As the Senate begins consideration of health system reform, the American Medical Association (AMA) urged Senate leaders today to keep in mind patients at risk of losing their insurance coverage. "Significant changes to the ACA or Medicaid program potentially threaten the ability for millions of Americans to obtain and retain coverage. It is these citizens, constituents, and patients who should be at the center of this debate," wrote AMA CEO James L. Madara, MD.
The full text of the letter is below, and it can be downloaded in PDF format here.
Dear Majority Leader McConnell and Leader Schumer:
On behalf of the physician and medical student members of the American Medical Association, I am writing to reaffirm the principles that we believe should guide consideration of any changes to the Affordable Care Act (ACA) considered by the Senate.
Throughout the current debate we have consistently recommended that any proposals to replace portions of the current law should pay special attention to ensure that individuals currently covered do not lose access to affordable, quality health insurance coverage. Proposals should maintain key insurance market reforms, such as coverage for pre-existing conditions, guaranteed issue, and parental coverage for young adults, as well as stabilize and strengthen the individual insurance market, ensure that low and moderate income patients are able to secure affordable and adequate coverage, and adequately fund Medicaid, Children's Health Insurance Program, and other safety net programs. Furthermore, we believe that the health care system can be further strengthened by reducing regulatory burdens that detract from patient care and increase costs and by providing greater cost transparency throughout the health care system.
Significant changes to the ACA or Medicaid program potentially threaten the ability for millions of Americans to obtain and retain coverage. It is these citizens, constituents, and patients who should be at the center of this debate. For those Americans who have been able to afford quality health insurance for the first time because of the subsidized coverage available to them under the ACA, any new proposal should ensure that comprehensive coverage options remain available and affordable, regardless of income, age, or place of residence. Tax credit proposals should be structured to take these factors into account.
Similarly, for those who gained coverage by reason of the Medicaid expansion, new proposals must ensure that quality coverage remains available and affordable for them as well and that state governments that chose to accept enhanced federal funding are not disadvantaged in their efforts to improve and preserve the health of their citizens. Changes to the financing of Medicaid must also guarantee that the safety net remains strong and is able to respond quickly, not only to changes in enrollment but to sudden and unforeseen increases in necessary medical expenditures such as epidemics or break-through treatments for serious medical conditions.
We believe that the ACA was a major step toward the ultimate goal of ensuring that quality, affordable health insurance is available to all Americans, regardless of their health care status or economic situation. We recognize that the current law can be improved and that there are problems that need to be fixed. However, we do not support changes to the health care system that would result in health care coverage being beyond the reach of those who are currently covered, that would weaken the health care safety net, or that would compromise the ability of physicians to provide care for our patients.
We continue to stand ready to work with Congress to address the shortcomings of the current system and ensure that health insurance coverage is within reach of every American family.
James L. Madara, MD
CEO and Executive Vice President, AMA