The Senate on Thursday unveiled its version of the American Health Care Act, the bill that would repeal the Affordable Care Act and roll back Medicaid.
The Senate’s version of the bill, called the Better Care Reconciliation Act of 2017, is very similar to the bill passed by the House. A few changes from the House bill of note: an even lower growth rate for Medicaid funding for states, pushing the end of the Medicaid expansion back four years, and lower the income threshold for eligibility of premium subsidies to about $42,000.
The legislation is one of monumental unpopularity on both sides of the aisle, and passed the House with difficulty after the Congressional Budget Office found that 23 million people would lose healthcare coverage.
The bill cuts spending and taxes—especially for the wealthiest families by repealing the surtax on investment income—but at a substantial cost, especially to older and low-income people. By 2024, the Medicaid expansion would be completely gone. The Senate’s bill also provides less funding for stabilization of high-risk pools, and by 2026 funding to stabilize would be gone.
The bill in all its forms has a massive number of detractors that extend past party lines, including four Republican senators as of Thursday afternoon, which may derail the legislation. Even President Donald Trump himself, who personally worked to whip the bill through the House, called the AHCA bill “mean.”
Combining the data from numerous national polls, analysis by the New York Times showed that Oklahoma is the state that supports the bill the most, and the support is at just 38% – with 45% of the population opposing it.
National polls show just 29% of Americans support the Republicans’ health bill, and in many Republican-heavy, Trump-friendly states, the support is still just 35%. It makes sense: supporting and signing a bill like this would violate Trump’s campaign promises not to touch Medicaid and Medicare. This bill fundamentally weakens Medicaid and takes away funding from Medicare.
Not only do these poll numbers indicate a sort of bipartisan consensus around this bill, health and medical groups have universally lashed it. Many of these groups support significant healthcare reform—including changing Obamacare—but not in the way the AHCA, or the Better Care Reconciliation Act, do. Here are seven of the many health-focused groups and what they had to say about the AHCA and the Senate’s new bill.
American Medical Association
AMA President Andrew W. Gurman, M.D.: “Not only would the AHCA eliminate health insurance coverage for millions of Americans, the legislation would, in many cases, eliminate the ban against charging those with underlying medical conditions vastly more for their coverage.”
“America should not go backward to the time when our fellow citizens with pre-existing health conditions faced high costs for limited coverage, if they were able to obtain coverage at all.”
AARP descended on Capitol Hill in early June to urge senators not to back many of the specific provisions in the bill publically released on Thursday. The powerful special interest group called on the Senate to reject the bill: This new Senate bill was crafted in secrecy behind closed doors without a single hearing or open debate—and it shows. The Senate bill would hit millions of Americans with higher costs and result in less coverage for them. AARP is adamantly opposed to the Age Tax, which would allow insurance companies to charge older Americans five times more for coverage than everyone else while reducing tax credits that help make insurance more affordable.”
American Academy of Pediatrics
A statement from the AAP on Thursday: “The physician leaders of six organizations representing more than half a million of America’s frontline physicians are strongly opposed to the Better Care Reconciliation Act. The U.S. Senate’s proposed health reform bill contains provisions that would do great harm to patients by repealing and undermining essential coverage and key patient protections established by the Affordable Care Act and make health care unaffordable for millions of Americans.”
American Hospital Association
“From the onset of this debate, America’s hospitals and health systems have been guided by a set of key principles that would protect coverage for Americans.
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.”
Federation of American Hospitals
Chip Kahn, president of Federation of American Hospitals: “At this time, the [Better Care Reconciliation Act] 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.”
American Cancer Society Cancer Action Network
The American Cancer Society’s Cancer Action Network denounced the the Senate’s healthcare bill as it denounced the AHCA. “Based on a preliminary read of the Senate health bill released today, the proposed legislation appears to significantly weaken the ability of millions of cancer patients, survivors and those at risk for the disease to find and afford adequate, meaningful health care coverage,” the group wrote.
One particular aspect the ACS has criticized in the past is lifetime caps, which protect patients from having their insurance stop paying halfway through an expensive treatment, such as chemotherapy.
American Heart Association
The CEO of the American Heart Association ripped the Senate’s bill on Thursday. “The Senate draft health care bill is literally heartless. If passed it would erode the very patient protections and coverage Americans need the most,” she wrote. “Our analysis of the proposed GOP health care reform plan indicates that, relative to current law, it significantly diminishes the existing Medicaid program, reduces access to quality coverage, raises premiums for older and low-income individuals and limits benefits. Despite its name, this isn’t better care.”
American Diabetes Association
The American Diabetes Association expressed “extreme” disappointment with the AHCA and asked the Senate to preserve the ACA in late May when the bill was in the Senate’s court. After the House passed the bill, the Association wrote: “The most alarming last-minute changes to the bill will allow states to waive the requirement for essential health benefits and health status rating. Weakening these rules will give insurers the ability to charge people with pre-existing conditions, such as diabetes, higher prices. It will also allow insurers to deny people with diabetes coverage for the care and services they need to treat their disease. States that waive these protections would be required to set up a risk sharing program, which could include a high-risk pool. Historically, high-risk pools have resulted in higher premiums, long waiting lists and inadequate coverage.”