American Psychiatric Association Tells Congress That AHCA Replacement Bill Still Falls Far Short

April 27, 2017

APA and five other major medical organizations are urging Congressional leaders to reject the latest Republican effort to replace the Affordable Care Act (ACA), saying the newly amended replacement bill for the American Health Care Act (AHCA) “would dramatically increase costs for older individuals, result in millions of people losing their health care coverage, and return to a system that allows for discrimination against people with pre-existing conditions.”

In a letter delivered yesterday to House Speaker Paul Ryan (R-Wis.) and Minority Leader Nancy Pelosi (D-Calif.), as well as members of the House of Representatives, the medical organizations said that while the ACA is imperfect, it has extended access to care to millions that could be endangered by the proposed replacement bill.

The five groups that signed the letter with APA were the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Congress of Obstetricians and Gynecologists, and the American Osteopathic Association. APA was part of the same coalition of organizations that had expressed its strong opposition to the AHCA in late April.

Last month a previous version of the American Health Care Act failed to garner enough votes for passage in the House of Representatives. An important new provision of the revised version, which appears to have gained traction in recent days, would allow individual states to obtain waivers to opt out of providing “essential health benefits”—including treatment for mental illness and substance use—defined in the ACA.

“Under the proposed ‘Limited Waiver’ authority, insurers in such states would once again be allowed to charge unaffordable premiums to people with pre-existing conditions based on their individual health risks, and decline to cover 10 categories of essential services including prescription drugs, physician and hospital visits, preventive services, and mental and behavioral health benefits,” APA and the five other organizations wrote. They noted that they were especially concerned about the changes that would

• Allow insures to deny millions of people facing addiction access to treatment and therapy, when such services are needed more than ever to address the opioid epidemic in the United States.
• Make health care even more expensive and further reduce access to care for millions, especially those over the age of 50.
• Force individuals with multiple chronic conditions into underfunded state-sponsored high-risk pools, which have been proven ineffective numerous times.
• Allow for gender rating by enabling states to opt out of maternity care coverage.

The six organizations provided several recommendations for retaining and improving the ACA. They included ensuring that coverage remains affordable by maintaining premium and cost-sharing subsidies available under current law; taking immediate action to provide long-term, adequate funding for the Children’s Health Insurance Program; and identifying and implementing policies that make primary, preventive, and mental health more readily available to all Americans.

“We recognize that our health care system is not perfect and reforms are needed. Our organizations and our members stand ready to work with Congress and the administration to improve our health care system. However, we urge Congress to reject the AHCA and instead focus on the implementation of policies that aim to improve our health care system versus those that seek to destabilize it and would make quality health care less available to millions of Americans.”