Yesterday doctors, hospitals, and insurers joined the chorus against Republicans’ Wealthcare Act. (More)
“That just won’t do”
The replacement bill, as written, would reverse the coverage gains achieved under the ACA, causing many Americans to lose the health care coverage they have come to depend upon.
That just won’t do.
We all know that our health system is highly complex, but our core commitment to the patients most in need should be straightforward. As the AMA has previously stated, members of Congress must keep top of mind the potentially life-altering impact their policy decisions will have.
We physicians often see patients at their most vulnerable, from the first time they set eyes on a newborn child to the last time they squeeze a dying loved one’s hand. We don’t want to see any of our patients, now insured, exposed to the financial and medical uncertainties that would come with losing that coverage.
That is, above all, why physicians must be involved in this debate.
Any ability to evaluate The American Health Care Act, however, is severely hampered by the lack of coverage estimates by the Congressional Budget Office (CBO). Lacking that level of analysis and needed transparency, we urge that Congress should. wait until an estimate is available before proceeding with formal consideration.
In addition to the lack of a CBO score, we have some additional policy concerns with the proposal.
For example, it appears that the effort to restructure the Medicaid program will have the effect of making significant reductions in a program that provides services to our most vulnerable populations, and already pays providers significantly less than the cost of providing care.
Health care coverage is vitally important to working Americans and their families. They rely on hospitals and health systems to provide them with access for their essential health care needs in a manner that is of the highest quality, not to mention the full range of critical life-saving services, including preventive benefits, that will further improve the quality of their lives and the health of the communities in which they live.
We recognize this measure represents the first step in a process. It is critical that this process be thoughtful and focused on finding ways to improve our health care system, particularly for the poor, elderly and disabled.
America’s Health Insurance Plans, the insurance industry’s largest trade association, sent a letter Wednesday saying that while it appreciated several of the proposed changes, the changes to Medicaid “could result in unnecessary disruptions in the coverage and care beneficiaries depend on.”
Of course Republicans dismissed such fears, just as they’re preemptively dismissing the Congressional Budget Office:
“First of all, that’s not going to happen,” said Rep. Richard Hudson, a member of the Energy and Commerce Committee, when asked how Republicans should respond to an estimate showing millions would lose their care. “Second of all, the CBO number is a false argument the Democrats have created. They didn’t have support for their bill. This bill is going to save hundreds of millions of dollars.”
That approach mirrors comments from Donald Trump’s White House. On Wednesday, press secretary Sean Spicer said that “CBO was way off last time,” and that “if you are looking there for accuracy you’re looking in the wrong place,” citing its estimates on the Affordable Care Act. (The CBO estimated before Obamacare was implemented that it would ensure up to 24 million people; it only ensured 11 million people, according to US News & World Report.)
In other words, if the CBO say the GOP’s plan will cover everyone and reduce the deficit, obviously the CBO are geniuses. If they say it will leave millions of Americans without insurance, tens of millions more with worthless insurance, and explode the deficit – a far more likely estimate – obviously the CBO are idiots.
“Women could face financial repercussions for being poor, or for using birth control, or for not using birth control, or for giving birth, or for having children who need medical care”
And then there’s the all-out attack on women’s health:
The GOP’s plan guts the Medicaid expansion, defunds Planned Parenthood, and sunsets a federal rule that requires that qualified insurance plans cover things like mental health care, maternity care, and pediatric dental and vision care, among other things. That means that states could individually choose not to require insurance plans to cover maternity care, and that women who are planning on having a child would need to purchase special insurance riders, which would likely be prohibitively expensive.
Further, the fate of the ACA’s birth control mandate – which allowed women to obtain contraception at no out-of-pocket cost, ostensibly because making it extremely easy for a woman to not get pregnant is more cost effective than dealing with a woman who is pregnant and does not want to be – is also up in the air.
In short, if the House GOP plan were signed into law as-is, women could face financial repercussions for being poor, or for using birth control, or for not using birth control, or for giving birth, or for having children who need medical care. How many iPhones does an out-of-pocket Cesarean Section cost?
Of course wingnut men insist that women who can’t afford birth control, or children, shouldn’t have sex at all. Coz yeah, that’s what it always comes back to.
“I do not think it will be well received in the Senate”
Again, fortunately, the Wealthcare Act may never become law:
The House bill to repeal and replace ObamaCare is facing growing opposition from Senate Republicans.
The plan, titled the American Health Care Act, is taking fire from both conservative and moderate factions of the Senate GOP caucus – underscoring the legislation’s perilous path in the upper chamber.
As in the House, arch-conservatives hate it because it doesn’t punish the poor enough:
Sen. Ted Cruz (R-TX) expressed skepticism Wednesday that the measure would be able to win enough support among Senate Republicans to pass.
“The House bill is a beginning, but the House bill as drafted, I do not believe, would pass the United States Senate,” the conservative firebrand told reporters.
Cruz made his comments after Sen. Rand Paul (R-KY) told reporters that the House bill, which he has dubbed “ObamaCare lite,” will be “dead on arrival” in the upper chamber.
“I think the White House, the administration and the president understand that there’s enough conservatives that they can’t pass ObamaCare lite,” Paul told CNN’s New Day on Wednesday.
And moderate Republicans think it’s too cruel:
Sen. Susan Collins (R-ME) said Wednesday that she’s “not crazy” about the current repeal measure.
“I do not think it will be well received in the Senate,” she told Yahoo News.
Collins is one of a handful of centrist Republicans who are concerned about what happens to ObamaCare’s Medicaid expansion.
The Maine Republican, who voted against the 2015 repeal bill, said she has “concerns” about the Medicaid language, as well as the provision to cut off Planned Parenthood funding.
Fact is, fewer Americans want to repeal Obamacare than want to expand it, and solid majorities favor most of its provisions. But tiny percentage who favor total repeal will be a majority of GOP primary voters … and that’s who House Republicans fear most.
When you’re imagining that voters will blame Democrats for the bill’s failure …
— Sean T at RCP (@SeanTrende) March 8, 2017
… you’re very close to admitting defeat.
Good day and good nuts