Congressman Jim Cooper

Representing the 5th District of Tennessee
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Groups opposing the American Health Care Act

Over 50 organizations oppose the proposed healthcare plan that will make Americans will pay more for less. The list includes nurses, doctors, hospitals, teachers, churches, and more. You can see a few here: 

AARP: AARP opposes this legislation, as introduced, that would weaken Medicare, leaving the door open to a voucher program that shifts costs and risks to seniors.

“Before people even reach retirement age, big insurance companies could be allowed to charge them an age tax that adds up to thousands of dollars more per year. Older Americans need affordable health care services and prescriptions. This plan goes in the opposite direction, increasing insurance premiums for older Americans and not doing anything to lower drug costs.

“On top of the hefty premium increase for consumers, big drug companies and other special interests get a sweetheart deal.

“Finally, Medicaid cuts could impact people of all ages and put at risk the health and safety of 17.4 million children and adults with disabilities and seniors by eliminating much-needed services that allow individuals to live independently in their homes and communities. Although no one believes the current health care system is perfect, this harmful legislation would make health care less secure and less affordable.

AARP stands ready to work with both parties on legislation that puts Americans first, not the special interests.

American Medical Association: The American Health Care Act (AHCA), released by Congress this week, is intended to repeal and replace the Affordable Care Act (ACA). But as introduced, it does not align with the health reform objectives that the AMA set forth in January to protect patients. While the ACA is imperfect, the current version of the AHCA is not legislation we can support.

The replacement bill, as written, would reverse the coverage gains achieved under the ACA, causing many Americans to lose the health care coverage they have come to depend upon.

In a letter sent today to leaders of the House committees that will mark up the AHCA, AMA CEO and Executive Vice President James L. Madara, MD, wrote that the proposed changes to Medicaid would limit states’ ability to respond to changes in service demands and threaten coverage for people with low incomes. Dr. Madara also noted that the proposed changes in tax credits and subsidies to help patients purchase private health insurance coverage are expected to result in fewer Americans with insurance coverage.

It is unclear the exact impact this bill will have on the number of insured Americans, and review by the nonpartisan Congressional Budget Office is still pending. The ratings and analytics firm S&P Global Ratings has already estimated that as many as 10 million Americans could lose coverage if this bill becomes law, saying that between 2 million and 4 million people could lose the insurance they purchased in the individual health exchanges under the ACA, and between 4 million and 6 million could lose their coverage under Medicaid.

That just won’t do.

We all know that our health system is highly complex, but our core commitment to the patients most in need should be straightforward. As the AMA has previously stated, members of Congress must keep top of mind the potentially life-altering impact their policy decisions will have.

We physicians often see patients at their most vulnerable, from the first time they set eyes on a newborn child to the last time they squeeze a dying loved one’s hand. We don’t want to see any of our patients, now insured, exposed to the financial and medical uncertainties that would come with losing that coverage.

That is, above all, why physicians must be involved in this debate.

American Hospital Association & Federation of American Hospitals: As lawmakers work to re-examine this law, patients and the caregivers who serve them across America are depending on Congress to make continued coverage a priority. We believe that any changes to the ACA must be guided by ensuring that we continue to provide health care coverage for the tens of millions of Americans who have benefitted from the law. We are pleased that so many in Congress also recognize the need to preserve patient coverage.

We believe the legislation needs to be reviewed through this lens, and carefully evaluated regarding its impact on both individuals and the ability of hospitals and health systems which are the backbone of the nation's health care safety net in terms of our ability to care for all of those who walk through our doors.

Any ability to evaluate The American Health Care Act, however, is severely hampered by the lack of coverage estimates by the Congressional Budget Office (CBO). Lacking that level of analysis and needed transparency, we urge that Congress should wait until an estimate is available before proceeding with formal consideration.

In addition to the lack of a CBO score, we have some additional policy concerns with the proposal.

For example, it appears that the effort to restructure the Medicaid program will have the effect of making significant reductions in a program that provides services to our most vulnerable populations, and already pays providers significantly less than the cost of providing care.

Providing flexibility to the states to expand coverage, and create innovative financing and delivery models to improve care and program sustainability, can be achieved through other alternatives. For instance, the expanded use of waivers -- with appropriate safeguards -- can be very effective in allowing state flexibility to foster creative approaches and can improve the program more effectively than through imposing per-capita caps.

In addition, the legislation repeals much of the funding currently dedicated to provide coverage in the future. Furthermore, we object to eliminating the funding from some sources, but leaving in reductions to payments for hospitals services. If coverage is not maintained at the current level, those resources need to be returned to hospitals and health systems in order to provide services to what will likely be an increased number of uninsured Americans.

At the same time, while we commend the recent actions by the Congress to address behavioral health issues, as well as the drug epidemic that is impacting virtually every community we serve, it is important to recognize that significant progress in these areas is directly related to whether individuals have coverage. And, we have already seen clear evidence of how expanded coverage is helping to address these high-priority needs.

Health care coverage is vitally important to working Americans and their families. They rely on hospitals and health systems to provide them with access for their essential health care needs in a manner that is of the highest quality, not to mention the full range of critical life-saving services, including preventive benefits, that will further improve the quality of their lives and the health of the communities in which they live.

We recognize this measure represents the first step in a process. It is critical that this process be thoughtful and focused on finding ways to improve our health care system, particularly for the poor, elderly and disabled.

We ask Congress to protect our patients, and find ways to maintain coverage for as many Americans as possible. We look forward to continuing to work with the Congress and the Administration on ACA reform, but we cannot support The American Health Care Act in its current form.

American Cancer Society Cancer Action Network: The bills released by the House Energy and Commerce Committee and the House Ways and Means Committee retain key patient protections prohibiting insurers from charging more based on health status and prohibiting pre-existing condition exclusions. However, these protections are hollow if patients and survivors can’t afford insurance that covers the health care services they need to treat their cancer diagnosis.

ACS CAN has long advocated that any changes to the health care law should provide equal or better coverage for cancer prevention, treatment and follow-up care than what is currently available. These bills have the potential to significantly alter the affordability, availability and quality of health insurance available to cancer patients and survivors. Changing the income-based subsidy to a flat tax credit, combined with reducing the standards for quality insurance could return cancer patients to a world where many are unable to afford meaningful insurance or are left to buy coverage that doesn’t meet their health needs.

In 2015, approximately 1.5 million people with a history of cancer between 18-64 years old relied on Medicaid for their insurance.  Nearly one-third of childhood cancer patients are insured through Medicaid at the time of diagnosis. The proposed repeal of Medicaid expansion along with significant federal funding changes could leave the nation’s lowest income cancer patients without access to preventive, curative and follow-up health care.

Moreover, reduced federal funding combined with state-specific eligibility and enrollment restrictions will likely result in fewer cancer patients accessing needed health care. For low-income individuals these changes could be the difference between an early diagnosis when outcomes are better and costs are less or a late diagnosis where costs are higher and survival less likely.

 According to multiple independent analyses, 30 million individuals, including many cancer patients and survivors, now have insurance facilitated by current law. ACS CAN will continue to urge lawmakers to strengthen and improve the law in a way that reduces the national cancer burden.

American Health Care Association (AHCA): Long term care providers across the country are disappointed that cuts to Medicaid are included in the Obamacare repeal and replace bill released yesterday. The current Medicaid system underfunds nursing center care by $22.46 per day, resulting in a shortfall of nearly $7 billion annually. The bill released yesterday will sharply reduce Medicaid funds across the board for all beneficiaries, making it harder than ever to maintain access to care for the most vulnerable in our society.

The residents in long term care centers are uniquely vulnerable. More than one million individuals call nursing centers their home and most rely on Medicaid for their care. This bill will cut Medicaid funding for seniors and individuals with disabilities, jeopardizing access to the care they need.

We strongly encourage Congress to protect Medicaid access for seniors and people with disabilities in the Obamacare repeal and replace effort.”

America’s Essential Hospitals: We appreciate that House Republicans offer the safety net some support in today’s reconciliation bill, including an eventual end to disproportionate share hospital cuts. Nevertheless, America’s Essential Hospitals remains deeply concerned about the legislation in its current form.

We are particularly disappointed lawmakers seem willing to consider this bill in committee without a Congressional Budget Office score and an estimate of how the bill might impact health care coverage. A score is crucial, as this legislation could place a heavy burden on the safety net by reducing federal support for Medicaid expansion over time and imposing per-capita caps on the program.

These changes alone could result in deep funding cuts for essential hospitals, which now operate with little or no margin. Our hospitals could not sustain such reductions without scaling back services or eliminating jobs.

Individuals and families — especially the vulnerable — could suffer. Communities could suffer, as well: Our hospitals are a key source of costly, lifesaving services, including trauma and neonatal intensive care, disaster response, and infection control. Without a CBO score, there are too many unknowns and too great a risk of coverage losses without affordable alternatives for many Americans.

Congress must work with all stakeholders to ensure that those who have coverage now do not lose it, that entitlement reform does not shift costs to states and providers, and that reform sustains a strong and secure safety net. Lawmakers must halt action on this bill until the CBO scores it and stakeholders can fully evaluate its provisions with that score in hand.

America’s Hospitals and Health Systems: On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, and our clinician partners —including more than 270,000 affiliated physicians, 2 million nurses and other caregivers —and the 43,000 health care leaders who belong to our professional membership groups, the American Hospital Association (AHA) is writing to express our views on The American Health Care Act, legislation to repeal and replace the Affordable Care Act (ACA).

As lawmakers work to re-examine this law, patients and the caregivers who serve them across America are depending on Congress to make continued coverage a priority. We believe that any changes to the ACA must be guided by ensuring that we continue to provide health care coverage for the tens of millions of Americans who have benefitted from the law. We are pleased that so many in Congress also recognize the need to preserve patient coverage.

We believe the legislation needs to be reviewed through this lens, and carefully evaluated regarding its impact on both individuals and the ability of hospitals and health systems which are the backbone of the nation's health care safety net in terms of our ability to care for all of those who walk through our doors.

Any ability to evaluate The American Health Care Act, however, is severely hampered by the lack of coverage estimates by the Congressional Budget Office (CBO). Lacking that level of analysis and needed transparency, we urge that Congress should. wait until an estimate is available before proceeding with formal consideration. In addition to the lack of a CBO score, we have some additional policy concerns with the proposal.

For example, it appears that the effort to restructure the Medicaid program will have the effect of making significant reductions in a program that provides services to our most vulnerable populations, and already pays providers significantly less than the cost of providing care.

Providing flexibility to the states to expand coverage, and create innovative financing and delivery models to improve care and program sustainability, can be achieved through other alternatives. For instance, the expanded use of waivers -- with appropriate safeguards -- can be very effective in allowing state flexibility to foster creative approaches and can improve the program more effectively than through imposing per-capita caps.

In addition, the legislation repeals much of the funding currently dedicated to provide coverage in the future. Furthermore, we object to eliminating the funding from some sources, but leaving in reductions to payments for hospitals services. If coverage is not maintained at the current level, those resources need to be returned to hospitals and health systems in order to provide services to what will likely be an increased number of uninsured Americans.

At the same time, while we commend the recent actions by the Congress to address behavioral health issues, as well as the drug epidemic that is impacting virtually every community we serve, it is important to recognize that significant progress in these areas is directly related to whether individuals have coverage. And, we have already seen clear evidence of how expanded coverage is helping to address these high-priority needs. Health care coverage is vitally important to working Americans and their families. They rely on hospitals and health systems to provide them with access for their essential health care needs in a manner that is of the highest quality, not to mention the full range of critical life-saving services, including preventive benefits, that will further improve the quality of their lives and the health of the communities in which they live.

We recognize this measure represents the first step in a process. It is critical that this process be thoughtful and focused on finding ways to improve our health care system, particularly for the poor, elderly and disabled.

We ask Congress to protect our patients, and find ways to maintain coverage for as many Americans as possible. We look forward to continuing to work with the Congress and the Administration on ACA reform, but we cannot support The American Health Care Act in its current form.

American Public Health Association: This proposal would jeopardize the health and lives of many millions of Americans. It would dramatically reverse progress we’ve made in controlling health care costs and assuring quality care, and it would gut patient protections, investments in prevention and access to care for the most vulnerable Americans.

American lives are on the line. It is particularly troubling that legislators plan to consider this proposal without a score from the Congressional Budget Office. We urge House members to oppose this plan and instead strengthen our nation’s commitment to improving the health and safety of all Americans.

National Disability Rights Network: The legislation revealed by House Republicans last night is a giant step backwards in the treatment and care of individuals with disabilities. 

It repeals the expanded Medicaid match that encourages the community integration of people with disabilities and counters biases that lead to institutionalization. It permits discrimination against people with disabilities in the insurance market for their pre-existing conditions. It caps Medicaid funding which means a sharp reduction in services and availability of this important health care lifeline for children and adults with disabilities. In short, this plan is terrible.

The National Disability Rights Network urges the House not to send people with disabilities back to a time when it was nearly impossible for us to obtain health insurance, live in the home of our choice or participate in community life. We will never go back to those days. Never.

National Partnership Women and Families: House Republicans’ Affordable Care Act (ACA) repeal bill would wreak havoc on our health care system by making health coverage more expensive and inadequate for millions of women and families. The shroud of secrecy surrounding the Republicans’ process and their attempt to sneak through a bill that would have such a devastating impact, without allowing anyone to review it, is shameful.

Now that the bill has been revealed, it is clear why Republicans didn’t want people to see it. Their proposal radically overhauls and cuts Medicaid while simultaneously gutting the ACA by repealing financial assistance for low-income families and making it harder for people to afford coverage. It also defunds Planned Parenthood from the Medicaid program, denying 2.5 million people access to essential health care.

The proposal jeopardizes the Essential Health Benefits (EHB) standard for our nation’s most vulnerable. The EHB standard is a groundbreaking advance for women's access to quality insurance coverage.

Moreover, the Republican bill interferes with women’s ability to make health care decisions by making abortion coverage inaccessible. It would harshen and expand already harmful abortion coverage restrictions, denying women the ability to access the care they need.

The Republican repeal bill is an affront to women and families. It reflects its authors’ determination to deny women access to quality, affordable health care, including the comprehensive reproductive health care and abortion services that are essential to their health, equality and economic security.

This bill takes us back to the days when there were few benefit standards or consumer protections in place – to a time when insurers were the ones who decided what and who they would cover, what doctors we could see, and where we could get care.

We demand an open and transparent process that enables the public to see what’s really in these plans and how it will affect their health and wellbeing. Right now, this Congress seems hell bent on taking health coverage away from tens of millions of people, increasing health care costs for working people, and destroying Medicaid. Our country’s women and families deserve better.

National Physicians Alliance: The National Physicians Alliance opposes the draft Republican House bill revealed last night. We believe the drastic cuts it proposes to Medicaid, coupled with the substantial reductions in subsidies that helped millions afford healthcare would be extremely detrimental to our patients.

Moreover, the bill would, in effect, shift huge costs onto working families, force many to pay more for worse coverage and push millions of American off of health coverage entirely. All the while, the proposed legislation hands millionaires, billionaires and health insurance CEOs a massive new tax break.

The National Physicians Alliance supports efforts to improve healthcare in America. However, we believe the misguided priorities in this bill would move us in the wrong direction.

AFL-CIO: Millions of people will lose their health care coverage thanks to a plan introduced by Congressional Republicans. This haphazard “repeal and replace” effort would result in painful taxes on working families, cuts to Medicaid, and tax giveaways for the super-rich. Of all the bad ideas in this flawed plan, forcing workers to pay a so-called “Cadillac tax,” on employer provided health care has to be among the worst. That’s a terrible plan for healthcare in America.

The reality is, this isn’t a healthcare plan at all. It’s a massive transfer of wealth from working people to Wall Street. For more than a century, the labor movement has fought to make health care a right for every American. The Republican plan contradicts this very idea by making care less affordable and accessible. It’s bad for healthcare, it’s bad for working families, it’s bad for our economy and we will fully oppose it.

American Federation of State, County, and Municipal Employees: The replacement plan put forward by congressional leadership is no replacement at all for the tens of millions of Americans who rely on the Affordable Care Act to keep their families healthy without fear of bankruptcy. It is simply a tax cut for corporations and the wealthy, funded by gutting Medicaid and shifting health care costs onto states and working families.

This so-called replacement plan strips women of access to vital preventive care services by defunding Planned Parenthood. It endangers Medicare solvency and allows insurance rates for older Americans to skyrocket. Millions of working people, children and people with disabilities will be put at risk. In fact, some of the only interests who stand to gain from this plan are the health insurance and pharmaceutical corporations that will receive massive tax breaks, paid for by increasing out-of-pocket costs for patients.

Though this bill has been kept secret, and congressional leadership has failed to provide lawmakers and the public with a CBO score for their legislation, we already know that it will leave millions without coverage. But the questions remain – how many will lose their coverage, and at what cost to jobs, local economies and state budgets? No vote should occur on this legislation until those questions are sufficiently answered.

National Council of La Raza (NCLR): This bill is a threat to America’s well-being and represents a step back to the days when health insurance was financially out of reach for too many working Americans. Our nation’s future depends on healthy and hard-working families. The changes to Medicaid will devastate a program that is a lifeline for 74 million vulnerable Americans, including children, people with disabilities, and 18 million Latinos. This effort to radically change the financing structure of Medicaid will jeopardize their lives.

Asian & Pacific Islander American Health Forum: Many things are clear from the bill, yet many unknowns remain. What we know is that millions of Americans, including Asian Americans, Native Hawaiians and Pacific Islanders (AAs and NHPIs) relying on coverage under the ACA will be worse off. Under the guise of flexibility, this plan would end Medicaid as we know it by phasing in per-capita caps. Under the guise of access, the bill would reduce the financial support that is allowing millions of low- and moderate-income Americans to afford their monthly premiums. House Republicans would offer fewer tax credits to individuals and families by restricting eligibility to citizens, nationals and “qualified aliens” under the Personal Responsibility and Work Opportunity Reconciliation Act definition. In contrast, the ACA provides assistance to all lawfully present persons. Limiting tax credits only to persons who are citizens or “qualified aliens” would render many immigrant groups with lawful status ineligible, including Compact of Free Association (COFA) migrants. More than eight in 10 previously uninsured AAs and NHPIs qualify for financial assistance through the ACA.

At the same time, the Centers for Medicare & Medicaid Services has proposed changes that would make it harder for consumers to sign up for and access affordable quality health coverage that they are eligible for under the ACA. The proposed rule, with a comment period ending today, would undermine the strength of the health insurance Marketplaces while reducing access for consumers.

In total, members of Congress who oppose the ACA are putting aside regular order to dismantle the law without fully explaining their plans. House Republicans are pushing this bill through committees without a score from the Congressional Budget Office and not taking into account the potential impact on the lives of 20 million Americans, including 2 million AAs and NHPIs who stand to lose coverage if the law is repealed.

National Committee to Preserve Social Security & Medicare: On behalf of the millions of members and supporters of the National Committee to Preserve Social Security and Medicare, I write to ask you to reject proposals being considered as part of the Affordable Care Act (ACA) repeal that would harm seniors by driving up their out-of-pocket costs for prescription drugs and preventive services, and hastening Medicare’s insolvency.

Since passage of the ACA, nearly 12 million people with Medicare have saved over $26.8 billion on prescription drugs, an average of $2,272 per beneficiary. The ACA reduces prescription drug prices for seniors and closes the coverage gap, known as the “donut hole.”   Prior to passage of the ACA, Medicare beneficiaries paid 100 percent of the cost of their drugs when in the coverage gap; under the ACA, beginning in 2011, beneficiaries paid a reduced cost for brand name and generic drugs. In 2017, Medicare beneficiaries in the donut hole receive a 60 percent discount on brand-name drugs and a 49 percent discount on generic drugs. The law closes the coverage gap in 2020 when beneficiaries will pay 25 percent of the cost of their drugs, what beneficiaries pay now before entering the donut hole.

Under provisions of the ACA, Medicare beneficiaries are eligible to receive many preventive services with no out-of-pocket costs – no coinsurance or Part B deductible. These services include flu shots and tobacco cessation counseling, as well as screenings for cancer, diabetes, cardiovascular disease and other chronic diseases. Seniors can also get an annual wellness visit so they can talk with their doctor about any health concerns. Over 40 million seniors received at least one preventive service with no out-of-pocket costs in 2016, and over 10 million beneficiaries made an annual wellness visit.

In addition, the ACA reduced the rate of increase in Medicare payments to providers and, over a six-year period, reduced overpayments to Medicare Advantage plans to bring them closer to the costs of care for a beneficiary in traditional Medicare. These reductions in Medicare spending, estimated by the Congressional Budget Office (CBO) to be $802 billion over ten years, are lowering costs for Medicare beneficiaries.

These reductions in spending not only make the Medicare program more financially sustainable, they reduce costs for seniors. The Part A deductible and copayments for inpatient hospital and skilled nursing facility care are based on hospital payments; lower payments mean lower out-of-pocket costs. The Medicare Part B premium, which covers 25 percent of program costs, and the Part B deductible, which increases at the same rate as the Part B premium, are lower than they were projected to be before passage of the ACA due to lower increases in program spending.

The ACA also includes important delivery system and payment reforms designed to bring down Medicare’s costs in ways that don’t harm care.  For example, the ACA established the Center for Medicare and Medicaid Innovation (CMMI) to develop and test new ways of delivering and paying for care that are intended to improve quality while reducing the rate of growth in Medicare spending. These include Accountable Care Organizations, bundled payments and medical homes – all of which are intended to provide incentives to physicians and others to provide high-quality coordinated care for beneficiaries, especially those with multiple chronic conditions and those dually eligible for Medicare and Medicaid. The ACA also aims to improve care and save costs through programs to reduce hospital acquired infections and unnecessary hospital readmissions by coordinating care and services for patients when they leave the hospital.

The ACA has improved Medicare Advantage plans for enrollees. From 2010-2017, the average MA premium is projected to have decreased by 13 percent and enrollment to have increased by 60 percent – to 18.5 million Medicare beneficiaries (32 percent). Since 2014, the ACA provides additional protections for MA plan members by limiting the amount these plans spend on administrative costs, insurance company profits, and items other than health care, to 15 percent of their Medicare payments. Also, due to the ACA, MA plans can no longer charge enrollees more than traditional Medicare for chemotherapy administration, skilled nursing home care and other specialized services.

The ACA is a highly complex piece of legislation that includes many benefit increases for seniors on Medicare, contains many program improvements that help to drive the cost of health care down and extends the solvency of the Part A trust fund.  For these reasons, we strongly believe that any replacement legislation should do no less than the ACA for our senior population.

National Center for Transgender Equality: Congress is rushing to repeal the Affordable Care Act and take away the protections we’ve gained over the past six years. Now, lawmakers have finally revealed their “replacement” plan—and it’s a mess. Tell Congress to not support this bill and put health care access out of reach for transgender people and millions of other Americans.

This bill would cause millions of people to lose their insurance. It would bring back the days when insurance companies could charge more for people with preexisting conditions—like gender dysphoria or other conditions related to being trans—or deny them coverage altogether. And it would gut Medicaid and take away funding from Planned Parenthood, one of the most important providers of health care for trans people in the country. The ACA’s protections have saved lives. Tell Congress that taking away those critical protections is dangerous and wrong.

Catholic Health Association of the United States: We are strongly opposed to the House GOP’s Affordable Care Act (ACA) “Repeal and Replace” legislation that asks the low-income and most vulnerable in our country to bear the brunt of the cuts to our health care system. In addition to moving away from an effective coverage expansion that has provided health care to more than 20 million working people, this proposal would also take many backward steps in the continual effort to improve our health care system, including:

Capping federal financing for the Medicaid program, which will lead to major reductions in benefits and coverage for vulnerable families

Eliminating cost-sharing subsidies for low-income people

Eliminating the income affordability adjustment for tax credits

Penalizing individuals with pre-existing conditions with a 30% monthly premium surcharge for a year, should they have a lapse in coverage

Creating barriers to initial and continuing Medicaid enrollment

This will substantially increase the number of uninsured people and uncompensated care costs for safety net providers. This nation is too great a country to pass legislation that substantially increases the number of uninsured by taking away coverage individuals and families just obtained, increases uncompensated care and disrupts the insurance market for the entire nation.

The Catholic Health Association’s Vision for U.S. Health Care calls for health care to be available and accessible to everyone, paying special attention to poor and vulnerable individuals. Radically restructuring the Medicaid program—with per capita caps or block grants—fundamentally undermines coverage for over 70 million poor and vulnerable children, pregnant women, elderly and disabled individuals in our nation. Federal Medicaid funding caps simply shift the cost burden onto local and state governments, providers and individual beneficiaries, ultimately leading to the loss of Medicaid coverage for millions of individuals.

The ACA is not a perfect law, and we have always said it should be improved where necessary. This new plan does not improve the law—instead, it undermines it and leaves behind millions of people who have obtained meaningful, affordable insurance that was not possible before the ACA.

We strongly encourage the full House to reject this ‘replacement’ bill and work to craft legislation that addresses the real issues without creating unneeded chaos in the system and coverage loss for those who need health care.

While there are many opportunities to improve both the Affordable Care Act and the Medicaid program by creating greater flexibility for state innovation, we believe this proposal will simply erode the safety net and jeopardize the health and economic safety of millions of Americans. We stand ready to work with all members of Congress to improve the availability, affordability, coverage and quality of our health care system in ways that do not harm those who need our help and support.

American Federation of Teachers (AFT): Ripping healthcare away from Americans to give huge tax breaks to the wealthy is about as cruel as it gets. This isn’t a healthcare plan—it’s a massive giveaway to insurance companies and those at the top, while it hits America’s families with a triple whammy of less coverage, higher costs and more taxes. This bill will potentially leave millions without coverage.

“That Republicans are now trying to ram something through after keeping it under lock and key makes it clear that they want to hide the details and cost from the American people. If something sounds too good to be true, it is. They know that if their true intent were exposed, Americans would soundly reject their efforts.

National Education Association: It’s time for the Republican leadership to come clean with the American people. Repealing the ACA will harm our students and their families by forcing cuts to critical programs, reducing financial support for lower-income Americans, and taxing the middle class. Bottom line, working Americans will pay more for less coverage while insurance executives and the wealthy get handouts.

The ACA expanded coverage to more than 20 million previously uninsured Americans, dramatically reducing the number of uninsured children in this country. The Republican leadership plan will reverse those gains, leading millions to potentially lose coverage while making drastic cuts in Medicaid funding, benefits, and eligible beneficiaries, and forcing some states to consider diverting money from education to health care.

Medicaid’s support for school-based health services will also suffer under the Republican leadership plan. Mental health care, vision and hearing screenings, diabetes and asthma management are just some of what school children stand to lose.

We will continue to defend the ACA and Medicaid, our country’s health care safety nets, and quality, affordable coverage for children and working families. It’s time for Congress to do the same and look out for students and ordinary Americans.

American Federation for Suicide Prevention: Suicide is currently the 10th leading cause of death in the United States. Every year 1 in 5 Americans struggle with a mental illness and veterans account for 1 in 5 suicide deaths. 1.1 million Americans attempt suicide every year.

The American Foundation for Suicide Prevention (AFSP) has set a bold goal to reduce the U.S. suicide rate 20% by 2025. Research has shown that treating the underlying mental health conditions that can lead to suicide is critical to preventing this tragic loss of life, which claims the lives of more than 43,000 Americans every year. Maintaining and increasing access to mental health and substance use treatment will help us achieve this 20% reduction in the suicide rate and save tens of thousands of lives.

As you consider making changes to the Affordable Care Act (ACA), AFSP urges you to keep important provisions that can help prevent suicide including:

Continued inclusion of mental health and substance use parity as an essential health benefit

Elimination of annual and lifetime caps

Preserving coverage of pre-existing conditions

Expanding access to care and preventive health coverage

Guaranteed coverage of people under their parent’s health plans up to the age of 26

Preserving funding of programs like Medicaid and Medicare to ensure access to mental health services for low income and elderly populations

We must ensure the gains we have made in mental health and substance use disorder coverage remain in place so every American has a path to a more healthy and productive life. Let us stand together to make this happen.

The American Foundation for Suicide Prevention is dedicated to saving lives and bringing hope to those affected by suicide. AFSP creates a culture that’s smart about mental health through education and community programs, develops suicide prevention through research and advocacy, and provides support for those affected by suicide. AFSP has 85 chapters in all 50 states with programs and events nationwide. In addition AFSP has tens of thousands of grassroots volunteers who are very concerned about maintaining parity and equal access to mental health and addiction services.

Cystic Fibrosis Foundation: The bills released by the two House committees this week fail to adequately protect people living with cystic fibrosis and place the lives of millions of Americans living with serious and chronic diseases at risk.

“The CF community has come so far in the fight against this deadly disease, and it's crucial that this progress is not jeopardized by inadequate, unaffordable health care coverage. At a time when advances in CF care are more promising than ever, these measures could restrict our community's access to existing therapies as well as new treatments as they become available.

“In particular, we are concerned that:

The legislation would effectively eliminate Medicaid expansion and alter its financing structure in a way that would put coverage of new and innovative treatments at risk. Medicaid provides a critical source of health care coverage for half of children and a third of adults with CF. We must preserve this safety net by retaining expanded eligibility and ensuring adequate funding for Medicaid. 

The bills do not support an individual market that works well for people with intensive health care needs, including people with CF. By providing states with funds that could be used for a wide range of activities -- including high-risk pools, reinsurance, provider payments and programs to promote access to preventive services -- these bills offer no assurance that, regardless of where they live, people with CF will be able to purchase an adequate, affordable plan in the individual insurance market.

The legislation inadequately supports young people with high health care needs by basing financial assistance primarily on age rather than income. This could leave younger individuals with CF without enough support to purchase a plan that covers the breadth of their specialty care. This is particularly important for our community, as 75 percent of people with CF are younger than age 30.

“We commend lawmakers for not exposing patients to higher premiums based on their health care status when they have a gap in coverage, as was put forward in other proposals. On behalf of the CF community, we urge members of Congress to protect and address the needs of people with cystic fibrosis, a life-threatening disease. We look forward to working with members of Congress as they continue to refine this legislation and will evaluate any bills through the lens of our policy principles.

HIV Medicine Association: The HIV Medicine Association is deeply concerned about the impact of the House ACA replacement bill on the health and lives of the 1.2 million Americans living with HIV. The private insurance market elements, such as the requirement for continuous coverage and the insufficient tax credits for lower income individuals, will likely shut the door on coverage in the individual insurance market for most people with HIV. Forty percent of individuals with HIV in care rely on the Medicaid program for their healthcare coverage. The House proposal to fund Medicaid based on a per capita cap will shift costs to the states and threaten access to healthcare services and treatment for the hundreds of thousands of individuals with HIV who are covered by the program. If advanced, the ACA replacement bill stands to threaten our progress in diagnosing and treating patients with HIV and increase healthcare disparities both between states and based on socioeconomic status. These proposals will not only harm individuals with HIV but will compromise our nation’s public health by leaving fewer with access to the antiretroviral treatment that keeps patients healthy and reduces their risk of transmitting HIV to near zero. We strongly urge the committees to reconsider the bill and the accelerated and non-transparent process with which these proposals have been advanced.

Leadership Conference on Civil and Human Rights: This proposal is truly disheartening. It doesn’t ensure that all Americans will continue to have health coverage, as its supporters claim. Rather, it drastically cuts financial assistance for low-income people living at or below the poverty line, undermines and places severe limitations on the Medicaid expansion, and proposes to defund Planned Parenthood centers from the Medicaid program.

Repealing and replacing the ACA and restructuring Medicaid with this plan would be detrimental to many communities that The Leadership Conference represents, in particular people of color and underserved populations. The ACA has resulted in millions of Americans gaining access to affordable and quality health care. Our most vulnerable populations are at risk of losing the coverage on which their lives depend.

We need a plan that serves the health needs of all Americans. This plan would do just the opposite and should be rejected

MomsRising: The House Republican plan to obliterate the Affordable Care Act and replace it with a plan that would make health insurance less affordable, less accessible, and less comprehensive is a dangerous step in the wrong direction. This bill would create a health care crisis by throwing millions of people off of their insurance. If it is enacted, fewer people would be covered and those who do have insurance would have weaker protections and face significantly higher costs. It is now clear why House Republicans tried to hide this bill for so long. Congress must reject it immediately.

The American Health Care Act makes a mockery of every campaign promise Donald Trump made about health care. It sets the stage for deep, punitive, permanent cuts to Medicaid in just a few years, which would cause grave harm resulting in rationing care for some of the most vulnerable people in our country: Black, Latinx, Asian, Native American, LGBTQ+, and low-income families; as well as pregnant women, people with disabilities, and the elderly. The Republican plan would allow insurance companies to raise premiums and out-of-pocket costs, especially for seniors. The only winners would be the wealthy, and the losers, as too often is the case, would be women, communities of color, and all those who struggle to pay for health coverage and care.

The GOP plan would put coverage out of reach for millions of families. It undermines one of the Affordable Care Act’s (ACA’s) greatest achievements—granting protection to those with pre-existing conditions—by forcing those with any significant gap in their insurance coverage to pay hefty penalties. Experts agree, this could lead to a toxic health care environment in which only those who are sick and can afford coverage get the health care they need.

It would be devastating for people like MomsRising member Helena of Plantation, FL, who is a self-employed, single mother of three. Helena could not afford health insurance but, once the ACA was implemented, she applied and was approved, with her kids, for Medicaid coverage. But because Florida didn't participate in the Medicaid expansion, she was ‘kicked off’ in 2016. Luckily, she says, ‘I was able to get coverage under the ACA, and qualified for the tax credit, so I'm still insured. I worry that my insurance will be taken away, and that my kids will no longer be covered.

Further harming the health of women and families, the American Health Care Act would defund Planned Parenthood, cutting off health care—including birth control, cancer screenings and other essential health services—for millions of women who have no other health care provider.

Simply put, this legislation would mean America’s moms and families pay more for less comprehensive coverage, putting our families’ and country’s economic security at risk.

MomsRising members have put pressure on Congress since January to reject a repeal of the ACA. Last month, our members delivered books with hundreds of stories from people who rely on the ACA, Medicaid, Medicare and CHIP to congressional offices in Washington D.C. and across the country to educate lawmakers about the impact of those programs. Thousands more have sent letters and made phone calls urging representatives to protect our health care coverage. We will work tirelessly to ensure that the American Health Care Act does not become law. Every lawmaker who supports it will have to answer to constituents.

Children’s Defense Fund: “The American Health Care Act threatens progress at a time when we must continue to move forward, not backwards for children. We urge you not to move the act out of committee without major revisions for children.” – Marian Wright Edelman

The Children’s Defense Fund is urging Leadership in the House Ways and Means and Energy and Commerce committees to not move the "American Health Care Act" forward out of committee. The bill to repeal the Affordable Care Act and decimate Medicaid was released March 6 and committee action is scheduled to begin today. The "American Health Care Act" takes from the poor to give hundreds of millions of dollars in tax breaks to the wealthy who need it least. The bill destroys Medicaid’s 50 year guarantee of affordable, comprehensive health coverage to poor and low income children and children with disabilities.

Families USA: The GOP health care proposal would be laughable if its consequences weren’t so devastating. 

This bill would strip coverage from millions of people and drive up consumer costs. It shreds the Medicaid social safety net that serves more than 72 million people, including many children, senior citizens and people with disabilities. And it once again leaves millions of people in America with chronic illness and disease at the mercy of insurance companies.

And they’re doing this without knowing the bill’s full impact on the federal budget.  

Consumers Union: Consumers should be able to understand the final bill before it is marked up and they deserve to see a score from the nonpartisan Congressional Budget Office to show the budgetary and coverage implications. The likelihood that this bill covers far fewer consumers (and those less fully) than those who received coverage under the ACA further makes a rushed, secretive process a wholly inadequate way to proceed.

Sister Simone Campbell, NETWORK Advocates for Catholic Social Justice: Our test for any ACA replacement bill is simple: Does the bill protect access to quality, affordable, equitable healthcare for vulnerable communities? After reviewing the House GOP replacement bill, the answer is a resounding no. Instead of providing greater health security, the bill increases costs for older and sicker patients and drastically cuts the Medicaid program, all while providing huge tax cuts to wealthy corporations and individuals. This is not the faithful way forward and must be rejected.”  

Young Invincibles: House Republicans introduced a bill to repeal and replace the ACA, which would have devastating effects on millions of young adults, a group which has seen the greatest health care gains under the ACA: in the past six years, Millennial uninsurance rates have dropped from 29 percent to 16 percent.

Planned Parenthood: One in five women in America has relied on Planned Parenthood, and their health care shouldn't get caught up in congressional Republicans' extreme agenda. This proposal would deny millions of women access to cancer screenings, birth control, and STD testing and treatment.