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Health Care and Consumer Groups Accross the Country Say ‘NO’ to Trumpcare 2.0

April 30, 2017

After the Republicans’ failed attempt to pass the Trumpcare dumpster fire – a plan which sought to kick 24 million Americans off of their health insurance and increase costs for millions – House Republicans have managed to make their disaster even worse. The revised Trumpcare would eviscerate the essential health benefits and protections for pre-existing conditions for millions of Americans – which will certainly lead to higher costs for less coverage and fewer protections.

Seniors, children, patient advocacy, disability, and other groups have come out against this latest version, as seen below:

A Coalition of Patient Advocacy Groups, Including American Cancer Society, American Heart Association, American Lung Association, American Diabetes Association, and March of Dimes

“In March, our patient advocacy organizations collectively urged Congress to ensure that any changes made to the Patient Protection and Affordable Care Act (ACA) provide affordable, accessible and adequate coverage and do not result in a loss of coverage for any Americans. The AHCA would do the opposite, causing at least 24 million Americans to lose health insurance, according to the non-partisan Congressional Budget Office. … We are alarmed by recent harmful changes to AHCA … These changes include allowing states to waive the requirement for essential health benefits… Another change allows states to waive protections against health status rating.  Weakening these rules would enable insurers to charge higher prices to people with pre-existing conditions, possibly making insurance unaffordable for those who need it most.  … The individuals and families we represent cannot go back to a time when people with pre-existing conditions could be denied coverage or forced to choose between purchasing basic necessities and affording their health care coverage. Given these factors, we oppose the latest draft of the AHCA. We urge Members of Congress to reject this legislation.”  [5/1/17]

American Academy of Pediatrics, American College of Physicians, American Congress of Obstetricians and Gynecologists, National Association of Nurse Practitioners in Women’s Health, National Partnership for Women & Families

Rather than support recent gains in women’s access to healthcare and coverage, the MacArthur Amendment and AHCA turn back the clock and reverse hard-won progress. …  The MacArthur Amendment would enable states to waive EHBs including those for maternity and newborn care, preventive services, and services for mental health and substance use disorders; [and] to waive community rating rules.  … Supporters of the bill claim this bill maintains protections for those with preexisting conditions, but allowing states to waive coverage of EHB and charge people more based on their health status renders the promise of coverage for preexisting conditions to be meaningless. … Women and families must not be made to suffer, lose access to care and coverage, and pay higher healthcare costs. … The AHCA and the MacArthur Amendment turn the clock back on women’s health and should not  move forward.” [5/1/17]

Association of American Medical Colleges

“This week, the House could vote on a new version of the American Health Care Act that includes the MacArthur amendment. …  The [MacArthur] amendment’s treatment of essential health benefits and health status underwriting dilutes protections for many Americans and would leave individuals with preexisting conditions facing higher premiums and reduced access to care. The shortcomings in the underlying bill remain the same. The original analysis from the Congressional Budget Office indicated that 14 million Americans would lose their health insurance coverage as early as next year, and as many as 24 million by 2024. Nothing in the bill has changed that alters the fact that this legislation would lead to fewer Americans with quality insurance, less affordable coverage for those who have it, and the destabilization of the current Medicaid program.”  [5/2/17]
Children’s Hospital Association

“On behalf of our nation’s children’s hospitals and the patients and families they serve, Children’s Hospital Association (CHA) continues to oppose the newly modified American Health Care Act (AHCA) and strongly urges the House of Representatives to reject the bill. Recently adopted changes only worsen the AHCA by putting children with preexisting conditions at increased risk of losing health care coverage and failing to correct the Medicaid cuts that would impact over 30 million kids. … The block grant option in particular would be devastating to children as it eliminates Medicaid’s EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) benefit which ensures children receive immunizations, mental health assessments and vision, eye and hearing exams as well as other medical services they might need. CHA urgently asks members of Congress to vote against the AHCA.”  [4/27/17]

Children’s Leadership Council

The Children’s Leadership Council opposes the American Health Care Act (AHCA) because it would jeopardize health care for millions of babies, children, youth and families. We urge you to vote NO on this legislation. … The ACHA’s changes to Medicaid would radically restructure a program that has worked for more than 50 years to support children’s health.  The Medicaid cap would shift $839 billion to states, forcing them to cut eligibility, benefits, or provider rates that could have disastrous health consequences.  There is no question that the massive cuts to Medicaid, increased premiums likely for millions of families, and eliminating the Essential Health Benefits requirements under current law will seriously harm children and families. … This legislation is a dangerous step backward.”  [5/1/17]

Consortium for Citizens with Disabilities

The Consortium for Citizens with Disabilities (CCD) is strongly opposed to the amended American Health Care Act. The amended American Health Care Act retains the original bill’s proposals to dramatically cut Medicaid services that are vital to people with disabilities and seniors through per capita caps, which CCD has opposed. … The newest amendments to the American Health Care Act make the bill even more harmful to people with disabilities.  The new amendments would allow states to easily obtain waivers that would allow them to charge higher premiums to people with pre-existing conditions, including people with disabilities.  They would also allow states to seek waivers from the Affordable Care Act’s requirement to provide essential health benefits, including services for people with disabilities… We urge you to oppose the bill should it come to a vote.”   [4/28/17]

National Education Association

“Apparently, snatching health care coverage from children and families was not enough for House Republican leaders and the Trump administration. To make a terrible bill even worse, a new amendment to the American Health Care Act (AHCA) would allow states to jettison existing essential health benefit requirements and permit insurance companies to charge people with pre-existing conditions more than they charge healthy people. … If the AHCA and new amendment are enacted, millions of kids and families would effectively lose the health care coverage they need. The new amendment also threatens to make insurance for people with pre-existing conditions prohibitively expensive.”  [4/27/17]

American Society of Clinical Oncology

“On behalf of the American Society of Clinical Oncology (ASCO), I write to express our strong opposition to the American Health Care Act (AHCA), as currently amended.  … Studies show that when cancer patients do not have adequate insurance they receive less care, receive it later, and have worse outcomes than those with better insurance coverage.  …  The AHCA as currently constructed will create or worsen barriers to care.  It will add costs to the system, decrease access to appropriate treatment and increase existing disparities of care.  We are especially concerned with provisions allowing state waivers that could erode important protections for people with cancer, including pre-existing condition safeguards, coverage of essential services, and access to affordable health insurance.  … ASCO strongly opposes passage of the AHCA in its current form.”  [4/27/17]

American Thoracic Society

“On behalf of the 16,000 members of the American Thoracic Society (ATS), I want to voice my grave concerns with the latest legislative proposal developed to repeal and replace the Affordable Care Act (ACA). … The ATS opposes any legislation that does not ensure affordable health insurance coverage for Americans currently insured under the ACA.  We are concerned that allowing states to waive important insurance reforms in the Affordable Care Act will lead to reduced coverage for many Americans and significant price increases for patients with pre-existing conditions. Further, we are concerned that reliance on “high risk pools” will not adequately meet the health insurance needs of many Americans with pre-existing conditions. We note that previous attempts at implementing state-based high risk pools have been largely unsuccessful. Members of the ATS serve a large and diverse patient population, including patients with respiratory diseases, critical illnesses and sleep disorders such as asthma, COPD, pneumonia, sepsis and obstructive sleep apnea. Our patients cannot afford to lose affordable health insurance coverage for any period of time.”  [4/27/17]

Lutheran Services in America

Lutheran Services in America continues to oppose the drastic and unnecessary restructure of the Medicaid guarantee to a per capita cap system as proposed in the American Health Care Act (AHCA). Furthermore, we oppose the bill’s new provisions that eliminate protections for people with pre-existing conditions as these provisions would be devastating to people with chronic diseases and disabilities. … In addition, the modified bill maintains the AHCA’s drastic cuts and fundamental restructuring of the Medicaid program, shifting significant risks and costs to states, and to the people who need and provide Medicaid services. …  Lutheran Services in America respectfully urges members of Congress to reject this or any legislation that would erode Medicaid, increase the number of uninsured and/or decrease protections for pre-existing conditions.”  [4/28/17]

American Thoracic Society

“On behalf of the 16,000 members of the American Thoracic Society (ATS), I want to voice my grave concerns with the latest legislative proposal developed to repeal and replace the Affordable Care Act (ACA). We are concerned that allowing states to waive important insurance reforms in the Affordable Care Act will lead to reduced coverage for many Americans and significant price increases for patients with pre-existing conditions. Further, we are concerned that reliance on “high risk pools” will not adequately meet the health insurance needs of many Americans with pre-existing conditions. We note that previous attempts at implementing state-based high risk pools have been largely unsuccessful. Members of the ATS serve a large and diverse patient population, including patients with respiratory diseases, critical illnesses and sleep disorders such as asthma, COPD, pneumonia, sepsis and obstructive sleep apnea. Our patients cannot afford to lose affordable health insurance coverage for any period of time.”  [4/27/17]

Planned Parenthood Federation of America

“The latest Republican proposal to repeal the Affordable Care Act is the worst legislation for women’s health in a lifetime. It eliminates the community rating provision, allowing insurers to charge people with pre-existing conditions an exorbitant amount for coverage. Despite the fact that the proposal claims to maintain the current prohibition on gender rating, it still allows insurers to once again discriminate against women and charge more for being a woman. Eliminating the community rating provision disproportionately affects women, since insurers can claim having given birth, having had a C-section, or having been a survivor of domestic violence is a so-called pre-existing condition.  For example, a woman who had breast cancer could be charged more than $28,000 per year for coverage and  a woman who was previously pregnant could be charged more than $17,000 per year for  … They took a bad bill that would result in 24 million people losing their insurance and higher premiums and actually made it worse. [4/27/17]

Federal AIDS Policy Partnership

“The undersigned 77 organizations are writing to strongly urge you to oppose the amended American Health Care Act (AHCA) on behalf of the 24 million or more Americans estimated to lose coverage, including tens of thousands of people with HIV.  …  Healthcare coverage can be a life or death issue for people living with HIV, and in the three years that the Patient Protection and Affordable Care Act (ACA) coverage has been available it has made a critical difference. … We cannot afford to go back to the pre-ACA sick care system that focused on treating disability and disease rather than preventing it.  Please support access to healthcare coverage for the more than 52 million Americans living with pre-existing conditions, including 1.1 million living with HIV. We hope we can count on you to oppose the amended American Health Care Act.”  [5/1/17]

AIDS United

“AIDS United seeks a health care system that will eventually enable the end of HIV in the United States.  AHCA makes major changes to the U.S. health care system that would, if passed, worsen the provision of HIV prevention services for people at risk for HIV and the treatment and care for people living with HIV.  … AIDS United is especially concerned that the [MacArthur] amendment, far from improving the situation, will make it easier for insurance companies to raise rates on people living with HIV, people with other chronic conditions and the elderly. … AIDS United notes that thanks to Congress’s strong response over many years, the U.S. has made substantial progress in responding to the HIV epidemic. However, doing so requires a strong health care system that can ensure that people living with HIV are able to access care and treatment …  H.R. 1628 will reverse some of the gains that we have made in ensuring coverage for both prevention and treatment. AIDS United urges you to decide to vote no and publicly state your position prior to any vote.”  [4/28/17]

American College of Nurse-Midwives

“On behalf of the American College of Nurse-Midwives …, we strongly urge the House of Representatives to vote NO on the revised American Health Care Act (ACHA).  The legislation, in its current form, would further impeded access to healthcare and coverage for millions of women and newborns.  Midwives stand for improving access to quality care and coverage for women and newborns…including, but not limited to, coverage and access to a full range of preventative, reproductive and sexual health services under state Medicaid programs and coverage and access to essential health benefits (EHBs), including maternity and newborn care. The newly-revised AHCA language will end this guarantee and radically turn back the clock on the progress made in women’s health. Specifically, the “MacArthur Amendment” would enable states to apply for the ability to waive EHBs, including those for maternity and newborn care, to waive community rating rules, and to shift patient with preexisting conditions or illnesses into high-risk pools. These provisions, if adopted, could have dire consequences for women’s health and health coverage.”  [4/27/17]

AARP

“This harmful legislation still puts an Age Tax on older Americans and puts vulnerable populations at risk through a series of backdoor deals that attempt to shift responsibility to states.  Older Americans need affordable health care services and prescriptions.  This legislation still goes in the opposite direction, increasing insurance premiums for older Americans and not doing anything to lower drug costs.  AARP continues to oppose legislation that would impose an Age Tax, eliminate protections for pre-existing conditions, weaken Medicare, erode seniors’ ability to live independently because of billions of dollars in Medicaid cuts, and give sweetheart deals to drug and insurance companies while doing nothing to lower the cost of health care or prescription drugs. We intend to let all 38 million of our members know exactly how their Representative votes on this bill in newsletters, in our publications, on social media and in other formats.”  [4/26/17]

American Medical Association

“After reviewing the MacArthur Amendment to H.R. 1628, the American Health Care Act (AHCA), the American Medical Association (AMA) remains opposed to passage of this legislation. As we have previously stated, we are deeply concerned that the AHCA would result in millions of Americans losing their current health insurance coverage. Nothing in the MacArthur amendment remedies the shortcomings of the underlying bill.  The MacArthur Amendment would allow states to apply for waivers for critical consumer protections provided in the Affordable Care Act (ACA), including …. the requirements that health insurers must cover certain essential health benefits, and the ban on health status underwriting.  The current ban on health status underwriting protects individuals from being discriminated against by virtue of their medical conditions. Prior to the passage of the ACA, such individuals were routinely denied coverage and/or priced out of affordable coverage. We are particularly concerned about allowing states to waive this requirement because it will likely lead to patients losing their coverage.”  [4/27/17]

American College of Physicians

“The College strongly believes in the first, do no harm principle. Therefore, we continue to urge that Congress move away from the fundamentally flawed and harmful policies that would result from the American Health Care Act and from the changes under consideration—including the proposed “Limited Waiver” amendment—that would make the bill even worse for patients.”  [4/24/17]

American Hospital Association

“The latest version of the AHCA continues to put health coverage in jeopardy for many Americans. Our top concern is what this change could mean for older and sicker patients, including those with pre-existing conditions, such as cancer patients and those with chronic conditions. For these reasons, along with our previously stated concerns about the AHCA, we cannot support the bill. … The amendment proposed this week would dramatically worsen the bill.  The changes included put consumer protections at greater risk by allowing states to waive the essential health benefit standards, which could leave patients without access to critical health services and increase out-of-pocket spending.  This could allow plans to set premium prices based on individual risk for some consumers, which could significantly raise costs for those with pre-existing conditions.”  [4/27/17]

America’s Essential Hospitals

“This latest version of the AHCA is not an improvement. It’s simply bad policy that will cut a lifeline of health care for millions of Americans. The legislation also would leave unchanged more than $800 billion in Medicaid cuts over the next decade, breaking the nation’s safety net and saddling state, local governments, and taxpayers with new costs for indigent care.  The nation has spoken on the AHCA: only 17 percent of the public support it and their elected representatives have rejected it once already.” [4/26/17]

Catholic Health Association

“It is critically important to look at this bill for what it is. It is not in any way a health care bill.  Rather, it is legislation whose aim is to take significant funding allocated by Congress for health care for very low income people and use that money for tax cuts for some of our wealthiest citizens.  This is contrary to the spirit of who we are as a nation, a giant step backward that should be resisted.”  [4/27/17]

U.S. Conference of Catholic Bishops

“It is deeply disappointing to many Americans that, in modifying the American Health Care Act to again attempt a vote, proponents of the bill left in place its serious flaws, including unacceptable modifications to Medicaid that will endanger coverage and affordability for millions of people, according to reports,” said Bishop Dewane. “Sadly, some of the recently proposed amendments—especially those designed to give states flexibility—lack apparent safeguards to ensure quality of care. These additions could severely impact many people with pre-existing conditions while risking for others the loss of access to various essential coverages.” [4/27/17]

American Nurses Association

“The new bill is an even further departure from our principles; endangers consumer protections put into place by the ACA.   [4/26/17]

American Cancer Society Cancer Action Network

“The American Cancer Society Cancer Action Network (ACS CAN) is deeply concerned about a proposed amendment to the American Health Care Act (AHCA) that would create an option for states to obtain waivers from the Essential Health Benefits (EHB) and the community rating rule. These two rules work together to guarantee access to comprehensive and affordable insurance that covers cancer prevention and treatment for patients and survivors with pre-existing conditions.  … In short, the proposal could lead to bare bones coverage plans that push significant costs onto patients who access care.”  [4/20/17]

American Lung Association

“The American Lung Association requests that Representatives oppose the American Health Care Act (AHCA) with the new amendment by Rep. MacArthur.  The American Lung Association opposes the MacArthur amendment because would allow states to opt-out of the Essential Health Benefits (EHB) – resulting in millions of Americans having inadequate care.  … All Americans – regardless of the state in which they live – need adequate coverage for the range of essential health services and treatments including life-saving cancer screening.”  [4/26/17]

March of Dimes

“Women and children need quality, affordable insurance coverage to be born healthy and lead healthy, productive lives. Unfortunately, in its current form, the MacArthur amendment to American Health Care Act will deny millions of pregnant women, babies, and their families the affordable coverage and quality services they need. … The MacArthur amendment will offer states and health plans numerous opportunities to charge people with pre-existing conditions higher rates, design plans that explicitly exclude the services they are most likely to need, and erect barriers to care.”  [4/26/17]

Families USA

“America’s families must be heard. By now, it should be clear to House Republicans and the Trump Administration from all the town halls, letters, phone calls and tweets that this is not what people want. They do not want to return to the dark days when insurers were free to charge the sick and old more for coverage and offered policies that covered very little, often leaving people to cope with staggering medical bills. It’s time for President Trump and the GOP to drop this harmful effort to undermine the nation’s health care system. It’s time to move on.”   [4/26/17]

American Psychological Association

“We are writing on behalf of the American Psychological Association and the American Psychological Association Practice Organization to express our opposition to the American Health Care Act, as recently revised and proposed for floor consideration. Our organizations comprise nearly 115,700 members and affiliates, who are clinicians, researchers, educators, consultants, and students.”  [4/26/17]

Arc of the United States

“The Arc of the United States is strongly opposed to the amended American Health Care Act. The amended American Health Care Act retains the original bill’s proposals to dramatically cut Medicaid services that are vital to people with disabilities and seniors through per capita caps. The new amendments make the AHCA even more harmful to people with disabilities.”  [4/26/17]

Chronic Illness and Disability Partnership

“On behalf of the Chronic Illness and Disability Partnership as well as allied organizations, we are writing to strongly urge you to oppose the American Health Care Act (AHCA), with or without the amendment to allow states to waive community rating and Essential Health Benefits protections (the MacArthur Amendment). If enacted, the amended bill will only increase the 24 million Americans estimated to lose coverage under the AHCA, including millions of individuals living with chronic conditions and disabilities. The MacArthur Amendment seeks to deliver cheaper insurance to healthy Americans by undercutting crucial Essential Health Benefits requirements and excluding the most vulnerable Americans from the private insurance market by allowing states to remove crucial consumer protections.”   [4/27/17]

Democratic Governors Association

“This new proposal is nothing more than the reheated leftovers of the failed Trumpcare bill.  Just like last month’s bill, this one would slash Medicaid funding, throw millions out of health coverage and leave states holding the bag.  The only fresh idea in this proposal is a new way to raise insurance rates on sick people.  States are happy to work with the federal government on strengthening health care, but we never asked for the flexibility to jack up premiums on people with pre-existing conditions.  Congress should again reject this disastrous proposal that would wreck state budgets and cut millions off of health coverage.”   [4/27/17]

National Nurse United

“The original version of the American Health Care Act posed a mortal threat to the health and well-being of our patients, and to the health security of our country. The new version, which incorporates changes negotiated between the House Freedom Caucus and Congressman Tom MacArthur, will be even worse for our patients. This new version has not yet received a score from the Congressional Budget Office, and it should not be considered by the House until a CBO score has been made public.”  [4/26/17]