid (72.9%).
Just under half of physicians favored the individual mandate, which penalizes people who don’t buy insurance.
That gap between support for covering people with preexisting conditions and ensuring a mechanism to enroll large numbers of healthy people is of concern, the authors note. “These results point to an important need to educate healthcare providers and the public about the fundamental inseparability of these provisions: policies that do not address adverse selection would lead to increased and unsustainable health insurance costs.”
Senior House Republication Diane Black (TN) told Fortune key House committees would on draft repeal legislation within the next two weeks. “Then we expect that probably toward the latter part of February, or the first part of March, that we should be ready to go with the final reconciliation bill” to repeal the law, she said.
Without a filibuster-proof Senate, budget reconciliation is the fastest way for Congress to scale back Obamacare by allowing lawmakers to target and vote on critical pieces of the legislation. However, the process can’t be used for parts of the law that aren’t budget-dependent.
Senate Majority Leader Mitch McConnell (R-AL) has said the House and Senate will work closely to ensure their versions of reconciliation are closely aligned, to ensure swift passage and ACA repeal.