New healthcare bill violates core American values
House Republicans unveiled their plan to replace the Affordable Care Act this week, a proposal that threatens to undo or undermine the major achievements of health reform since 2010. The American Health Care Act (AHCA) would claw back investments in public health and prevention; phase out the Medicaid expansion; repeal the need-based subsidies that have enabled millions to purchase insurance plans on the individual market; degrade the quality of healthcare plans; and fundamentally restructure Medicaid -- resulting in deep cuts to coverage and services to a program that currently covers more than 70 million low-income and disabled Americans. The bill would also “defund” Planned Parenthood for one year, shutting down access to basic healthcare services for millions, and threatens to bar private insurance coverage for abortions.
We oppose any proposals that cut healthcare coverage, access, and services. Now is the time to expand -- not revoke -- access, invest in quality care, and make healthcare more responsive to the conditions that shape health, safety, and equity in the first place. At a time when more hospitals and health systems are moving upstream and investing in community prevention, the proposed bill shifts the focus back to preventable “sick” care and creates additional burdens by increasing the ranks of the uninsured.
We must not only sustain but redouble our investments in prevention and public health. In establishing the Prevention and Public Health Fund, the Affordable Care Act recognized that investing in community-based prevention -- that is, changing community conditions to support health, safety, and equity in the first place -- must be at the heart of any efforts to save lives, reduce demands for healthcare services, and lower overall healthcare spending. While there’s much that states, cities, and regional health systems can do to invest in prevention, there’s simply no substitute for federal investments like the Prevention and Public Health Fund.
If the American Health Care Act passes, the Prevention and Public Health Fund will be eliminated, which would cut more than one-tenth of the Centers for Disease Control and Prevention’s budget. States stand to lose over $3 billion to prevent chronic disease, administer life-saving vaccinations, prepare for emergency outbreaks, prevent the spread of deadly infections, and invest in the community resources that enable everyone to lead healthier lives.
Steep health inequities exist in our country -- along lines of race, ethnicity, socioeconomic status, sex and gender identity, immigration status, language status, age, ability, and geography. Communities that have been historically underserved need targeted investments to improve community infrastructure, in addition to an expansion and reorientation of the healthcare system that currently fails to meet their needs. Any replacement to the Affordable Care Act must include a strong commitment to funding prevention and public health.
The Affordable Care Act set out to extend coverage to millions of uninsured Americans, reorient the health system to focus on delivering quality care and producing improved health outcomes, and embed community-based prevention to keep people from becoming sick and injured in the first place. Over the past seven years, much progress has been made -- and much remains to be done. We still need to extend coverage to over 28 million Americans, ensure access to high-quality, culturally competent care for all, regardless of ability to pay, and address the root causes of inequities in health and safety outcomes. The way forward on health reform is clear.
The American Health Care Act, on the other hand, seems designed to cut healthcare costs not by preventing illnesses and injuries, but by cutting healthcare coverage, access, and services for millions. The replacement plan does all this on the backs of the people who need quality, affordable healthcare the most: people living under or near the poverty line, people living with disabilities and chronic diseases, and communities whose members rely heavily on Medicaid and subsidies to access care. This is an unacceptable price to pay and -- as packed town halls across the country have so powerfully demonstrated -- violates core American values of fairness and opportunity.
We urge you to call your Congressional representatives to voice opposition to the AHCA, and to any future efforts to defund investments in prevention and public health.