The House of Representatives has officially given final approval to the Republicans' tax overall, but healthcare organizations continue to raise concerns about provisions that could hurt patients and health insurance plan members.
The House voted a second time on the bill following a parliamentary issue and it is now ready for Trump's signature, The New York Times reports.
The Association for Community Affiliated Plans wrote a letter (PDF) to Congress decrying the plan, which includes a repeal of the Affordable Care Act's individual mandate and could lead to cuts to funding for Medicaid and other entitlements.
Democrats are warning of cuts to Medicaid, Medicare and Social Security as a result of the tax plan, too.
After increasing the deficit by at least $1.5 trillion, congressional Rs will move to cut Social Security, Medicare and Medicaid and blame it on “out of control spending" of their own making. https://t.co/jJkkzyXt4Q— Senator Bob Casey (@SenBobCasey) December 19, 2017
If Medicaid funds are slashed, it could force state budgets to cut allocations for public health initiatives and other local programs, the group said.
"The repeal of the individual mandate and the modifications to the state and local taxes, combined with the stated intent that an additional $1.5 trillion in federal debt created by this legislation will be used to justify dramatic and devastating cuts in federal healthcare programs like Medicaid, will have disastrous impacts on America’s healthcare system," ACAP wrote.
The American Hospital Association said that results of the House and Senate's joint conference on the tax plan were "mixed" for the hospitals it represents. The group praised the bill's provisions that allow hospitals to retain access to tax-exempt bonds and keeps a tax deduction for patients with high medical expenses.
However, it expressed concern about the individual mandate repeal and the impact that could have on patients. The Congressional Budget Office estimates that 13 million fewer people would be insured if the mandate is repealed, though Standard & Poor's challenged that figure and estimated instead between 3 million and 5 million fewer people will be insured.
"It is unfortunate that the important task of reforming the tax code will erode health coverage for many," the AHA said.
The American Academy of Family Physicians and AARP expressed similar concerns. AAFP said it would support bipartisan tax reform but could not back legislation that includes a repeal of the individual mandate AARP, in a letter to Congress, said potentially sweeping cuts to Medicare and Medicaid would be "detrimental to already vulnerable population."
The Arc called the bill "irresponsible" and that although "this year the disability rights community has endured ongoing Congressional attacks" it will prepare to defend Medicaid and other programs that benefit patients with mental and physical disabilities."
"Each vote in favor of this bill was a vote against constituents with disabilities and sets the wheels in motion to quite possibly go back in time to an era when people with disabilities had little opportunity to live a life of their choosing, in the community," the group's CEO, Peter Burns, said.
"As we have shown time and time again, we are a force to be reckoned with. We will remain active in our opposition to attacks on the basic rights and health of people with disabilities and their families."