AAFP President John Meigs, M.D., of Centreville, Ala., makes a case for maintaining essential health insurance guarantees during a meeting with Sen. Jeff Flake, R-Ariz.
Before the Senate takes action on legislation that could affect millions of individuals who recently obtained health insurance, the AAFP and five other frontline physician groups met with legislators and their staffs to raise a red flag about reducing access to care.
The six organizations -- the AAFP, the American Academy of Pediatrics, the American College of Physicians, the American Congress of Obstetricians and Gynecologists, the American Osteopathic Association and the American Psychiatric Association -- together represent more than 560,000 physicians and medical students. Now that the American Health Care Act (AHCA) has passed the House, they wanted to warn the Senate about the consequences of the legislation.
AAFP President John Meigs, M.D., of Centreville, Ala., and leaders of the other organizations met with Sens. Jeff Flake, R-Ariz., and Dean Heller, R-Nev., on May 11. They also met with staff in the offices of Sens. Roy Blunt, R-Mo.; Cory Gardner, R-Colo.; Lisa Murkowski, R-Alaska; and Rob Portman, R-Ohio.
- The AAFP and five other frontline physician organizations recently met with senators and legislative staff on Capitol Hill to urge them to maintain health insurance coverage guarantees and access to health care.
- AAFP President John Meigs, M.D., of Centreville, Ala., and leaders of the other organizations sat down with Sens. Jeff Flake, R-Ariz., and Dean Heller, R-Nev., on May 11.
- The organizations warned about flaws in the American Health Care Act that the House recently passed.
"Our biggest push was on Medicaid and the need to maintain essential benefits," Meigs told AAFP News. "We emphasized how important it was to keep the consumer protections regarding health benefits in the current law. Hopefully, they'll lean toward people over politics when the time for voting comes."
The organizations' key message is that the AHCA contains fatal flaws that could reduce coverage for millions of individuals and substantially increase costs for others. An estimated 24 million people will lose coverage within the next 10 years if the legislation is enacted, according to a report(www.cbo.gov) on an earlier version of the bill from the nonpartisan Congressional Budget Office.
One Senate staff member predicted that unless bipartisan support coalesces during current negotiations, the Senate might have to revisit the legislation this summer, according to Meigs.
"We need bipartisan support on this issue," Meigs said. "If this bill passes with only Republican votes, there is no reason for the other party to engage. Then we'll refight this battle every time the administration changes."
The organizations told senators and their staff that they will not support any legislation to repeal the Patient Protection and Affordable Care Act (ACA) that results in loss of coverage for people who currently have insurance, reduces Medicaid eligibility, or triggers higher costs for older and sicker patients.
The AHCA would replace income-based cost-sharing subsidies for premiums with age-based tax credits that would effectively make premiums and deductibles unaffordable for many individuals. And although expansion of Medicaid was a key component of the ACA that enabled millions of individuals to obtain necessary care, the AHCA calls for ending the higher federal contribution to Medicaid by 2020. The legislation also would prohibit any new states from expanding Medicaid.
Speak Out to Senators
The AAFP offers members a Speak Out tool that makes it easy for family physicians to tell their senators to come up with bipartisan solutions to improve the nation's health care system.
"Medicaid expansion was the one issue that resonated most with Senate staff," Meigs said of the meetings on Capitol Hill. "Most of the staff we met with were from Medicaid expansion states, and if that goes away, a lot of people will get hurt."
Another AHCA flaw that the organizations pointed out is that it would allow states to waive essential health benefit requirements, which would affect the current ban on annual or lifetime coverage limits. If a state did not require coverage of chemotherapy, for example, insurers could place limits on payments for cancer treatment. This would affect both patients who buy coverage on the individual market and those with employer-sponsored coverage.
When considering changes to the existing health care law, the organizations recommended that the Senate ensures any new legislation meets six crucial criteria:
- expanding access to care for all;
- protecting the safety net;
- stabilizing the individual insurance market;
- ensuring that children, adolescents and adults are not denied coverage;
- reducing costs, especially for pharmaceuticals; and
- increasing investment in primary care.
Beyond giving the organizations a chance to press their case with legislators, Meigs said the meetings also helped build rapport among the physician groups.
"Having six organizations with everybody on the same page is good for all of us," he said. "We have an opportunity to develop coordination on several issues."
For physicians who wonder whether it is worthwhile to continue meeting with legislators whose decisions may appear to be predetermined, Meigs warned about the consequences of staying on the sidelines.
"If we don't keep the heat on them and keep raising these issues, then they will be more inclined to ignore our requests and concerns," he said. "I am reminded of the old adage, 'The squeaky wheel gets the grease.' We might not get the grease, but we still have to squeak."
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