CBO Score Confirms Industry’s American Health Care Act Concerns

March 14, 2017 - After the Congressional Budget Office released their cost estimate on the American Health Care Act (AHCA) several healthcare industry leadership groups reaffirmed their concerns about the bill, which may leave approximately  14 million Americans without health insurance should the law pass.

Overall, the number of uninsured americans would rise to between 21 and 24 million between the years of 2018 to 2026, with a final 2026 estimate of 52 million uninsured, the CBO says. Steep Medicaid cuts are expected to contribute to the bulk of coverage losses.  

“These are people, not numbers—people who all too often will be left without access to regular care, putting their health at risk,” said AAMC President and CEO Darrell G. Kirch, MD, in a statement. “Many of them will come to our nation’s teaching hospitals, but they may wait until they are in crisis and the costs and complexity of treatment have increased.”

Kirch made mention of the federal budget savings the AHCA would yield, but stated plainly that these 14 million people will need health care, and those care costs will fall upon teaching hospitals to absorb uncompensated care.

“High-quality, affordable health insurance should be available to all, and programs to support the health care safety net must be maintained at least at current levels until other comparable coverage expansions are available,” Kirch said. “The report from the CBO shows that the AHCA does not rise to the level of these core principles.”

The President of the AMA, Anwer W. Gurman, MD, also issued a statement upon receiving the final CBO estimates.  

“Today’s estimates from the nonpartisan Congressional Budget Office underscore the AMA’s concerns about the AHCA as it is written: If this bill were to become law, CBO projects 14 million Americans who have gained coverage in recent years could lose it in 2018. For the AMA, that outcome is unacceptable,” Gurman said.

Gurman also makes note that these 14 million americans are some of the most vulnerable healthcare consumers, as he hopes members of Congress will reform the proposed legislation to focus on making sure these vulnerable people are covered.

“While the Affordable Care Act was an imperfect law, it was a significant improvement on the status quo at the time, and the AMA believes we need continued progress to expand coverage for the uninsured.”

Earlier this month, the American Hospital Association (AHA) penned a letter to Congress that not only asked for a CBO estimate but also cited several reasons why they couldn’t support the current AHCA bill.

“In addition to the lack of a CBO score, we have some additional policy concerns with the proposal,” the AHA said.

“For example, it appears that the effort to restructure the Medicaid program will have the effect of making significant reductions in a program that provides services to our most vulnerable populations, and already pays providers significantly less than the cost of providing care. Providing flexibility to the states to expand coverage, and create innovative financing and delivery models to improve care and program sustainability, can be achieved through other alternatives.”

The AHA also said that they supported current congressional efforts and programs that combat prescription drug and opioid epidemics, but stated that the AHCA and a full ACA repeal would damage these programs.

Another healthcare leader, the American Academy of Family Physicians (AAFP) also said that the AHCA was “rushed” and will have insufficient, non-political input.

“We are concerned that by rushing to a mark-up tomorrow in the Energy and Commerce and Ways and Means Committees, there will be insufficient time to obtain non-partisan estimates of this legislation’s impact by the Congressional Budget Office, or for medical organizations like ours and other key stakeholders in the healthcare community to offer substantive input on the bill,” the AAFP said.

The AAFP added that modifications were needed as the AHCA would adversely affect patients and physicians.

Both the AMA and the AAMC also expressed initial concern over the AHCA with similar concerns on uninsured rates and improper compensation models, noting that the CBO’s report confirmed what these organizations already saw in the AHCA provisions.