From the president of the National Medical Association (NMA), to the Honorable Members of the United States Congress:
You now have before you a bill, the American Health Care Act, for your consideration which is intended to replace the Patient Protection and Affordable Care Act (ACA) which was signed into law on March 23, 2010. Called Obamacare, the current legislation has led to the provision of health care insurance coverage for millions of previously uninsured American citizens, resulting in documented improvement of health status and savings of lives, especially in poor and minority communities.
Obamacare is now under threat of repeal by your august body, which will result in loss of coverage and protection by an estimated 20 to 30 million Americans, with corresponding increases in illness and death.
The bill that you now have before you would not prevent this catastrophe from happening but would actually be the cause of it, because large numbers of the most vulnerable people in our society will not be able to afford coverage under the AHCA plan, which favors the wealthy and penalizes the poor and under-represented minorities whose interests are served by the National Medical Association.
Specifically, the AHCA has fatal flaws and deficiencies that make it untenable and unacceptable as a measure to replace Obamacare. For example, the tax-credit structure of the bill gives a tax break to the rich while removing the financial support that allows the insurance marketplaces to operate successfully; without such support, middle-class individuals who do not receive health insurance coverage from their employers will have nowhere to turn to shop for affordable plans. Because of the scarcity of high-quality plans, market forces will drive up the cost of health insurance to unreachable heights for most citizens, resulting in a drastic increase in the numbers of uninsured individuals. Another liability in the AHCA plan is the scrapping of most subsidies which will also put the purchase of health insurance out of the reach of most of the public.
Still another flaw is the planned pullout from Medicaid expansion by 2020 which will leave millions more poor people adrift in a dangerous undertow of lack of insurance coverage. A freeze on Federal payments to the states would accompany the withdrawal from Medicaid expansion. This is an absolute violation of the public trust that was given to the 31 states that signed on to expanded Medicaid on behalf of their constituents.
There are other flaws in the AHCA bill which render it reprehensible and unworthy of the support of your august body. Although there are problems with certain aspects of Obamacare, these are fixable. We trust that your collective wisdom and your interest in the welfare of the American people will move you to reject the AHCA, retain the ACA, and to take the bipartisan steps necessary to adjust the ACA for the benefit of our citizens.
For the National Medical Association,
Richard Allen Williams, MD, FACC, FAHA, FACP 117th President