The AAFP and four other primary care physician organizations met with senators this week to lay out priorities for any legislation that might replace the Patient Protection and Affordable Care Act (ACA).
AAFP President John Meigs, M.D., of Centreville, Ala., (left) speaks to reporters in Washington, D.C., about the importance of maintaining health insurance for patients who received coverage through the Patient Protection and Affordable Care Act.
Before the meetings, the organizations spoke with reporters from top news outlets about the impact that repeal of the law could have on patient care and to explain their united position that Congress should not reverse health insurance coverage gains for individuals enrolled in plans listed in the marketplaces established by the ACA.
Expansion of Medicaid under the ACA in 31 states enabled 10 million more individuals to obtain necessary care and provided women with greater continuity of coverage, but there is room for improvement.
"From the beginning we said the ACA is a good start," said AAFP President John Meigs, M.D., of Centreville, Ala. "It's not perfect. Prescription drug prices are too high. We need incentives for young people who want to buy insurance."
- The AAFP and four other primary care physician groups met with senators this week to tell them the important points that should be addressed by any legislation that might replace the Patient Protection and Affordable Care Act (ACA).
- While the groups were clear in their message about the gains they want to protect in any future legislation, they remain neutral on the question of repealing the ACA.
- The organizations insisted that anything that replaces the ACA should ensure that patients who recently obtained insurance do not lose their coverage or have to pay significantly more in premiums, copays or deductibles.
Meigs and other organization leaders insisted that anything that replaces the ACA should ensure that patients who recently obtained insurance do not lose their coverage or have to pay significantly more in premiums, copays or deductibles. They noted that insurance coverage among children is now at 95 percent, an all-time high and a gain that should be preserved.
"The question is whether medical care is a right or a privilege," asked Hal Lawrence, M.D., CEO and EVP of the American Congress of Obstetricians and Gynecologists (ACOG). "Most people would agree that it is a right and that we need to have universal access. We have to find a better way to cover that."
Joining the AAFP and ACOG in the meetings on Capitol Hill were the American Academy of Pediatrics, the American College of Physicians (ACP) and the American Osteopathic Association (AOA). While the groups are clear in their message to Congress about the gains they want to protect in any future legislation, they remain neutral regarding the future of the ACA.
"There is room for improvement (in the ACA)," ACP President Nitin Damle, M.D., M.S., explained in response to a reporter's question. "Whether they replace or repeal it is not within our purview as physicians. We want to address our patients' concerns."
Meigs told AAFP News after the briefing that it was important for the five organizations to speak to reporters and senators with a unified voice. In the meetings with senators and their staff members, they spelled out five priorities for lawmakers if the ACA is replaced:
- Do not increase the number of uninsured patients.
- Protect the health care safety net.
- Ensure patients are protected from excessive insurance costs.
- Maintain premium subsidies.
- Protect small insurance markets.
The organizations also are adamant that patients should not be denied care because of pre-existing conditions -- a situation faced by 27 percent of the patient population -- nor should they be subject to lifetime caps on coverage. The provision in the ACA that allows children to be covered by a parent's plan until they reach age 26 should continue as well, the group stated.
Meigs said the two most important elements for good health outcomes are that patients have insurance and a usual source of care.
Physicians are hearing from their patients about affordability, and the organizations emphasized that any replacement legislation should address cost. William Burke, D.O., trustee and chair of the department of governmental affairs at the AOA, recalled a conversation in which his barber said that as a small businessman he is paying $1,200 per month in insurance premiums on a policy with a $5,000 deductible.
One reporter asked the panel what the medical community will do if the ACA is replaced by legislation that falls short.
"We didn't get everything we wanted from the ACA," Meigs said. "(HHS secretary nominee Rep. Tom) Price is going to hear from us and Congress will hear from us. We represent 500,000 physicians who are doing the majority of primary care in this country."
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