NPAF Statement on the American Health Care Act

2017-03-09 | March 8, 2017

The National Patient Advocate Foundation welcomes a robust and thoughtful dialogue about how best to create affordable health coverage that allows people to access the care they need.  While we applaud the important patient protections included in the American Health Care Act -- including a ban on lifetime and annual limits, coverage for preexisting conditions and coverage for dependents up to age 26 -- the bill as proposed also has several provisions that in combination would severely limit access for many Americans, particularly lower-income individuals and their families who have or are likely to be diagnosed with a life-threatening or chronic condition.

This population of patients is precisely who NPAF represents.  Therefore, we feel it is essential to express our concerns over the provisions most likely to impact them.

  1. The proposed changes to Medicaid would likely undermine a valuable safety net for so many of the poorest, sickest and most vulnerable people for whom the expansion provided a path to coverage.
  2. The proposed premium tax credits would not be sufficient to make coverage affordable for most low income families. The current structure of existing ACA subsidies for both premiums and out of pocket costs is what makes coverage affordable for so many.  The lack of a viable income-based subsidy in the bill, combined with the proposed changes to Medicaid, could pose a serious health risk to low income patients.
  3. While we understand the importance of finding a strong incentive for people to enroll and maintain their coverage, we also know that low income patients are at high risk for lapses in coverage due to changes in financial status that make it difficult for them to maintain coverage without adequate subsidies or safety nets. The premium increase penalties for those who don’t maintain continuous coverage are likely to hit low income families the hardest and create a significant financial hurdle to their ability to renew coverage if it lapses.   

We will continue to review the details of this bill and look forward to working with Congress to ensure patient voices are heard in support of equitable access to affordable care.