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American Health Care Act amendments make the bill worse

April 28, 2017
Area(s) of Interest: Advocacy Health Care Reform 


Congress could vote early next week on an amended version of H.R. 1628, the American Health Care Act (AHCA). The California Medical Association (CMA) and the American Medical Association believe the new amendment makes the bill worse for physicians and patients, and are urging Congress to revamp the legislation.  


"It is time to engage in a bipartisan dialogue with physicians and other experts on the front lines caring for patients, to develop modifications that protect health care coverage, address affordability and improve access to physicians," CMA President Ruth Haskins, M.D., to House Majority Leader Kevin McCarthy (R-Bakersfield) and House Minority Leader Nancy Pelosi (D-San Francisco), urging them to withdraw the bill.  


CMA has reviewed the new amendment, known as ""the MacArthur amendment,"" which is supported by the House Freedom Caucus (formerly the Tea Party Caucus). The amendment allows insurers in states that obtain waivers to:



  • Stop providing essential health benefits, such as maternity and mental health coverage.

  • Reestablish annual and lifetime limits on benefits, such as chemotherapy.

  • Charge more for sicker patients with pre-existing conditions.


Because patients with pre-existing conditions will be priced out of the insurance market, the amended bill would require states to establish high-risk pools, but it would not provide adequate funding. This would end insurance protections for patients with pre-existing conditions and cause more people to become uninsured. The amendment also shifts an enormous burden to the states and physicians for uncompensated care.


Even without this amendment, the AHCA is not good for Californians. It cuts Medicaid by $880 billion ($13 billion in California), which would doom California to even lower physician payment rates and poorer access to care for Medicaid patients. The bill would cause 24 million more Americans (3-4 million more Californians) to become uninsured. It would also make insurance unaffordable for low- to moderate-income families by eliminating the income-based tax credits.


CMA is asking Congress to withdraw H.R. 1628 and engage in a more thoughtful dialogue with physicians and other health care provider experts to develop a bill that improves our health care system – rather than reducing coverage and limiting access to physicians. More than a dozen Republican Senators have indicated that they cannot support the House bill.


It’s important that Congress makes changes to the legislation to preserve Medicaid, improve access to doctors through a Medicaid rate increase, ensure that currently covered Californians do not lose coverage, protect individuals with pre-existing conditions and guarantee that insurance is affordable through income-based tax credits.


The House does not currently have the required 216 votes necessary for passage, but they are getting closer. CMA is asking physicians to contact their Members of Congress and urge them to start over with a bill that improves access to coverage and physicians.  


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