Senate Republicans revealed a discussion draft of their bill to repeal and replace the ACA Thursday.
Here is how 11 groups reacted to the Better Care Reconciliation Act.
American Hospital Association President and CEO Rick Pollack said the bill does not go far enough to protect people's coverage.
"Unfortunately, the draft bill under discussion in the Senate moves in the opposite direction, particularly for our most vulnerable patients. The Senate proposal would likely trigger deep cuts to the Medicaid program that covers millions of Americans with chronic conditions such as cancer, along with the elderly and individuals with disabilities who need long-term services and support. Medicaid cuts of this magnitude are unsustainable and will increase costs to individuals with private insurance.
"We urge the Senate to go back to the drawing board and develop legislation that continues to provide coverage to all Americans who currently have it."
The American Medical Association said it has called for insured people to maintain access to affordable, quality coverage; adequate funding for Medicaid, CHIP and other safety-net programs; and keeping reforms such as coverage for pre-existing conditions. However, the organization said the BCRA "violates many of those principles."
"On behalf of the physician and medical student members of the American Medical Association, I am writing to express our opposition to the discussion draft of the Better Care Reconciliation Act released on June 22, 2017," the AMA said in a letter to Senate leaders. "Medicine has long operated under the precept of Primum non nocere, or 'first, do no harm.' The draft legislation violates that standard on many levels." Access the full letter here.
America's Essential Hospitals President and CEO Bruce Siegel, MD, expressed concerns about the bill's potential effects on Americans and essential hospitals.
"Today's Senate bill makes few material improvements to the deeply damaging House legislation, and might be worse overall. For the hospitals that protect millions of Americans and their communities — our essential hospitals — this bill might even accelerate decisions by some to reduce services or close their doors.
"This could leave many people without local sources of lifesaving services, such as trauma, burn and neonatal intensive care. It would kill jobs — more than 1.5 million nationally by some estimates, including tens of thousands in states as diverse as Maine, West Virginia, Arizona and Alaska. It would undermine progress toward defeating national health threats, such as the opioid epidemic and others.
"Particularly troubling is the opaque process senators have followed to reach this point. Legislation of this scope and with such potential for harm demands a fair and public hearing, but Senate leaders so far have rejected that. This is a slap in the face to the democratic process and bad policymaking for the country.
"America's Essential Hospitals stands by two guiding principles: affordable health care coverage for all Americans and sufficient resources for essential hospitals to meet their vital community mission. The Senate plan violates both principles and will make our nation sicker, less productive and less secure."
Association of American Medical Colleges President and CEO Darrell Kirch, MD, said he is "disappointed" in the bill.
"Despite promises to the contrary, it will leave millions of people without health coverage, and others with only bare bones plans that will be insufficient to properly address their needs. As the nation's medical schools and teaching hospitals see every day, people without sufficient coverage often delay getting the care they need. This can turn a manageable condition into a life-threatening and expensive emergency.
"Rather than stabilizing the health care marketplace, this legislation will upend it by crippling the Medicaid program while also placing untenable strain on states and providers.
"As Congress has discussed repealing and replacing the Affordable Care Act, the AAMC has held steadfast that any replacement bill should at least maintain current levels of health coverage, not weaken Medicaid, and be the result of a deliberate and transparent process. The bill that came out of the Senate today meets none of those principles.
"We urge members of the Senate to reject this bill and return to the drawing board to draft legislation that does not result in millions of Americans going without health insurance. The AAMC stands ready to work with Congress to craft a solution that protects and improves the health of all."
Federation of American Hospitals President and CEO Chip Kahn said while the FAH is concerned about the BCRA, the Senate still has time "to make critical revisions to keep the promise of accessible, affordable healthcare coverage and ensure Medicaid remains a viable program because it is essential to our most vulnerable neighbors."
"FAH has been explicit about our health reform core principles: maintain coverage levels, reasonable Medicaid structural reforms, sustain affordable, high quality individual coverage, protect employer-sponsored insurance and roll back untenable cuts to hospital reimbursement. At this time, the BCRA draft does not sufficiently meet those principles which are so important to those Americans our community hospitals serve and our employees who care for those patients every day. Now is the time for the Senate to hit reset and make key improvements to this legislation."
Mount Sinai Health System (New York City) President and CEO Kenneth Davis, MD, expressed opposition to the bill.
"We are still reviewing the details but the current Senate legislation could have a devastating effect on hospitals and patients across the country. Millions of people will likely become uninsured and hospitals will be pushed to the brink, especially those who treat Medicaid patients. If the new bill becomes law, for the first time in more than 50 years the United States would become a less compassionate society. I urge Congress to reject these drastic cuts."
Partnership for Medicaid, a nonpartisan, nationwide coalition of healthcare providers, safety-net health plans, counties and labor, expressed concerns over Medicaid provisions in the Senate GOP bill.
"We are in strong opposition to proposals that include devastating cuts to the Medicaid program and undermine coverage for the more than 70 million people served by this safety-net program. The changes to the House-passed American Health Care Act made by the Senate will further slash the rate of Medicaid funding provided to states in the long term. Capping funding will ultimately reduce access to care for beneficiaries, prevent the program from being responsive to unexpected public health and economic challenges, shift costs to states and local governments and drastically reduce payments to providers and plans.
"The Partnership for Medicaid also remains united in its opposition to transitioning the Medicaid program to a block grant. We are deeply troubled the Senate bill continues to include a block grant option, which undercuts the long-term viability of the program and Medicaid's role as a safety net."
PrescribeWellness CEO Al Babbington commented on behalf of the pharmacy solutions software provider.
"This new healthcare overhaul certainly doesn't meet President Trump's request for a plan with heart. The challenge is that you can't balance a budget, reduce costs and still offer coverage to all in need. The answer is provider status for pharmacies, allowing them to provide preventive health care and chronic care management services to reduce overall spend, help states more effectively use their Medicaid funds and keep Americans out of hospitals and emergency rooms."
EBG Advisors President Robert Atlas commented on behalf of national healthcare law firm Epstein Becker Green.
"In general the Senate proposal closely tracks the House-passed proposal. There are modest improvements in protections for people with pre-existing conditions buying coverage in the individual market. In Medicaid, where per capita caps would take effect in fiscal year 2020, the allowable inflation index actually becomes stingier than the House bill's starting in fiscal year 2025. It changes from the medical component of Consumer Price Index in fiscal year 2020-2024 to the general CPI. For a state to keep its Medicaid eligibility intact at that point, it would have to become a true model of efficiency in the intervening years."
Physicians for Reproductive Health advocacy fellow Diane Horvath-Cosper, MD, expressed concerns about potential loss of coverage for Americans, along with various other issues.
"As a physician who witnesses the struggles of people who need healthcare, I know the Better Care Reconciliation Act will devastate the health of our country. The Senate bill will take away coverage from millions of patients, harming those who can least afford it: low-income women, people of color, children, the elderly and people with disabilities. It decimates Medicaid, cuts funding from Planned Parenthood, and will roll back women's health by decades.
"Let us be clear: Doctors do not want the BCRA. Patients do not want the BCRA. The only groups this bill will benefit are insurance executives, drug companies and the wealthy.
"The ability to get healthcare is central to the well-being of our country — it affects our economic security, the stability of our families, our capacity to thrive. It is literally a matter of life or death for millions. This is too important to write legislation in secret and to force a vote without thorough evaluation and debate. We need healthcare policies based on medical evidence, not arbitrary deadlines and politics.
"No amendments will make this a good health care bill. We urge the Senate to listen to medical professionals, listen to the patients across the country, and stop this bill."
Benefitfocus Senior Director of Product Strategy Shandon Fowler noted how the bill would affect Medicaid.
"The Senate version of the bill would likely take the Medicaid rollback further than the House bill because it would cap annual increases based solely on the Consumer Price Index, whereas the House bill provided for an increase based on medical cost trend. So, since the CPI grows at a slower rate than medical trend, states would be getting fewer real dollars year over year for their Medicaid programs.
"Medicaid, of course, is a major source of revenue for hospitals, especially children's hospitals. So the impacts of this decrease may be felt particularly hard among this key constituency and would necessitate either declines in services or increased costs to those holding private insurance."
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