The American Medical Association has announced that they oppose the Republican health care bill because it would harm patients by causing people to lose access to healthcare.
In a letter to Senate Majority Leader McConnell and Minority Leader Schumer, James L. Madara, Executive Vice President and CEO of the AMA wrote:
I am writing to express our opposition to the discussion draft of the “Better Care Reconciliation Act” released on June 22, 2017. Medicine has long operated under the precept of Primum non nocere, or “first, do no harm.” The draft legislation violates that standard on many levels.
In our January 3, 2017 letter to you, and in subsequent communications, we have consistently urged that the Senate, in developing proposals to replace portions of the current law, pay special attention to ensure that individuals currently covered do not lose access to affordable, quality health insurance coverage. In addition, we have advocated for the sufficient funding of Medicaid and other safety net programs and urged steps to promote stability in the individual market.
Though we await additional analysis of the proposal, it seems highly likely that a combination of smaller subsidies resulting from lower benchmarks and the increased likelihood of waivers of important protections such as required benefits, actuarial value standards, and out of pocket spending limits will expose low and middle income patients to higher costs and greater difficulty in affording care.
The AMA is particularly concerned with proposals to convert the Medicaid program into a system that limits the federal obligation to care for needy patients to a predetermined formula based on per-capita-caps. At the recently concluded Annual Meeting of the AMA House of Delegates, representatives of more than 190 state and national specialty medical associations spoke strongly in opposition to such proposals. Per-capita-caps fail to take into account unanticipated costs of new medical innovations or the fiscal impact of public health epidemics, such as the crisis of opioid abuse currently ravaging our nation. The Senate proposal to artificially limit the growth of Medicaid expenditures below even the rate of medical inflation threatens to limit states’ ability to address the health care needs of their most vulnerable citizens. It would be a serious mistake to lock into place another arbitrary and unsustainable formula that will be extremely difficult and costly to fix.
We are also concerned with other provisions of the legislation beyond those directly affecting insurance coverage. The Affordable Care Act’s Prevention and Public Health Fund was, according to the Department of Health and Human Services, established to “provide expanded and sustained national investments in prevention and public health, to improve health outcomes, and to enhance health care quality.” These activities are key to controlling health care costs and the elimination of support for them runs counter to the goal of improving the health care system. We also continue to oppose Congressionally-mandated restrictions on where lower income women (and men) may receive otherwise covered health care services – in this case the prohibition on individuals using their Medicaid coverage at clinics operated by Planned Parenthood. These provisions violate longstanding AMA policy on patients’ freedom to choose their providers and physicians’ freedom to practice in the setting of their choice.
Forty economists, including six Nobel Prize winners, also came out in opposition to the bill on Monday. All told, it is virtually impossible to find a non-partisan group within the medical community that supports this legislation. From all corners, the warning has been consistent. The Better Care Act is a bad bill that will harm millions of Americans.
If Republicans pass this bill, they will be defying the will of doctors, patients, and the American people. Any Republican who votes for Trumpcare in a state where it is not supported deserves to be thrown out of office.
Awards and Professional Memberships
Member of the Society of Professional Journalists and The American Political Science Association
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