Key Industry Groups Blast Amended Obamacare Repeal Bill

Speaker of the House Paul Ryan, R-Wis., listens during a news conference with Vice President-elect Mike Pence, following a closed-door meeting with the GOP caucus at the Capitol in Washington, Wednesday, Jan. 4, 2017. Pence and Ryan promised repeal of President Obama’s health care law now that the GOP is in charge of White House and Congress.  (AP Photo/J. Scott Applewhite)
J. Scott Applewhite/AP

Two advocacy groups for the health care industry on Thursday came out against the new proposed amendment to House Republicans’ bill to repeal and replace Obamacare, arguing that the amendment could still put many Americans’ health coverage at risk.

The American Hospital Association said in a statement that the amendment would actually make Republicans’ legislation worse for patients.

“The amendment proposed this week would dramatically worsen the bill. The changes included put consumer protections at greater risk by allowing states to waive the essential health benefit standards, which could leave patients without access to critical health services and increase out-of-pocket spending,” the group said in a statement. “This could allow plans to set premium prices based on individual risk for some consumers, which could significantly raise costs for those with pre-existing conditions.”

The group also noted that the Congressional Budget Office has not yet determined how many people would lose or gain coverage with the new amendment. The CBO projected that the AHCA in its initial form would cost 24 million people their health insurance by 2026, and the AHA said that it’s “unlikely this amendment would improve these coverage estimates.”

“As the backbone of America’s health safety-net, hospitals and health systems must protect access to care for those who need it and ensure that the most vulnerable patients are not left behind. The AHCA continues to fall far short of that goal,” the AHA said in its statement.

The American Medical Association, the largest advocacy group for doctor’s in the United States, on Thursday sent a letter to House leaders expressing concern that the bill would still cost people their health insurance.

“As we have previously stated, we are deeply concerned that the AHCA would result in millions of Americans losing their current health insurance coverage.  Nothing in the MacArthur amendment remedies the shortcomings of the underlying bill,” James Madera, CEO of the AMA, wrote in the letter.  “The amendment does not offer a clear long-term framework for stabilizing and strengthening the individual health insurance market to ensure that low and moderate income patients are able to secure affordable and adequate coverage, nor does it ensure that Medicaid and other critical safety net programs are maintained and adequately funded.”

The amendment, offered by moderate Rep. Tom MacArthur (R-NJ) and backed by the conservative House Freedom Caucus, would allow states to apply for waivers from certain Obamacare mandates.

Madera wrote that the AMA is “particularly concerned” that the new amendment would allow states to apply for a waiver from underwriting that Madera says “protects individuals from being discriminated against by virtue of their medical conditions.”

“Prior to the passage of the ACA, such individuals were routinely denied coverage and/or priced out of affordable coverage. We are particularly concerned about allowing states to waive this requirement because it will likely lead to patients losing their coverage,” he wrote.

“Although the MacArthur Amendment states that the ban on preexisting conditions remains intact, this assurance may be illusory as health status underwriting could effectively make coverage completely unaffordable to people with preexisting conditions,” Madera continued. “There is also no certainty that the requirement for states to have some kind of reinsurance or high-risk pool mechanism to help such individuals will be sufficient to provide for affordable health insurance or prevent discrimination against individuals with certain high-cost medical conditions.”

The AMA previously came out against the AHCA in its original form due to “the expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient populations.”

The proposed amendment to the bill has brought conservative members of the House on board, but moderate members have approached the new amendment with skepticism. Some moderates who supported the initial bill are now taking a second look with the new compromise.