Healthcare industry welcomes decision to yank ACA replacement bill

Groups representing physicians, family medicine and hospitals were pleased to see the American Health Care Act (AHCA), the Republican-sponsored replacement to the Affordable Care Act (ACA), tabled before a scheduled House vote on March 24—even though it left plenty of uncertainty for insurance markets.

The vote was called off by House Speaker Paul Ryan after it became clear the bill didn’t have enough support amongst Republicans to pass.

Almost all major medical associations had opposed the bill, mainly for its projected impact on insurance coverage: 24 million more people would be uninsured by 2026 if the legislation became law, effectively reversing the ACA’s gains in coverage.

It wasn’t a surprise when those same groups, like the American College of Physicians, applauded the bill’s demise and asked for many of its provisions to be kept out of any future healthcare reform effort.

“Congress should once and for all abandon any effort to cap the federal contribution to Medicaid or block grant the program, end support for Medicaid expansion, repeal essential evidence-based benefits, or replace the Affordable Care Act’s income-based premium and cost-saving subsidies with regressive age-based ones that will raise premiums and deductibles for most Americans, especially, for older, poorer and sicker patients,” ACP President Nitin Damle, MD, MS, said in a statement.

The associations all painted the death of the AHCA as an opportunity for Congress to refocus its healthcare policy efforts. America’s Essential Hospitals, a coalition of public hospitals, urged lawmakers to roll back the ACA’s cuts to Medicaid disproportionate share hospital (DSH) payments. The American Academy of Family Physicians (AAFP) said the goal should be to “immediately stabilize” the insurance market, further expand Medicaid and tackle the issue of narrowing networks.

“It should guarantee access to primary care by requiring that all primary care physicians be considered ‘in-network’ by health plans and by making visits to a patient’s primary care physician not subject to health plan deductibles,” wrote AAFP President John Meigs, Jr., MD.

What shapes healthcare legislation after the AHCA process—which saw a bill scheduled for a vote 18 days after being introduced and with provisions tacked on in the final hours—is a mystery. President Donald Trump has said his administration is moving on to other legislative priorities while claiming the ACA markets are “imploding,” but the Republican-controlled Congress has already introduced other ACA alternatives, like the Patient Freedom Act.

Federation of American Hospitals President and CEO Chip Kahn’s statement mentioned the possibility that legislators would continue trying to change or get rid of the ACA in some fashion.

“If the Congress chooses to go back to the drawing board on ACA repeal and replace legislation in the future, it is important that a recrafted plan puts patients first. We stand ready to work with lawmakers on next steps,” Kahn wrote.