AMA Physicians Reject House ACA Replacement Bill

Andrew W. Gurman, MD Andrew W. Gurman, MD
President
American Medical Association
@AndyGurmanMD

The American Health Care Act (AHCA), released by Congress this week, is intended to repeal and replace the Affordable Care Act (ACA). But as introduced, it does not align with the health reform objectives that the AMA set forth in January to protect patients. While the ACA is imperfect, the current version of the AHCA is not legislation we can support.

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.

In a letter sent today to leaders of the House committees that will mark up the AHCA, AMA CEO and Executive Vice President James L. Madara, MD, wrote that the proposed changes to Medicaid would limit states’ ability to respond to changes in service demands and threaten coverage for people with low incomes. Dr. Madara also noted that the proposed changes in tax credits and subsidies to help patients purchase private health insurance coverage are expected to result in fewer Americans with insurance coverage.

It is unclear the exact impact this bill will have on the number of insured Americans, and review by the nonpartisan Congressional Budget Office is still pending. The ratings and analytics firm S&P Global Ratings has already estimated that as many as 10 million Americans could lose coverage if this bill becomes law, saying that between 2 million and 4 million people could lose the insurance they purchased in the individual health exchanges under the ACA, and between 4 million and 6 million could lose their coverage under Medicaid.

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.

Editor’s note: In the coming weeks, a series of AMA Wire® articles will explore policies that form the basis of the AMA’s advocacy on health reform. Read parts one (“Protecting insurance gains is priority No. 1”) and two (“No going back on key market protections”).

Reprinted with permission and as Published by the American Medical Association on AMA Wire at: https://wire.ama-assn.org/ama-news/physicians-reject-house-aca-replacement-bill

Letter re: the AHCA being driven through the US House

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YOU May Not Be Allowed to Vote in the Next Election

VoterIDThree bills that threaten OUR rights to vote were introduced this month at the Nevada Legislature.  They are unwarranted legislation in search of a problem that doesn’t exist.  We cannot let them become law!

SB 169, AB 253, and AB 266 require voters to show a limited number of acceptable forms of ID. These types of Voter ID laws impact vulnerable populations who are left struggling to obtain identification that will allow them to exercise their constitutional right to vote.

Introductions of AB 253 and AB 266 were held on Tuesday, March 17, in Assembly Committee on Legislative Operations and Elections at 4 p.m. Contact your Assembly member now and let them know that you oppose any Voter ID bills that will make it difficult for Nevada’s citizens to vote.

There is a false notion that every Nevadan has an ID and if they don’t, they can easily walk over to the DMV and get one. The “Let Nevadans Vote” coalition has been conducting surveys with vulnerable populations such as the elderly and homeless families and through that process, they’ve learned just how difficult it is to obtain an ID. Here are a few of their stories with names removed to protect their privacy:

One Reno woman moved here from another state and lacks a Nevada ID. Her supporting documents were lost to theft and she’s had difficulty just getting a copy of her birth certificate, saying it was “hard as heck” and she has to “jump through hoops.” She’s indigent and reports having both physical and mental disabilities, and relies on public transportation to get around.

A 2014 voter registered as a nonpartisan is currently jobless, homeless, and relies on public transit that he can barely afford. His birth certificate and social security card were stolen, a common occurrence when experiencing homelessness. The only ID he has is a Clarity Card issued by Catholic Charities, which doesn’t meet the requirements of this bill.

Another voter lives in a rural county, 90 miles away from the only DMV office in her county. Everybody in her local community knows her upon sight, but she doesn’t have the requisite ID prescribed by the legislation being proposed to allow her to vote.  She doesn’t drive.  She doesn’t own a car.  She doesn’t have a valid driver’s license (why would she?).  Now add to that, that there is no available public transportation she could utilize to make the hour and a half trip to the DMV to get the ID, nor to make the hour and a half trip back to her home.

Yet another man lives in a rural county in a group facility for those with disabilities. He’s a Vietnam War veteran and Agent Orange snuck up him some time ago.  He’s been voting by mail-in ballot for some time now.  Like the lady in the last example, it’s 90 miles to the nearest DMV facility.  He no longer drives and he also doesn’t have a car or a valid Driver’s license.  There’s no public transportation, and even if there was, just the 3-hour round trip would be exceptionally stressful given his current health conditions.  To be able to vote in future elections, he would not only need to make the trip to the DMV but to the Registrar of Voters office as well to present his ID for the record.

In each of these cases, an undue burden  is placed on each person who should clearly be qualified to vote.  Please contact your Assembly member and make it clear that, as their constituent, you oppose passage of Voter ID bills SB 169, AB 253, and AB266.  You can also use the “Opinions” app at the 2015 NV Legislative Session page to read the bills and comments from others as well as to leave your comments about each bill:  https://www.leg.state.nv.us/App/Opinions/78th2015/A/