Just one day after members of the House of Representatives released for public review a draft of the American Health Care Act(bit.ly), the AAFP fired off letters to leaders of the House Energy and Commerce Committee(3 page PDF) and the House Ways and Means Committee(3 page PDF) to express "significant concerns" with the proposed bill.
Among those concerns were shortcomings in preserving the health care coverage millions of Americans currently receive through the Patient Protection and Affordable Care Act, as well as in ensuring its continued affordability and comprehensiveness.
The March 7 letters, signed by AAFP Board Chair Wanda Filer, M.D., M.B.A., of York, Pa., also asked the two committees -- each charged with initial consideration of the draft bill -- to send it to the Congressional Budget office (CBO) for an independent analysis.
"We strongly encourage the committee to seek and secure CBO analysis prior to consideration of and voting on this proposal," said the AAFP. "We believe it is important, when making a decision on policies that will impact over 275 million people, to ensure that the full impact is clearly understood."
The letter pointed out that AAFP policy has championed the concept of "health care coverage for all" since 1989 and listed provisions in the draft bill that are consistent with current AAFP policy. For instance, the draft bill prohibits health insurer discrimination based on an individual's age, gender, race or health history, and takes steps to ensure that patients with pre-existing medical conditions can get health insurance.
- The AAFP provided a prompt response to a draft of a proposed health care bill, the American Health Care Act, the House released March 6.
- The Academy's chief concerns were the measure's shortcomings in preserving the health care coverage millions of Americans currently receive through the Patient Protection and Affordable Care Act, as well as in ensuring its continued affordability and comprehensiveness.
- The AAFP urged the House Ways and Means Committee and the House Energy and Commerce Committee to submit the proposed bill to the Congressional Budget Office for review.
The draft also addresses unacceptably low Medicaid payment rates and offers states a policy solution.
Those particulars aside, the AAFP took issue with many other components of the draft bill and said it was "deeply troubled by the negative impact it would have on individuals, families and our health care system."
Specifically, the AAFP said it feared the proposed bill would cause millions of currently insured individuals to lose their coverage and that the "phased-in implementation" it outlines would "destabilize insurance markets over the next three years and directly harm millions of people."
Furthermore, the AAFP emphasized that Americans need more than access to health care coverage, as proponents of the draft bill have suggested it would provide; rather, they must be able to secure that coverage.
Because the draft bill fails to address the affordability of health care coverage -- or health care more generally -- the AAFP said it would require many people to spend a larger percentage of their income on premiums and deductibles and lead to "greater financial insecurity for many."
The Academy further noted the absence of policy proposals to foster competition in the insurance market in the draft measure and called out the negative impact this would have, particularly on rural communities.
Additionally, "The AAFP continues to be deeply concerned with ongoing efforts, at all levels of government, that seek to identify, isolate and hinder access to legal, safe and effective health care services to women.
"We are equally concerned with efforts that seek to limit, and in some cases prohibit, the ability of physicians, other qualified health care professionals and health care facilities to deliver these legal health care services, as appropriate, to individual patients," said the Academy.
The letter decried the draft bill's "inappropriate intrusion into the patient-physician relationship" as being outside the scope of legislative bodies.
"The patient-physician relationship needs to exist in an environment of honesty and transparency, and it should be unencumbered by any legislative and/or regulatory interference except in matters clearly related to overall public health," said the AAFP.
In closing, the AAFP said the draft bill appeared to focus on taking health care coverage and benefits away from Americans, in stark contrast to some 20 years of progress.
"Over the past two decades, our nation, in a bipartisan manner, has made significant and measurable improvements" to the country's health care system, said the AAFP. "As a result of these efforts, our nation's uninsured rate is presently at a historic low."
The Academy offered its expertise to help policymakers "identify and implement policies that will continue to decrease the number of uninsured in our country, establish a competitive private insurance market, and make health care affordable for all."