In addition, the AMA is concerned about provisions in the bill that would repeal the Prevention and Public Health Fund and eliminate or restrict patients’ ability to choose their own providers, including access to affiliates of Planned Parenthood.
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In the March 8 statement, AMA President Andrew W. Gurman, MD, encouraged Congress to ensure that people who need coverage get it and that those who have it get to keep it.
“We encourage you [Congress] to ensure that low- and moderate-income Americans will be able to secure affordable and adequate coverage and that Medicaid, CHIP, and other safety net programs are maintained and adequately funded,” he said.2
Among the low- to moderate-income Americans who may be at significant risk of receiving reduced access to care under the AHCA: senior citizens. In a letter to Congress, Joyce A. Rogers, senior vice president, government affairs, American Association of Retired Persons (AARP), detailed concerns over the increases to healthcare costs for Americans aged 50–64 in the new bill.4
Illustrating the detrimental effect of tailoring tax credits for obtaining private health coverage on age vs. income, Ms. Rogers pointed out that premium costs under the AHCA could increase by $3,200 for a person who is 64 years old. Putting even more meat on the proposed tax credit framework, she said that premium costs for a 64-year-old person earning $25,000 annually would increase to more than $4,400 per year—more than $5,800 per year if that person earns $15,000 annually.
“In addition to these skyrocketing premiums, out-of-pocket costs could significantly increase under the bill, with the elimination of cost-sharing assistance in the current law,” she said.
Ms. Rogers also highlighted concerns over Medicaid changes, underscoring that the per capita cap by state could overwhelm the ability of states to sufficiently shoulder the costs of care without federal support. “In terms of seniors, we have serious concerns about setting caps at a time when per-beneficiary spending for poor seniors is likely to increase in future years,” she said.
What to Expect
Along with pushback from providers and medical groups, House Republicans are facing opposition from other key players that could make the AHCA bill in its current form difficult to pass.
“Despite moving quickly in its first week in the House, the AHCA may face headwinds later from opposition within the Republican party, and there’s a possibility the Senate Parliamentarian could remove portions of the bill that do not pertain to budget reconciliation,” says Dr. Worthing.