‘Unacceptable’ coverage losses drive hospital, doctor opposition to ACA replacement bill

Hospital groups, the American Medical Association (AMA) and several other healthcare organizations said they can’t support the American Health Care Act (ACHA), the Republican-sponsored replacement for the Affordable Care Act (ACA), after an estimate that 24 million more people would become uninsured by 2026 if the bill becomes law.

The Congressional Budget Office (CBO) report on the AHCA said the bill would succeed in lowering insurance premiums by 10 percent by 2026. All the gains made in insurance coverage under the ACA, however, would disappear, beginning with 14 million choosing to drop insurance or losing coverage by the end of 2018.

Numerous groups, including the AMA, called such a dropoff “unacceptable.”

“While the Affordable Care Act was an imperfect law, it was a significant improvement on the status quo at the time, and the AMA believes we need continued progress to expand coverage for the uninsured,” AMA President Andrew Gurman, MD, said in a statement. “Unfortunately, the current proposal—as the CBO analysis shows—would result in the most vulnerable population losing its coverage.”

The AMA had opposed the AHCA when it was first unveiled on March 6, and it has launched a new site encouraging physicians to email members of Congress asking for changes in the bill.

Other groups who lined up against the bill last week pointed to the CBO report to back up their opposition. American Hospital Association President and CEO Rick Pollack said it couldn’t support legislation “that the CBO and others clearly indicate would reduce coverage for so many people.” The Alliance of Community Health Plans said the report should be taken as a sign to “step back and thoughtfully consider viable alternatives.”

America’s Essential Hospitals, a coalition of public hospitals, said the bill’s savings for the federal budget come from hundreds of billions of dollars in cuts to Medicaid. As prior estimates had predicted, the costs wouldn’t disappear, but instead be transferred to hospitals in the form of increased uncompensated care.

“These hospitals, which already operate with little or no margin, could not sustain these additional costs. Fewer services and workforce reductions almost certainly would follow in many communities,” said America’s Essential Hospitals President and CEO Bruce Siegel, MD, MPH.

The AARP said the biggest financial impact would fall on the older American it represents, with the drop in premiums for younger people owed largely to increasing premiums on those between the ages of 50 to 64.

“Additionally, after facing a massive premium increase before eligibility for Medicare, the bill leaves the door open to turning the successful insurance program in to a voucher program that shifts costs and risks to seniors, and gives big drug companies and other special interests a sweetheart deal,” AARP Executive Vice President Nancy LeaMond said in a statement.