March 23, 2017
A mechanic in his 50s, uninsured for decades and struggling with heart disease, felt like he was a ticking time bomb. A woman with diabetes who lost her employer-based insurance went without her medicines for over a year. A young man with uncontrolled blood pressure went to the ER regularly for refills of his medicines until he became eligible for Medicaid and could see a family doctor. These are only a few examples of the countless new patients we have seen in our offices who were finally able to get the care they needed after Pennsylvania entered the health insurance exchanges in 2013 and fully expanded Medicaid under the ACA in January 2015.
Now the Trump Administration and the Republican-controlled Congress want to take insurance away. The Congressional Budget Office (CBO) announced its review of the American Health Care Act (AHCA), the Republican-proposed bill in the House of Representatives, meant to replace the Affordable Care Act. Alarmingly, the report estimates 14 million Americans will lose health coverage by 2018, and a shocking 24 million by 2026.
The greatest losses in coverage would occur among those with Medicaid, but many with employer-based coverage would lose coverage as well. Some may say that the CBO estimate is not precise, but quibbling about exactly how many Americans will lose coverage is a distraction. If passed, the proposed AHCA bill will create millions of uninsured Americans, with dire consequences for families across the United States.
The coverage losses would come at a time when access to care, and especially mental health and addiction services, is especially needed as our state, like many others, battles an opioid epidemic. The bill would also restrict reimbursement for essential reproductive health and family planning services provided through organizations like Planned Parenthood, severely limiting access to care for women across the country.
As practicing physicians in Philadelphia, we value the daily, human connections with our patients. Despite claims otherwise, passage of the AHCA would deeply undermine the patient-provider relationship. Nothing impacts our ability to care for patients more than the loss of insurance. Simply put, we cannot do our job if patients do not have access to health care.
We have seen firsthand the damage that losing insurance coverage can have on people’s health. We know that when people lose health coverage, serious medical conditions like heart disease or diabetes go untreated. When people lose health coverage, important, life-saving preventive services like cancer screenings and blood pressure measurements are postponed, which have life-altering consequences. Studies have shown that lack of health insurance increases the risk of death, with one estimate suggesting an increased risk as high as 40 percent.
Reducing health care coverage for millions of Americans restricts people’s access to health care and endangers the lives of many. Without continuous and comprehensive health insurance, families are often forced to create workarounds, cobbling together health care services through piece-meal programs and costly emergency room visits. Some have to make choices on whether to pay for their medication or put food on the table.
The AHCA would have serious consequences for our patients. We are concerned for older patients who will face rising premiums, for women who may lose access to needed care, and for all of the families who stand to lose health coverage from this bill. We stand with our patients who are at risk and we oppose the AHCA, and we urge our elected representatives to do so as well.
Miranda Aragón, M.D., Family Medicine Resident
Mudit Gilotra, M.D., Family Physician
Rhea Powell, M.D.-M.P.H., Internist
Adam Rafi Rom, M.D., Family Physician
John Stoeckle, M.D., Family Physician
Lin-Fan Wang, M.D., Family Physician