The chief executive of the American Medical Association (AMA) writes to Congress urging them to vote against the proposed amendments to the Patient Protection and Affordable Care Act (ACA). It is his belief that the MacArthur Amendment does not protect the provision of affordable healthcare to all Americans, the primary goal of the ACA.
Simultaneously expanding health-care coverage and maintaining affordability to everyone is a challenging task. The ACA, commonly referred to as ObamaCare, included the introduction of Medicaid that enabled low-income families to get healthcare insurance thereby vastly increasing the proportion of US citizens with healthcare insurance. In addition, people not taking out healthcare insurance were liable for additional tax payments. The increase in coverage was funded by tax increases on the most wealthy.
President Trump, in line with years of Republican campaigning, pledged to remove ObamaCare and replace it with The American Health Care Act of 2017 (AHCA). In the AHCA, there would be no subsidy system and it would be replaced with a fixed $4,000 a year maximum. There would also no longer be a tax penalty for not being covered by insurance and insurers will be able to rise insurance rates for those who have had no insurance for over 12 months. The new act would also decrease the amount spent by the federal government on Medicaid.
Republican leaders had been hoping to pass the AHCA using the reconciliation rule that allows certain budget-related bills to be passed without having to go through Senate. However, the spilt amongst Republicans, with some wanting completely new healthcare legislation whereas others refuse to accept any loss of coverage, meant there was insufficient support to achieve a majority. The amended bill, on which Congress was due to vote in March, was thus withdrawn.
In a bid to revive the bill, the republicans are now proposing the MacArthur Amendment which is a compromise intended to please both factions of republicans. However, the amendment would still result in millions of Americans losing their healthcare coverage and could make coverage unaffordable for people with pre-existing conditions, allowing it to be determined by the sates.
The chief executive of the AMA issued a letter to congress yesterday urging them to vote against the amendment. Dr JL Madara wrote “Nothing in the MacArthur amendment remedies the shortcomings of the underlying bill. The amendment does not offer a clear long-term framework for stabilizing and strengthening the individual health insurance market to ensure that low and moderate income patients are able to secure affordable and adequate coverage, nor does it ensure that Medicaid and other critical safety net programs are maintained and adequately funded”.
In addition, the AMA have launched a website,patientsbeforepolitics.org intended to encourage physicians and patients to join the effort to ensure access to affordable, meaningful healthcare for all Americans.
In contrast, the House Freedom Caucus shows support for the AHCA and gave the statement:
“The MacArthur amendment will grant states the ability to repeal cost driving aspects of Obamacare left in place under the original AHCA. While the revised version still does not fully repeal Obamacare, we are prepared to support it to keep our promise to the American people to lower healthcare costs.”
- American Medical Association press release 27 April 2017. Available at https://www.ama-assn.org/ama-letter-congressional-leaders-reform-health-care-system