Doctors, nurses, patient groups urge Senate to reject latest ACA repeal legislation

Add doctors and nurses to the growing list of providers opposed to the Graham-Cassidy legislation in the U.S. Senate, the latest effort to repeal the Affordable Care Act, which they say could leave millions of patients across the country without affordable health insurance coverage.

“Similar to proposals that were considered in the Senate in July, we believe the Graham-Cassidy Amendment would result in millions of Americans losing their health insurance coverage, destabilize health insurance markets, and decrease access to affordable coverage and care,” wrote James L. Madara, M.D., CEO and executive vice president of the American Medical Association, in a letter (PDF) to Majority Leader Mitch McConnell and  Democratic Minority Leader Chuck Schumer. “We sincerely urge the Senate to take short-term measures to stabilize the health insurance market by continuing to fund cost sharing reduction payments.”

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The AMA has consistently recommended that Congress ensure that any efforts to replace portions of the ACA would not leave currently insured individuals without coverage. Any legislation must maintain essentials of the ACA, including coverage for pre-existing conditions, parental coverage for young adults, stabilization and strengthening of the individual insurance market, affordable and meaningful coverage and guarantees that Medicaid, the Children’s Health Insurance Program and other safety-net programs are funded, the group said in the letter.

The Association of American Medical Colleges, which represents medical schools and major teaching hospitals, also sent a letter (PDF) urging senators to reject the legislation and to instead work with stakeholders to put together a bipartisan bill. The  American College of Obstetricians and Gynecologists and the American Hospital Association also came out in opposition to the bill. 

National Nurses United, an association that includes almost 185,000 registered nurses, called the bill “vicious” and said it targets the most vulnerable people. “This last ditch attempt to repeal the ACA poses a mortal threat to the health and wellbeing of patients across the United States,” said the group’s Co-President Deborah Burger, R.N. in an announcement.

Under the proposal, at least 32 million people will lose their healthcare insurance, she said.

Avalere Health, a strategic advisory company, this morning released a new analysis (PDF) that finds the bill would lead to a reduction in federal funding to states by $215 billion through 2026 and more than $4 trillion over a 20-year period. The bill will repeal aspects of the ACA and instead provide states with block grants to fund health insurance coverage.

“The Graham-Cassidy bill would significantly reduce funding to states over the long term, particularly for states that have already expanded Medicaid,” Caroline Pearson, senior vice president at Avalere, said in a statement. “States would have broad flexibility to shape their markets but would have less funding to subsidize coverage for low- and middle-income individuals.”

A bipartisan group of 10 governors sent a letter (PDF) Tuesday asking Senate leaders not to consider the legislation. The letter was signed by governors John Hickenlooper, D-Colo., John Kasich, R-Ohio, Bill Walker, I-Ark., Steve Bullock, D-Mont., Tom Wolf, D-Pa., Terence McAuliffe, D-Va., John Bel Edwards, D-La., Brian Sandoval, R-Nev., Charles Baker, R-Mass., and Phil Scott, R-Vt.

Consumer and patient groups also urged senators to reject the bill. The AARP on Tuesday said in a statement addressed to senators that the bill will increase costs for older Americans with an age tax, reduce coverage and undermine protection for pre-existing conditions.

The group said it was troubled that the Senate is rushing to consider the bill without any hearings, mark-ups and any Congressional Budget Office analysis of coverage losses and impact on premiums. "It is irresponsible for the Senate to take a vote on a bill impacting tens of millions of Americans and one-sixth of our nation’s economy without information on the potential consequences," the group’s executive vice president Nancy A. LeaMond wrote.


And 16 patient and provider groups opposed the bill which they said will limit funding for the Medicaid program, roll back benefit protections and potentially open the door to annual and lifetime caps on coverage.

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“Affordable, adequate care is vital to the patients we represent,” the groups wrote, saying the bill just repackages many of the problematic provisions of the Better Care Reconciliation Act voted down earlier this year. Some of the groups that signed the letter included the ALS Association, the American Cancer Society Cancer Action Network, the American Diabetes Association, the American Heart Association and the American Lung Association.