America’s Frontline Physicians Say Revised Graham-Cassidy Stands to Do Even More Harm to Patients

Sep 25, 2017

Washington, DC – Representing more than half a million of America's frontline physicians and medical students, leaders from six major medical organizations including the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, the American Congress of Obstetricians and Gynecologists, the American Osteopathic Association and the American Psychiatric Association, issued the following joint statement about the revised version of the Graham-Cassidy bill to repeal the Affordable Care Act:

The revised version of the Graham-Cassidy bill stands to do even more harm to the American people than the already harmful version the Senate was considering last week. The revised bill allows states to opt-out completely of ensuring essential benefits. States can again allow insurers to limit annual and lifetime coverage that patients receive. This would result in bare-bones plans that would give patients insurance in name only. Under the revised bill states only have to issue a vague statement saying they “shall” provide access to affordable coverage, with no definition of what is affordable or what is covered. The revised bill would allow states to offer plans with lower or no “actuarial equivalent” standards, meaning higher deductibles and out-of-pocket costs for patients.

All of that is in addition to the devastating cuts and caps on Medicaid, and complete elimination of Medicaid expansion, that were already included in the bill. While the bill’s sponsors have offered estimates suggesting that a few select states will get additional federal dollars under the revised bill (while most others will experience billions of dollars in cuts), such estimates do not include the impact of cutting and capping the Medicaid program and the impact on all states when all federal contributions to the states sunset in 2027. Nor do the changes in funding allocations undo the irreparable harm that will be done to all patients, in all states, by eliminating protections for preexisting conditions, re-establishing annual and lifetime caps, allowing sale of “bare-bones” insurance, and cutting funding for the 73 million Americans on Medicaid.

Throughout this process, our organizations together have been calling for a return to regular order. With no opportunity for physician or patient expertise during the bill’s development, the bill will not meet the goal of improving our health care system. Now, with the rush to pass something by the end of this week, they are pushing a version of legislation that will not allow more than the most cursory review by the Congressional Budget Office. Without the opportunity for committee mark-ups and amendments, without the opportunity for independent analysis by physicians and other stakeholders they are recklessly pushing a bill that will impact our patients immensely.

We call on the U.S. Senate to do the right thing for children, for women, for our seniors, for those with chronic conditions, for those battling mental health disorders and addiction. We call on them to do the right thing for all of us and reject the Graham-Cassidy bill.

When this legislation was first released we told the Senate leadership about our concerns. We pointed them to testimony we provided to the Senate HELP committee where we outlined the types of reforms we think should be made to our health care system; bipartisan efforts to stabilize the health insurance marketplaces, create competition among insurers, and lower the costs of health care. We look forward to working with Congress to advocate for passage of a health care reform bill that will improve and not harm the health and well-being of all Americans.

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About the American Academy of Family Physicians

Founded in 1947, the AAFP represents 124,900 physicians and medical students nationwide. It is the only medical society devoted solely to primary care. Family physicians conduct approximately one in five office visits -- that's 192 million visits annually or 48 percent more than the next most visited medical specialty. Today, family physicians provide more care for America's underserved and rural populations than any other medical specialty. Family medicine's cornerstone is an ongoing, personal patient-physician relationship focused on integrated care. To learn more about the specialty of family medicine, the AAFP's positions (5 page PDF) on issues and clinical care, and for downloadable multi-media highlighting family medicine, visit www.aafp.org/media. For information about health care, health conditions and wellness, please visit the AAFP's award-winning consumer website, www.FamilyDoctor.org(www.familydoctor.org).

About the American Academy of Pediatrics

The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds.

About the American College of Physicians

The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 152,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.

About the American Congress of Obstetricians and Gynecologists

The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation's leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 58,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women's health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion. www.acog.org

About the American Osteopathic Association

The American Osteopathic Association (AOA) represents more than 129,000 osteopathic physicians (DOs) and osteopathic medical students; promotes public health; encourages scientific research; serves as the primary certifying body for DOs; and is the accrediting agency for osteopathic medical schools. Visit DoctorsThatDO.org to learn more about osteopathic medicine.

About the American Psychiatric Association

The American Psychiatric Association is the oldest medical association in the country founded in 1844. The APA is also the largest psychiatric association in the world with more than 37,000 physician members specializing in the diagnosis, treatment, prevention and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. Follow us on Twitter at @APAPsychiatric. For more information please visit www.psychiatry.org.

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