t’s been attacked on the right and on the left, and now, the Republican plan to replace the Affordable Care Act is running into opposition from the medical establishment.

This week, the leaders of the American Hospital Association and American Medical Association wrote separately to lawmakers, outlining their concerns with the American Health Care Act. House GOP leaders on Monday unveiled the measure, which would roll back the ACA’s Medicaid expansion, eliminate the mandate that most people have insurance, and change the way tax credits are allotted to help people buy insurance.

Because the Congressional Budget Office has not yet reviewed the bill, it’s not clear how much it would cost and how many people it would cover, but it is anticipated that many people would lose their insurance.


“While we agree that there are problems with the ACA that must be addressed, we cannot support the AHCA as drafted because of the expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient populations,” the AMA’s chief executive, Dr. James Madara, wrote, noting that the ACA has extended coverage to an estimated 20 million people.

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Madara’s letter specifically took issue with the AHCA’s proposed changes to federal Medicaid funding, the elimination of the Prevention and Public Health Fund, and the provision of tax credits based on people’s age instead of income level to help them buy coverage.

The AMA faced some blowback when it endorsed then-Representative Tom Price’s nomination to be Health and Human Services secretary because of his opposition to the ACA. This week, Price spoke to reporters at the White House about the bill and why the administration viewed it as an improvement over the ACA.

In his letter, AHA CEO Richard Pollack expressed similar concerns as the AMA about people losing coverage. Both letters also noted how expanded coverage had helped people access treatment for mental health and substance abuse.

“It is important to recognize that significant progress in these areas is directly related to whether individuals have coverage,” Pollack wrote. “And, we have already seen clear evidence of how expanded coverage is helping to address these high-priority needs.”

Two House committees are slated to start marking up the AHCA Wednesday.

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