‘Mortal threat to wellbeing of our patients, health security of country’

Calling the proposed American Health Care Act (AHCA) “a mortal threat to the health and well-being of our patients and to the health security of our country,” National Nurses United today urged all House members to defeat the proposed bill in the upcoming showdown vote Thursday.

In a letter to House members this week, NNU Co-Presidents Deborah Burger, RN and Jean Ross, RN, cited the devastating loss of coverage for 24 million Americans predicted by the Congressional Budget Office if the bill is enacted, and added “there is not a single aspect of this legislation that will benefit our patients who lack the health care services that they need.”

Last minute maneuvers Wednesday to save the fundamentally flawed bill, such as seeking to strip out minimum “essential benefits” in plans that would be eligible for federal tax credits for those buying those plans “would be a further disaster,” added Burger today.

“Increasingly, we would see people locked into junk insurance plans having to pay enormous sums to get the additional coverage they need. It also violates the promise made by the President and leading Republicans that they would enact a plan that lowers costs,” Burger said.

Burger also sharply criticized language that would allow states to deprive Medicaid coverage to low income adults if they are unemployed – even if they are trying to work and unable to be hired. “There is simply no excuse to adopt such a mean spirited provision that would deny health care to someone based on their employment status. It is unconscionable and cruel,” added Burger.

Among the many other problems with the proposed law cited in their letter earlier this week, Burger and Ross said nurses oppose AHCA provisions that:

• Eliminate the Prevention and Public Health Fund, which will worsen the health of our communities, spread infectious disease, and increase health system costs;
• Phase out coverage for Medicaid expansion in Medicaid expansion states beginning in 2020, while preventing new states from receiving enhanced Federal Medical Assistance Percentage in order to expand Medicaid;
• Institute a per capita cap for Medicaid, along with the option for states to use a block grant instead. Both options will reduce coverage for the most vulnerable, shift care from clinics to emergency rooms, increase system costs for the chronically ill as they defer treatments because of cost, and unfairly shift the burden of costs to the states;
• Empower individual states to determine eligibility, scope and benefits for Medicaid as per their own discretion, but there will be no increase in federal monies to cover expanded eligibility;
• Eliminate funding to Planned Parenthood which will worsen women’s health, and create burdens for women, families and society from unsafe pregnancies and other health conditions no longer treated;
• Eliminate the definition of “essential benefits” – a move that makes all patients vulnerable to the distortions and marketing games of insurance companies;
• Repeal the cost-sharing subsidies of the ACA, and destroy the ability of 80% of people currently buying insurance on the Exchanges to maintain coverage;
• Open the door for junk insurance. The bill includes a penalty for lack of continuous coverage, creating a big incentive for patients to buy low-cost, no-coverage plans;
• Fail to encourage low-cost coverage, because the legislation shifts thousands of dollars in spending from insurance company spending to the individual’s out of pocket costs;
• Reproduce the failed “high – risk pools” of the 1990’s and 2000’s, through the “Patient and Stability Fund”. It is inevitable that the number of eligible patients will overwhelm the resources of these high risk pools;
• Repeal the Medicare Hospital Insurance Tax, which will reduce funding and destabilize the Medicare program that our nation’s seniors rely on;
• Allow insurers to charge seniors five times the amount of a younger person. This revision will prove to be deadly for our nation’s seniors, and it reveals the extent to which this reform will benefit the profit margins of insurance companies, at the expense of patients’ lives.

The punitive nature of the AHCA is perhaps most evident, said Ross, in the late addition to the bill that would allow states to deprive Medicaid coverage to low income adults if they are unemployed – even if they are trying to work and unable to be hired. “There is simply no excuse to adopt such a mean spirited provision that would deny healthcare to someone based on their employment status. It is unconscionable and cruel,” added Burger.

“Our experience at the bedside, coupled with analysis from health policy researchers, confirm our conclusion that this bill does not address the primary concerns of our patients: getting the care they need when they need it, without overwhelming financial burdens,” wrote Burger and Ross to House members.

“On behalf of registered nurses across the country, we urge the rejection of this flawed, and deadly, proposal. We urge you to instead support guaranteed healthcare for all, through an improved, expanded Medicare for All program,” Burger and Ross concluded.