Many major medical associations quickly spoke out against the American Health Care Act (AHCA), calling the Republican-sponsored plan to replace the Affordable Care Act (ACA) “bad policy” that could “destabilize our healthcare system,” after it passed by a narrow margin in the House.

Many of the same groups were against the bill both when it was originally introduced and before an amended version went up for a vote on May 4. Several, like the American Hospital Association, called its passage “disappointing,” citing its cuts to Medicaid and granting state waivers on “essential protections for older and sicker patients, including those with pre-existing conditions, such as cancer patients and the chronically ill.”

Others, like the American Academy of Family Physicians (AAFP), laid out their opposition in stronger terms.

“It will destabilize our health care system, cause 24 million Americans to lose their coverage, and allow for discrimination against patients based on their gender, age, and health status,” said AAFP President John Meigs Jr., MD.

Among the other notable responses to the AHCA vote:

·American Medical Association President Andrew Gurman, MD: “The bill passed by the House today will result in millions of Americans losing access to quality, affordable health insurance and those with pre-existing health conditions face the possibility of going back to the time when insurers could charge them premiums that made access to coverage out of the question.”

·American College of Physicians President Jack Ende, MD: “This vote makes coverage unaffordable for people with pre-existing conditions, allows insurers to opt-out of covering essential benefits like cancer screening, mental health, and maternity care, and  cuts and caps the federal contribution to Medicaid while sunsetting  Medicaid expansion. As a result, an estimated 24 million Americans will lose their coverage, and many more will be at risk of paying higher premiums and deductibles.”

·American Academy of Pediatrics President Fernando Stein, MD: “AHCA is bad policy for children and dangerous policy for our country, and the American Academy of Pediatrics will continue to speak out against it.”

·American College of Cardiology President Mary Norine Walsh, MD: “As it stands, the AHCA would allow states to bypass existing federal protections for sick and elderly people and potentially undermine coverage for critical services for patients with heart disease.”

·America’s Essential Hospitals President Bruce Siegel, MD: “This is not reform. This is legislation that will take us back to a time when working individuals and families were forced to choose between health care coverage and life’s other necessities. In fact, it will leave us in a worse place than before the law it seeks to replace, the Affordable Care Act.

The health insurance industry offered more muted criticism of the AHCA. The Blue Cross Blue Shield Association didn’t say whether it supported or opposed the bill in its statement, though it did suggest several changes be made in the Senate, such as funding cost-sharing reduction subsidies and basing tax credits for buying insurance on income and geographic location, as the ACA does, and not just age, as proposed by the AHCA. America's Health Insurance Plans (AHIP), health insurers' largest trade group, similiarly pointed at portions of the AHCA for the Senate to modify.

“The American Health Care Act needs important improvements to better protect low- and moderate-income families who rely on Medicaid or buy their own coverage,” AHIP President and CEO Marilyn Tavenner said in a statement. “We stand ready to work with members of the Senate and all policymakers, offering our recommendations for how this bill can be improved to ensure the private market delivers affordable coverage for all Americans.”