Opposition to Trumpcare Continues to Build Among Health Care and Consumer Groups Across the Country
Amazingly, Republicans have managed to make Trumpcare even worse. The MacArthur Amendment would completely gut the protections for people with pre-existing conditions by allowing states to waive essential health benefits and community rating rules, which prevent insurers from charging people with pre-existing conditions more. This will make it all but impossible for millions of Americans fighting illness to afford the coverage they desperately need.
As seen below, over the last few days, the number of health care, consumer, seniors, children, disability and other groups that are speaking out against Trumpcare continues to grow.
"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]
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]
AFL-CIO
"On behalf of the 12.5 million working people represented by the AFL-CIO, I urge you to oppose the American Health Care Act (AHCA, H.R. 1628). In a stunning fashion, this bill takes health coverage away from about 24 million people while providing massive tax cuts for the wealthy and large corporations. No one in good conscience can support this legislation… While it is packaged as health care reform, a straightforward look at this legislation shows that it is fundamentally designed to pare back public commitments to health coverage in order to benefit the wealthy…. The AHCA replaces ACA subsidies that support a minimum level of coverage with tax credits so small that at least 3 million people will be unable to afford coverage in the individual market, according to the Congressional Budget Office (CBO)… The bill also decimates Medicaid, ending the program as we know it—placing seniors, people with disabilities, and children in jeopardy of losing access to care. The AHCA slashes the program by $839 billion dollars over ten years, and CBO estimates that these cuts will result in 14 million people losing their coverage… Employer-based health insurance, the nation's major source of coverage, also gets hit… The reasons for opposing this legislation, which sacrifices health coverage for millions to support tax cuts for the few, are clear. We hope you stand with working people when you make your choice." [5/4/17]
"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]
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 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]
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]
"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]
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]
"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]
"The new bill is an even further departure from our principles; endangers consumer protections put into place by the ACA. [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]
American Public Health Association
"On behalf of the American Public Health Association, a diverse community of public health professionals who champion the health of all people and communities, I write to express our continued strong opposition to H.R. 1628, the American Health Care Act of 2017, legislation to repeal the Affordable Care Act. The amended bill would be even worse for the nation's health than the original proposal and does nothing to improve the health of the American public. Additionally, the bill would have the greatest negative impact on the health of the most vulnerable Americans… The amended bill would allow states to opt-out of requiring health plans to cover the 10 essential health benefits such as maternity care, mental health and substance abuse disorder services and prescription drug coverage. It would also allow insurers to charge significantly higher premiums for people with pre-existing conditions and possibly allow insurers to charge older adults even higher premiums… Not only would the bill phase out the Medicaid expansion under the ACA, it would also make other troubling changes to the Medicaid program, converting it to a per capita program. The most recent CBO analysis estimated the bill would cut federal spending on Medicaid by $839 billion over the next decade, drastically cutting resources to states, many of which are already struggling with tight budgets… We ask you to oppose this and future efforts to repeal or weaken the ACA." [5/4/17]
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]
"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]
"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]
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]
"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]
"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]
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]
"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]
Chronic Illness & 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[MacArthur Amendment]. If enacted, the amended bill will only increase the 24 million Americans estimated to lose coverage under the AHCA …The MacArthur Amendment, through its waiver program, would allow insurers to effectively deny coverage to the 27% of all Americans living with pre-existing conditions….The MacArthur Amendment, along with the Upton Amendment, also potentially promotes high-risk pools as a solution for covering population. It is unacceptable to segregate the 52 million Americans living with preexisting conditions out of the private insurance markets and into high-risk pools. After decades of experience with high-risk pools, we know that these programs do not work for Americans living with chronic illnesses and disabilities… The MacArthur and Upton Amendments would further increase the negative impact that the AHCA would have on people living with chronic illnesses and disabilities by allowing insurers to once more use health status underwriting ...We hope we can count on you to oppose the American Health Care Act, with or without the MacArthur and Upton Amendments. [5/4/17]
A Coalition of Patient Advocacy Groups, Including American Cancer Society, American Heart Association, American Lung Association, American Diabetes Association, and March of Dimes
"The undersigned organizations, representing millions of patients, stand opposed to the American Health Care Act (AHCA) and urge members of Congress to vote no. This bill remains fundamentally harmful to patients, despite the inclusion of recent amendments. Current law protects patients from being charged more for health insurance based on a pre-existing condition. The AHCA, including the MacArthur and Upton Amendments, would undermine that vital safeguard. The various patches offered by lawmakers—including high risk pools and financial assistance with premiums—do not in any way offer the same level of protection provided in current law. Moreover, other equally important problems with the bill remain, including: Allowing states to waive the guarantee of essential health benefits… Eliminating Medicaid expansion coverage for millions of Americans…[and] Increasing out-of-pocket costs for many Americans, including some of the sickest and elderly among us. We urge members to oppose the American Health Care Act, including the Upton and MacArthur Amendments." [5/4/17]
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]
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]
"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]
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]
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]
March of Dimes
"The March of Dimes is deeply disappointed that the House is moving ahead with a vote on the American Health Care Act and urges all Representatives to vote No on it. Unfortunately, the AHCA is projected to undermine health coverage for millions of pregnant women and their families. Under the AHCA, 24 million Americans are projected to lose health insurance coverage. The March of Dimes estimates that 6.5 million of those individuals will be low-income women of childbearing age. Millions of Americans with pre-existing conditions will likely find themselves unable to afford insurance coverage, or to find health plans that cover the services they need, like maternity and newborn care. These provisions will harm, not help, our nation's pregnant women, children and families. Although our nation's health system has problems, the AHCA is not the solution. The March of Dimes urges all Representatives to oppose the American Health Care Act, and instead to come together with patients and other stakeholders from across the health care system to design a plan that will provide all Americans with quality, affordable health coverage." [5/4/17]
National Committee to Preserve Social Security & Medicare
"We opposed the AHCA when it was first scheduled for consideration in the House of Representatives in March and, unfortunately, the MacArthur/Meadows amendment only makes the bill more objectionable because it would further increase premiums and decrease coverage for millions of Americans… The MacArthur/Meadows amendment would require states receiving this waiver to set up high-risk pools, where people with pre-existing conditions could buy health insurance. However, most high-risk pools have failed because they did not have enough money to cover sicker enrollees and the AHCA has the same problem…The National Committee urges you to vote against the American Health Care Act. It weakens Medicare's solvency leaving it vulnerable to benefit cuts and privatization, threatens access to Medicaid's long-term care benefits, and requires seniors to pay more for less health care coverage. [5/4/17]
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]
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]
The National Rural Health Association
"The National Rural Health Association urges a NO vote on the American Health Care Act (AHCA)… The AHCA does nothing to improve the health care crisis in rural America, and will lead to poorer rural health outcomes, more uninsured and an increase in the rural hospital closure crisis…The AHCA will hurt vulnerable populations in rural America, leaving millions of the sickest, most underserved populations in our nation without coverage, and further escalating the rural hospital closure crisis…Congress has long recognized the importance of the rural health care safety net and has steadfastly worked to protect it. And now, much of the protections created to maintain access to care for the 62 million who live in rural America are in jeopardy. We implore Congress to continue its fight to protect rural patients' access to care." [5/4/17]
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]
Service Employees International Union
"On behalf of the 2 million members of the Service Employees International Union (SEID), America's largest healthcare union, I write to voice strong opposition to the American Health Care Act (AHCA). New provisions in the legislation manage to make a bad bill worse. Not only does the bill cause millions to lose insurance coverage, face higher costs, and end Medicaid as we know it, but now it also strips essential protections for those with pre-existing conditions. The AHCA will leave millions of men, women, and children without access to high quality, affordable health care. The AHCA legislation unequivocally jeopardizes working families' safety, health, and financial security." [5/2/17]
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]