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​ACA Replacement Proposed, Concerns Abound for Physicians & Their Patients

March 9, 2017

House Republicans in Washington on Tuesday released a new federal healthcare proposal they are calling the American Health Care Act (AHCA), the long-anticipated effort to repeal-and-replace the Affordable Care Act (ACA).

Almost immediately upon its release, the GOP bill sparked controversy – chiefly among Republicans themselves with some arguing the new proposal did not go far enough to overturn the ACA, or Obamacare, with some derisively referring to the plan as ‘Obamacare Lite.’

The Ohio State Medical Association (OSMA) has reviewed the plan and is concerned the AHCA could make it difficult for some people who obtained coverage under the ACA to maintain their medical insurance. The OSMA will provide additional information about the effort to replace the ACA on March 17 during the OSMA’s Annual Education Symposium at the Hilton Easton in Columbus.

“The OSMA has remained neutral on whether the ACA should be fully repealed-and-replaced but we have consistently said that whatever proposal that emerges must ensure that access to quality health care is readily available and affordable for anyone who needs it,” said OSMA president Brian Bachelder, MD. “This proposal, as it currently reads, may not ensure this goal. This is a deep concern.”

Much like the ACA, the GOP bill would provide support to individuals to purchase insurance but rather than a subsidy the AHCA would provide tax credits. Additionally, under Obamacare the support is tied to a person’s income – the less they earn, the more subsidy they can receive to apply towards their insurance. The GOP plan would tie the credits to a person’s age with elderly people receiving more but potentially paying significantly higher premiums.

The American Medical Association (AMA) on Wednesday issued a statement opposing the GOP plan, largely because of the difference in applying tax credits.

“As drafted, the AHCA would result in millions of Americans losing coverage and benefits,” said AMA president Andrew W. Gurman, MD. “By replacing income-based subsidies with age-based credits, the AHCA will also make coverage more expensive—if not out of reach—for poor and sick Americans.”

The GOP plan also calls for rolling back Medicaid expansion, an ACA tool used to provide coverage to more than 700,000 Ohioans since 2013. Ohio Gov. John Kasich has been a strong proponent of maintaining Medicaid expansion and on Tuesday he issued a statement opposing the GOP plan.

“Phasing out Medicaid coverage without a viable alternative is counterproductive and unnecessarily puts at risk our ability to treat the drug addicted, mentally ill, and working poor who now have access to a stable source of care,” Kasich said.

Also troubling for some, the GOP plan was introduced with no cost estimates attached, leaving many to wonder if the plan is even fiscally feasible.

The GOP plan keeps a few key ACA provisions, such as, allowing children to stay on their parents’ insurance until age 26 and not allowing insurers to boot patients for pre-existing conditions or charge those individuals more because of their health history.

The OSMA will continue to monitor developments in Washington and offer updates to members. A keynote address at next week’s OSMA Annual Education Symposium will also provide updates on the ACA and its proposed replacement. Suzanne Falk, associate director of government affairs for the Medical Group Management Association, will deliver the address covering the status of healthcare issues in Washington, including recently finalized implementation details for transitioning to the new MIPS and APMs and the newly proposed AHCA.

>> Register today for this event

For more information on the GOP proposal to replace the ACA, please read:
Kaiser Health News: Five Ways The GOP Health Bill Would Reverse Course 
Washington Post: House GOP Proposal to Replace Obamacare Sparks Broad Backlash
New York Times: The Parts of Obamacare Republicans Will Keep, Change or Discard



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