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January 5, 2017

AMA to GOP: Don't repeal the Affordable Care Act without a replacement plan in place

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    The American Medical Association (AMA) in a letter sent Tuesday to congressional leaders called on lawmakers to outline plans to replace the Affordable Care Act (ACA) before they repeal the law.

    GOP planning to advance repeal without replacement plan in place

    Senate Budget Committee Chair Mike Enzi (R-Wyo.) on Tuesday introduced a budget resolution that initiates Republicans' efforts to repeal the ACA through the budget reconciliation process. The process allows bills related to spending and revenue to be passed by a simple majority of at least 51 votes, without being subject to a filibuster. Republicans lack a filibuster-proof majority in the Senate, but hold 52 seats in the chamber.

    The budget resolution instructs two House committees and two Senate committees to draft and approve legislation by Jan. 27 that would repeal parts of the ACA.

    The resolution does not include specific details on a plan to replace the ACA, although it does include "reserve funds" that would allow lawmakers to use savings generated from repealing the ACA to help offset the cost of a replacement plan.

    Senate Majority Whip John Cornyn (R-Texas) said Republicans would like to work with Democrats on a replacement plan after completing the repeal process.

    AMA urges lawmakers to introduce replacement before repealing ACA

    In the group's letter, AMA CEO James Madara wrote that "before any action is taken through reconciliation or other means that would potentially alter coverage, policymakers should lay out for the American people, in reasonable detail, what will replace current policies." He continued, "Patients and other stakeholders should be able to clearly compare current policy to new proposals so they can make informed decisions about whether it represents a step forward in the ongoing process of health reform."

    Madara also wrote that plans to replace the ACA should ensure that "gains in the number of Americans with health insurance coverage be maintained."

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    Madara added that although AMA supported the ACA's passage, the group "recognize[s] that the ACA is imperfect and there are a number of issues that need to be addressed." He wrote, "As such, we welcome proposals ... to make coverage more affordable, provide greater choice, and increase the number of those insured."

    ACP raises concerns about repeal process

    In related news, the American College of Physicians (ACP) in a separate letter sent Tuesday to congressional leaders also raised concerns about Republicans' plan for repealing the ACA without offering a replacement plan.

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    ACP President Nitin Damle wrote that repealing the ACA before proposing a replacement plan "that could be thoroughly evaluated based on its impact on quality, access, and coverage, would create chaos in insurance markets, causing plans to pull out of the markets with more than [seven] million losing coverage in 2017 alone."

    Damle warned that repealing the law without immediately replacing it could "destabilize[e] coverage in the meantime, resulting in tens of millions of Americans losing coverage, benefits, and other protections established by" the ACA.

    Damle also urged lawmakers not to repeal major ACA provisions through the budget reconciliation process, adding that doing so could abolish "essential coverage and consumer protections established by the [law]."

    However, Damle also acknowledged that the ACA "is not perfect" and added that ACP is open to discussions about "constructive, bipartisan approaches to improve" the law (Sullivan, The Hill, 1/3; Japsen, Forbes, 1/3; Versel, MedCity News, 1/3; Gever, MedPage Today, 1/3; American College of Physicians letter, 1/3).

    5 must-have upgrades for the consumer-focused health system (with or without the ACA)

    5 must-have upgrades for the consumer-focused health system

    Failure to prepare for today's consumer-driven reality is a risky strategy in any market. Increased out-of-pocket costs, the improvement of price transparency tools, the emergence of meaningful alternatives to traditional care sites, and the weakening of the traditional patient-physician relationship have accelerated the growth of a consumer market.

    Health systems that do not build real consumer loyalty are in danger of losing substantial share to new competitors. If they hope to grow, organizations must build long-term durable relationships with their customers. Check out this infographic to see five upgrades health systems should make to succeed in this new era of health care.

    Download the infographic

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