The AAFP is urging House lawmakers to vote "No" on the American Health Care Act(www.congress.gov) (AHCA) because the legislation stands to greatly reduce the number of individuals with health insurance and make health care even more unaffordable for many of those who retain coverage.
A March 20 letter(2 page PDF) from the AAFP to House Speaker Paul Ryan, R-Wis., and Minority Leader Nancy Pelosi, D-Calif., makes clear that the stance comes only after legislators failed to include in the AHCA most of the Academy's many suggestions for improving the nation's health care system.
This engagement began as early as December 2016 with proposals for reforms(5 page PDF) that would fix flaws in the Patient Protection and Affordable Care Act while preserving important elements of the law. The AAFP offered a detailed list of legislative recommendations with the reminder that changes "must be patient-centered, be focused on enhancing and improving our health care system for all Americans, and acknowledge the important role of primary care and family physicians in our health care system."
- The AAFP is urging lawmakers to vote "No" on the American Health Care Act (AHCA), which does not include most of the Academy's suggestions for improving the health care system.
- Recognizing that important health care reforms are needed, the AAFP has been actively engaged with legislators since December to offer proposals for patient-centered changes that improve the system for all.
- Among the legislation's flaws, it fails to encourage the continuous physician-patient relationships that are essential to effective health care.
As legislation was being crafted, the AAFP continued to suggest changes to improve the nation's health, including measures to encourage continuous physician-patient relationships, such as requiring insurers to designate all primary care physicians as "in network."
"It is well-recognized that the two most influential indicators of health are continuous health care coverage and a usual source of care, typically through a continuous relationship with a primary care physician," the AAFP reminded Ryan and Pelosi in the most recent letter, which was signed by Board Chair Wanda Filer, M.D., M.B.A, of York, Pa. "Unfortunately, the AHCA fails both measures."
Among the AAFP's top concerns for health care reform are improving the stability of insurance exchanges, ensuring that health insurance premiums are affordable and expanding access to primary care. But under the bill that the House Budget Committee voted 19-17 to advance on March 16 -- without hearing witness testimony or making substantial changes -- patients would carry a heavier cost-sharing responsibility, and low- and middle-income families with older members would face much higher health care costs.
That's why, the letter stated, the AAFP must encourage all House lawmakers to vote against the AHCA when it comes to the floor on March 23.
"The AAFP has significant concerns with the AHCA and is deeply troubled by the negative impact it would have on individuals, families and our health care system writ large," the Academy wrote.
"It is clear that this legislation will result in millions of people losing their health care coverage," the letter stated. "Those who retain coverage will face escalating premiums and deductibles that will further separate them and their health care needs from the health care system."
In fact, a review by the nonpartisan Congressional Budget Office(www.cbo.gov) revealed that if the AHCA is enacted as written, 24 million fewer individuals will have health insurance in 2026.
The bill also would reduce federal Medicaid spending and limit its growth, ending coverage for many essential benefits and other important services such as substance abuse and oral health care. It also would eliminate federal guarantees of access to mental health care and addiction treatment for Medicaid beneficiaries in states that expanded Medicaid.
In addition, the AHCA would prohibit Medicaid payment for some health care professionals and facilities, which would mean millions of women would lose access to essential health services.
The letter highlighted several provisions in the proposed law that do align with the AAFP's policies. Specifically, the AHCA would continue to prevent insurers from denying coverage based on pre-existing medical conditions or from placing lifetime caps on coverage. But overall, the legislation falls far short of what the country needs.
The AAFP said it recognizes that the health care system is far from perfect, and there are areas of reform in current law that need to be pursued.
"We were hopeful that the House of Representatives would focus its energy and resources on improving our current health care system," the Academy wrote. "We were equally hopeful that pledges of 'patient-centered' reforms would prevail."
Related AAFP News Coverage
AAFP Expresses Significant Concerns With Health Care Proposal
Academy Urges Congressional Budget Office Analysis