American Health Care Act (Trumpcare #1) Advocacy Group Position Statements

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Listed below are 53 advocacy groups that oppose – and 20 advocacy group that support – the version of the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. Please send an E-mail to taxless3@comcast.net if you know other advocacy groups that have taken a position on the American Health Care Act.

The fifty-three advocacy groups listed next oppose the version of the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017.

1.1. AARP Statement

Listed next is the statement from AARP, Inc., formerly the American Association of Retired Persons, regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The AARP press release containing this statement can be found online at https://press.aarp.org/2017-05-04-AARP-Remains-Steadfastly-Opposed-to-Health-Bill.

“AARP is deeply disappointed in today’s vote by the House to pass this deeply flawed health bill. The bill will put an Age Tax on us as we age, harming millions of American families with health insurance, forcing many to lose coverage or pay thousands of dollars more for health care. In addition, the bill now puts at risk the 25 million older adults with pre-existing conditions, such as cancer and diabetes, who would likely find health care unaffordable or unavailable to them.

“AARP will continue to oppose this bill as it moves to the Senate because it includes an Age Tax on older Americans, eliminates critical protections for those with pre-existing conditions, puts coverage at risk for millions, cuts the life of Medicare, erodes seniors’ ability to live independently, and gives sweetheart deals to big drug and insurance companies while doing nothing to lower the cost of prescriptions.

“We promised to hold members of Congress accountable for their vote on this bill. True to our promise, AARP is now letting its 38 million members know how their elected Representative voted on this health bill in The Bulletin, a print publication that goes to all of our members, as well as through emails, social media, and other communications.”

In addition, the AARP Policy Book includes the public policies that have been approved by AARP’s all-volunteer Board of Directors. The AARP policy positions on expanding health care coverage can be found online at http://policybook.aarp.org/the-policy-book/chapter-7/s060-1.3570256.

1.2. ADAPT

1.3. Advocates For Youth

1.4. America's Essential Hospitals

1.5. America's Health Insurance Plans Statement

Listed next is the statement from America’s Health Insurance Plans (AHIP) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The AHIP press release containing this statement can be found online at https://www.ahip.org/ahip-issues-statement-as-the-ahca-act-heads-to-the-senate/.

“AHIP believes that every American deserves coverage and care that is affordable and accessible, including those with pre-existing conditions. The American Health Care Act needs important improvements to better protect low- and moderate-income families who rely on Medicaid or buy their own coverage. We stand ready to work with members of the Senate and all policymakers, offering our recommendations for how this bill can be improved to ensure the private market delivers affordable coverage for all Americans.

“Immediate challenges exist in the individual market today, and the bill includes key provisions to stabilize the market in 2018 and 2019. We need certainty now about funding for cost-sharing reductions that lower copayments for patients so they can better afford to get care from their doctor. The tax credit should be enhanced to reduce premiums and better meet the needs of people with low and modest incomes, are older, or live in areas with high health care costs.

“We want to work with the Senate to ensure the continued strength of the Medicaid program, which delivers real value to more than 70 million Americans. States need adequate resources to administer an efficient, effective program that helps beneficiaries improve their health. If changes are made to criteria for who is covered by Medicaid, we need to give people more time to adjust – and more time for the individual market to stabilize.

“More than 80 million Americans rely on the Medicaid and individual market, and they deserve affordable coverage and access to quality care. AHIP believes that by working together, we can create good private market solutions that improve the health and financial stability of all people.”

In addition, the AHIP positions on “Delivery System and Payment Reform” can be found online at https://www.ahip.org/issues/delivery-payment-system-reform/.

1.6. American Academy of Family Physicians Statement

Listed next is the statement from the American Academy of Family Physicians (AAFP) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The AAFP press release containing this statement can be found online at http://www.aafp.org/media-center/releases-statements/all/2017/house-ahca-may4.html.

“The American Academy of Family Physicians is deeply disappointed with the U.S. House of Representatives passage of the American Health Care Act. This legislation will harm millions of their constituents. It will destabilize our health care system, cause 24 million Americans to lose their coverage, and allow for discrimination against patients based on their gender, age, and health status. Its inadequate and temporary high-risk pool funds are simply a band aid that does nothing to provide health security to the nearly one in three Americans who have a pre-existing condition. Its provision allowing annual and lifetime caps on benefits diminishes the value of every policy sold in the future.

“We will continue to work with the U.S. Senate to develop policies that guarantee affordable care and coverage, that stabilize the individual insurance market, and that ensure health security for all Americans regardless of their age, gender, or current or past health history.”

The AAFP also reports that recent academic literature shows that individuals with high-deductible health plans delay or prolong seeking health care services as a result of the out-of-pocket financial obligations that exists with the high-deductible health plans. An AAFP proposal would provide individuals and families with a high-deductible health plan access to their designated primary care physician or primary care team without the obligation to meet the cost-sharing requirements (deductibles and co-pays) stipulated by their policy. A company issuing the high-deductible health plan would be required to provide full coverage for designated primary care services for the plan year. Covered services would include evaluation and management codes for new and existing patients (99201-99215), prevention and wellness codes (99381-99397), chronic care management, and transition care management codes. See the AAFP proposal details at http://blogs.aafp.org/cfr/inthetrenches/entry/patients_on_high_deductible_plans?cmpid=em_ITT_20170509.

1.7. American Academy of HIV Medicine Statement

Listed next is the statement from the American Academy of HIV Medicine (AAHIVM), regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The AAHIVM press release containing this statement can be found online at https://aahivm.org/2017/05/25/aahivm-says-american-health-care-act-shows-flagrant-disregard-for-millions-of-the-nations-most-vulnerable/.

The American Academy of HIV Medicine (AAHIVM), the nation’s largest independent HIV care provider organization, today pointed to the Congressional Budget Office’s (CBO) score of the revised American Health Care Act (AHCA) as proof that the AHCA will deny access to coverage for care and treatment for millions of Americans, including many of the 1.2 million people living with HIV.

According to the CBO, the passage of the AHCA will result in 23 million Americans losing health insurance over the next decade, with lesser savings to the federal deficit than originally projected.

“Now that the CBO score is available, we have a better understanding of the negative impact this bill will have on our country,” said James Friedman, Executive Director of AAHIVM. “We can’t lose sight of the fact that 23 million is not just a statistic. These are real people that desperately need and deserve access to adequate, affordable health care.”

The ACA allowed almost 20 million people to gain new access to health coverage over the last 4 years, according to figures issued by the Department of Health and Human Services (HHS). The CBO score indicated the House-passed bill to dismantle the Affordable Care Act would increase the projected number of people without health insurance by 14 million next year, and by 23 million by 2026.

“For too many years, people living with HIV were denied access to insurance until it was made available through the ACA,” stated Margaret Hoffman-Terry, MD, FACP AAHIVS, chair of the AAHIVM Board of Directors. “This plan will directly impact the lives of millions of individuals who will lose access to health care, including many of the HIV patients I see every day.”

The AHCA is now under consideration by the U.S. Senate. Many Senators have indicated they would pay specific attention to the CBO score indications of impact on patients.

“The AHCA, combined with the President’s newly released budget, amounts to a flagrant disregard for the health needs of vulnerable patient groups, including HIV patients and the poor and disabled,” concluded Friedman.

AAHIVM encourages lawmakers in the Senate to keep in place the provisions that protect people with pre-existing conditions, and ensure access, affordability and adequacy of coverage for all Americans.

In addition, more AAHIVM comments about the American Health Care Act can be found online at https://aahivm.org/2017/05/11/aahivm-comments-on-passage-of-extremely-harmful-health-bill-by-house-of-representatives/.

1.8. American Academy of Pediatrics Statement

Listed next is the statement from the American Academy of Pediatrics (AAP) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The AAP press release containing this statement can be found online at https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AHCAopposition.aspx.

“The American Health Care Act (AHCA) passed today by a vote of 217-213 in the U.S. House of Representatives, putting into motion a dangerous policy precedent and clearing the first hurdle to reversing the tremendous progress we've made in children's health care coverage. As the U.S. Senate considers this bill, pediatricians urge legislators to start over and find a new way forward.

"The rate of children's health coverage in our country is at a historic high of 95 percent; the AHCA would not only halt this progress, it would tear it down. By dismantling Medicaid through capped funding and the elimination of the Medicaid expansion, those who will suffer the most are those who need health care the most, including the 37 million children across the country who rely on the program. Medicaid works for these children, including those with special health care needs and those from low-income families – they are more likely to get check-ups, miss less school, graduate and enter the workforce than their uninsured peers.

"The bill also allows insurers to go back to putting annual and lifetime limits on coverage, meaning that a premature baby on private insurance could exceed her lifetime limit on coverage before she even leaves the hospital. In addition, the bill allows insurance companies to refuse to cover those with pre-existing conditions, or charge them more for coverage, meaning that conditions ranging from asthma to pregnancy to cystic fibrosis could completely devastate a family financially and leave those who need care unable to access it.

"AHCA is bad policy for children and dangerous policy for our country, and the American Academy of Pediatrics will continue to speak out against it. We urge U.S. senators to reject AHCA and instead support health care policies that put children and families first."

In addition, the AAP states, “The concept of quality health insurance includes portability, continuous coverage, streamlined and simplified administrative aspects, choice of clinician(s), affordability for families, and coordination with existing maternal and child health programs.” The AAP Endorsed Principles on Access (see http://downloads.aap.org/DOFA/AAP%20Access%20Principles.pdf) are listed next.

• Every child should receive care in a medical home with a primary care pediatrician, and access to pediatric medical subspecialists, pediatric surgical specialists, pediatric mental and dental professionals, and hospitals with appropriate pediatric expertise.

• Quality health care is a right, regardless of income, for all children, their families, pregnant women, and ultimately all individuals.

• Every child must have quality health insurance.

• All health insurance plans should have a comprehensive age appropriate benefits package directed to the special needs of the pediatric population as recommended by the American Academy of Pediatrics (AAP).

• All health plans should have payment rates that assure that children receive all recommended and needed services.

1.9. American Cancer Society Cancer Action Network Statement

Listed next is the statement from the American Cancer Society Cancer Action Network regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The press release containing this statement can be found online at https://www.acscan.org/releases/house-passed-health-bill-risks-pricing-cancer-patients-survivors-out-insurance-market.

Today the House of Representatives passed a health care bill that could leave cancer patients, survivors and those at risk for the disease unable to access or keep quality health insurance. The bill would create a coverage patchwork whereby patients with pre-existing conditions could be charged more for their coverage while simultaneously weakening the rules for what health services will be covered.

A statement from Chris Hansen, president of the American Cancer Society Cancer Action Network (ACS CAN) follows:

“The bill passed by the U.S. House today risks placing millions of Americans into a system in which they could be unable to afford their health coverage.

“Allowing patients to be charged more for coverage based on their health status risks making pre-existing condition protections virtually meaningless. A return to medical underwriting, combined with seriously weakened standards for what constitutes good coverage through the erosion of Essential Health Benefits, sets up a situation whereby payers can cherry-pick their customers and leave patients with serious conditions like cancer with few if any affordable insurance options.

“High-risk pools have not historically been an adequate safety-net. These programs have been unsustainable and underfunded. High-risk pool enrollees were often charged unaffordable premiums—usually 150-200% higher than the average standard rate—and faced potentially long waiting periods and strict coverage limitations; circumstances that are unacceptable for cancer patients and survivors who need immediate treatment and consistent follow-up care.

“Additionally, it is unclear how weakening the essential health benefits standards will affect cancer patients’ access to new therapies and key patient protections like the cap on out-of-pocket costs and the prohibition of lifetime and annual limits, both of which are applied only to essential health benefits. This bill could seriously weaken these key protections, jeopardize access to new therapies and leave cancer patients—both in the individual and employer-based market—vulnerable to higher out-of-pocket costs.

“There is no denying that current law needs improvement, however focusing on lower premiums for healthy people at the expense of the millions of Americans with pre-existing health conditions, including more than 16 million cancer survivors, is wrong.

“We call on the Senate to reject this legislation and stand ready to work with all lawmakers to develop policies that improve the law and encourage a strong health insurance market that provides affordable and comprehensive coverage options for those with serious diseases like cancer.”

The American Cancer Society Cancer Action Network is also working in every state and in Congress to expand health care options and protect existing law that help patients get true access to the care they need: see https://www.acscan.org/what-we-do/access-health-care.

1.10. American Chiropractic Association

1.11. American College of Cardiology Statement

Listed next is the statement from the American College of Cardiology (ACC) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The ACC press release containing this statement can be found online at http://www.acc.org/about-acc/press-releases/2017/05/04/14/39/acc-president-responds-to-todays-health-care-vote?w_nav=S.

"The American College of Cardiology opposes the American Health Care Act (AHCA) in its current form, and is disappointed by its passage today in the U.S. House of Representatives. As it stands, the AHCA would allow states to bypass existing federal protections for sick and elderly people, and potentially undermine coverage for critical services for patients with heart disease. This iteration of the AHCA is inconsistent with the ACC’s Principles for Health Reform, which reflect our belief in the importance of promoting patient access to meaningful insurance coverage and quality, cost-effective care," said American College of Cardiology President Mary Norine Walsh, MD, FACC.

"It is important for all members of Congress to prioritize protection for the most vulnerable Americans as health reform efforts move forward. The ACC will continue to work with lawmakers on both sides of the aisle to create solutions that maintain patient access to the coverage and care they need."

In addition, the ACC Principles for Health Reform can be found online.

1.12. American College of Physicians Statement

Listed next is the statement from the American College of Physicians (ACP) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The ACP press release containing this statement can be found online at https://www.acponline.org/acp-newsroom/acp-extremely-disappointed-by-house-vote-to-pass-the-ahca-urges-senate-to-reject-the-bill-and-start.

The American College of Physicians (ACP) is extremely disappointed that the U.S. House of Representatives passed the American Health Care Act (AHCA) today. This vote makes coverage unaffordable for people with pre-existing conditions, allows insurers to opt-out of covering essential benefits like cancer screening, mental health, and maternity care, and cuts and caps the federal contribution to Medicaid while sunsetting Medicaid expansion. As a result, an estimated 24 million Americans will lose their coverage, and many more will be at risk of paying higher premiums and deductibles.

The House action is by no means the end of the story, however. ACP will continue to do all that it can to ensure continued coverage and access for the millions of patients who have benefited from the Affordable Care Act. In a strongly worded letter to the United States Senate also sent today, ACP urged Senators to reject this harmful legislation and begin anew to craft bipartisan solutions to improve coverage and access for all Americans. Specifically, the Senate must reject the following policies that were included in the AHCA, as passed by the House:

The AHCA will make radical changes to the Medicaid program’s structure and financing, resulting in the rollback of coverage for many millions of the most vulnerable Americans. Specifically, ACP opposes capping, block granting and cutting the federal contribution to Medicaid, ending federal funding for Medicaid expansion, and eliminating the requirement that Medicaid cover essential health benefits.

The AHCA will allow states to opt-out of federal requirements that insurers cover essential health benefits; and that premiums be based on community rating rather than an individual’s health status. After analyzing the potential impact of the AHCA, The Brookings Institute concluded that “As a result, community rating would be eviscerated—and with it any meaningful guarantee that seriously ill people can access coverage.”

The AHCA will replace income-based premiums and cost-sharing subsidies with regressive age-based tax credits that result in higher premiums and deductible for most people, especially older, poorer and sicker patients.

Because of these and other ill-advised policies, the House-passed bill violates the fundamental principle so important to the ACP, which is First, Do No Harm. The College feels strongly that the Senate must reject this legislation as it will result in catastrophic harm by eroding coverage and essential consumer protections for the most vulnerable: older, sicker and poorer patients. Instead, we urge Congress to start over and seek agreement on bipartisan ways to make health care better, more accessible, and more affordable for patients rather than imposing great harm on them as the AHCA would do.

In addition, the ACP’s criteria for modifications and/or improvements to the Affordable Care Act are detailed online at https://www.acponline.org/acp_policy/letters/letter_to_congressional_leaders_opposing_american_healthcare_act_2017.pdf.

1.13. American College of Rheumatology Statement

Listed next is the statement from the American College of Rheumatology (ACR) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The ACR press release containing this statement can be found online.

“The American College of Rheumatology is committed to improving healthcare insurance access and affordability for Americans living with chronic, debilitating, and painful rheumatic diseases. Amid the ongoing debate in Congress concerning the future of the Affordable Care Act, the ACR has outlined specific provisions that would need to be included in any replacement bill to ensure Americans have continued access to rheumatologic care.

With the revised AHCA bill now moving to the Senate for review, the ACR remains deeply concerned that the legislation does not go far enough to ensure affordable insurance coverage for the 54 million Americans living with rheumatic diseases. If enacted in its current form, the legislation would make it harder for our patients to access the care they need to manage pain, avoid long-term disability, remain active in the workforce, and preserve their quality of life.

Changes made to the bill in recent weeks – specifically those outlined in the MacArthur Amendment – would allow states to opt out of many of the crucial consumer protections the ACA provides to chronic disease patients, including essential health benefits, the ban on health status underwriting, and the 3-to-1 age rating ratio. If states waive these protections, healthcare coverage will become unaffordable for individuals with pre-existing conditions like arthritis, and may lead to discrimination against individuals with certain high-cost medical conditions.

Furthermore, the $8 billion in additional funding for high-risk pools is a short-term fix for people with life-long care needs. High-risk pools have been historically underfunded, and chronically ill patients seeking this type of coverage regularly experience soaring deductibles and premiums. Without an official score from the Congressional Budget Office, there is no way to assess whether the additional funding would be enough to offset coverage losses for people living with arthritis.

The ACR urges Senate leaders to address these concerns in their consideration of the bill to ensure the millions of Americans living with rheumatic diseases can continue to access vital rheumatologic healthcare services.”

In addition, the ACR 2017 Health Policy Priorities can be found online at https://www.rheumatology.org/About-Us/Newsroom/Press-Releases/ID/801/ACR-Announces-2017-Health-Policy-Priorities.

1.14. American Congress of Obstetricians and Gynecologists Statement

Listed next is the statement from the American Congress of Obstetricians and Gynecologists (ACOG) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The ACOG press release containing this statement can be found online at http://www.acog.org/About-ACOG/News-Room/Statements/2017/ACOG-Condemns-House-Passage-of-the-AHCA.

“The American Congress of Obstetricians and Gynecologists (ACOG), the nation’s largest professional organization for women’s health care physicians, denounces U.S. House passage of the American Health Care Act (AHCA). This legislation turns back the clock on women’s health, and will threaten the health and well-being of America’s women and families. Our bottom line is simple: No one should be worse off than they are today.

“ACOG is the leading authority on women’s health and, for more than 65 years, the U.S. Congress has sought our moderate voice because of our steadfast commitment to ensuring public policy that is rooted in facts, science and evidence-based medicine. The facts are that cutting $880 billion out of the Medicaid program, eliminating Medicaid expansion, denying qualified providers the ability to offer Medicaid-covered primary and preventive care, allowing states to opt out of covering essential benefits including maternity care, and weakening protections for people with pre-existing conditions all lead to only one result: sicker patients and higher health care costs.

“This bill will not offer Americans more choice. Instead, it returns families to the days when having a child or facing a devastating diagnosis could easily mean bankruptcy.

“It harms pregnant women and babies by reverting to the years before the Affordable Care Act (ACA) when a woman’s maternity and other essential coverage depended on what state she lived in—when only five states required maternity coverage, only 12 percent of individual market plans offered this coverage, and maternity care riders offered little real financial protection.

“By eliminating the Medicaid expansion program, the House has acted to decimate low-income women’s access to care, a move that will cause the uninsured rate to skyrocket. Under the ACA, the uninsured rate for women ages 18 to 64 fell from 19.3 percent to 10.8 percent between 2010 and 2015. The AHCA would also deny Medicaid coverage of primary and preventive health care provided at Planned Parenthood clinics, setting a dangerous precedent of allowing Congress to pick and choose among qualified providers. Finally, this bill would kick new moms off Medicaid if they don’t fulfill a newly established work requirement within eight weeks of giving birth.

“In addition, the House has voted to deny Americans' freedom and states' flexibility by increasing barriers to abortion care for women, restricting employers from offering plans with abortion coverage, and prohibiting states from allowing plans that offer abortion coverage on their exchanges. This is political interference in the practice of medicine.

“This legislation is an assault on women’s health and ACOG is extremely disappointed in the House of Representatives for passing this harmful legislation. We urge the U.S. Senate to reject the AHCA and instead focus on ways to improve our nation’s health and help reduce health care costs.”

In addition, the ACOG 2017 Legislative Priorities can be found online at http://www.acog.org/Advocacy/ACOG-Legislative-Priorities.

1.15. American Diabetes Association Statement

Listed next is the statement from the American Diabetes Association regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The press release containing this statement can be found online.

The American Diabetes Association (Association) is disappointed that today, the U.S. House of Representatives narrowly passed the American Health Care Act (AHCA) legislation to repeal and replace the Patient Protection and Affordable Care Act (ACA). The Association remains deeply concerned with the AHCA and has expressed our reservations throughout the rushed legislative process. The most alarming last minute changes to the bill will allow states to waive the requirement for essential health benefits and health status rating. Weakening these rules will give insurers the ability to charge people with pre-existing conditions, such as diabetes, higher prices. It will also allow insurers to deny people with diabetes coverage for the care and services they need to treat their disease. States that waive these protections would be required to set up a risk sharing program, which could include a high-risk pool. Historically, high-risk pools have resulted in higher premiums, long waiting lists and inadequate coverage.

The non-partisan Congressional Budget Office (CBO) projected that up to 24 million people would lose their coverage should the AHCA become law. Access to adequate and affordable health care allows individuals to obtain the necessary medical services they require to manage their disease and prevent devastating complications. Thus, we are dismayed that the House passed a bill that will strip health insurance from millions of vulnerable Americans.

The Association is also alarmed by the significantly weaker tax credits compared to current ACA tax credits; the proposed continuous coverage premium penalty; and the proposed changes to Medicaid under this bill. If the AHCA is enacted, each of these elements will have a devastating effect on people with diabetes and will negatively impact their ability to manage their disease. Finally, the legislation repeals the Prevention and Public Health Fund after 2018, eliminating almost 40 percent of the Center for Disease Control and Prevention’s (CDC) chronic disease prevention and health promotion budget—a drastic step backwards for diabetes prevention.

The AHCA falls short of the minimum standards for an ACA replacement, which the Association outlined and that fellow patient advocacy groups agree are necessary to ensure continued access to health care for those who need it. The Association is discouraged by the passage of the AHCA in the House of Representatives. However, we stand ready to work with the Senate to address the dangerous provisions contained within this bill. We encourage Senators to reject the AHCA and work to improve health care for individuals with diabetes.

In addition, the “Federal Priorities” of the American Diabetes Association can be found online at http://www.diabetes.org/advocacy/advocacy-priorities/federal-priorities.html.

1.16. American Federation of Teachers

1.17. American Health Care Association

1.18. American Heart Association Statement

Listed next is the statement from the American Heart Association (AHA) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The AHA press release containing this statement can be found online at http://newsroom.heart.org/news/house-fails-cvd-patients-with-ahca-vote-says-american-heart-association.

“It’s extremely disappointing that today, members of the House of Representatives failed to stand up for America’s patients – particularly those who most rely on Congress’s strong leadership. For more than two decades, our Association has embraced the core belief and advocated that health care must be accessible, affordable and adequate for all Americans. It is inconceivable why the House majority would pass this bill since it does not meet these fundamental standards.

“The Affordable Care Act made it possible for 20 million more Americans to get quality health insurance coverage and, for the first time, provided guaranteed protections for individuals with pre-existing conditions. This bill, on the other hand, seriously erodes these protections, including for patients suffering from cardiovascular disease (CVD) – our nation’s no. 1 and most costly killer. For the patients we represent, comprehensive care can mean the difference between life and death. Healthcare is not a luxury item, it is a necessity. A recent Association study projected that nearly half of Americans will develop pre-existing CVD conditions by 2035, so it is all the more critical that access to reasonably priced, quality care is preserved and expanded, not diminished.

“Without a score from the Congressional Budget Office (CBO), it is unclear how many people will lose their health insurance coverage under this bill or be forced to pay more for the same or less adequate care. However, if the CBO analysis of the last proposal is any indication, coverage for millions of Americans will be in jeopardy. This is a serious concern to the American Heart Association as CVD patients who lack adequate coverage have worse health outcomes than patients with insurance. This latest version of the bill does little to address other issues we had with the original legislation, including the shifting of Medicaid costs to states. For these reasons and more, the AHCA fails cardiovascular disease patients across the U.S and the Association strongly opposes the bill.

“We urge the Senate to take a more thoughtful approach to our nation’s health care system and remember that American lives hang in the balance. We will continue to objectively and thoroughly evaluate all health insurance-related proposals based on our long-standing principles for healthcare reform and remain committed to working with Congress and the administration to identify and refine proposals that adhere to our principles and are fully responsive to the needs of Americans with heart disease and stroke.”

In addition, the AHA Principles for Healthcare Reform are presented in considerable detail online at http://circ.ahajournals.org/content/118/21/2209.full?related-urls=yesl118/21/2209.

1.19. American Hospital Association Statement

Listed next is the statement from the American Hospital Association (AHA) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The AHA press release containing this statement can be found online at http://www.aha.org/presscenter/pressrel/2017/050417-pr-ahca.shtml.

“America’s hospitals and health systems are deeply disappointed in the House passage of the AHCA because it will jeopardize health coverage for millions of Americans.

“Despite last-minute changes, the proposal eliminates essential protections for older and sicker patients, including those with pre-existing conditions, such as cancer patients and the chronically ill. It does little to help the 24 million Americans who would be left without coverage following repeal and makes deep cuts to Medicaid, which provides essential services for the disabled, poor and elderly people in this country.

“As the backbone of our nation’s health safety net, America’s hospitals and health systems — which include more than 270,000 affiliated physicians and 2 million nurses and other caregivers — believe it’s vital that Medicaid be protected.

“We urge the Senate to restart and reset the discussion in a manner that provides coverage to those who need it and ensures that the most vulnerable are not left behind.”

In addition, the December 6, 2016, AHA report “Estimating the Impact of Repealing the Affordable Care Act on Hospitals” concludes that if the Affordable Care Act is repealed

the number of uninsured would increase by 22 million people by 2026. The report states, “This reversal of coverage would represent an unprecedented public health crisis as individuals would lose their insurance coverage and no longer be able to follow their prescribed regimen of care. In addition, reduced Medicare and Medicaid DSH payments, if not restored in a repeal bill, would present serious challenges to hospitals, which would have to absorb the cost of uncompensated care associated with these newly uninsured individuals who need and receive hospital care.” The full report is available at http://www.aha.org/content/16/impact-repeal-aca-report.pdf.

1.20. American Lung Association Statement

Listed next is the statement from the American Lung Association regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The press release containing this statement can be found online at http://www.lung.org/about-us/media/press-releases/american-lung-association-calls-on-senate-to-protect-patients.html.

"The American Health Care Act will harm patients with lung disease and lung cancer. The American Lung Association calls on the Senate to reject the American Health Care Act. Quality and affordable healthcare with key patient protections is necessary for the health and safety of the more than 32 million Americans living with lung disease.

"The bill passed today by the House of Representatives fails the millions of Americans living with lung and other serious diseases. It will leave far too many people without quality and affordable healthcare coverage, while at the same time, rolling back key safeguards that protect patients with pre-existing conditions. The bill also significantly weakens Medicaid.The American Health Care Act will also result in the elimination of the Prevention and Public Health Fund, which funds 12 percent of the Centers for Disease Control and Prevention's budget.

"While the Affordable Care Act is by no means perfect, any changes to current law should prioritize preventing disease and preserving healthcare coverage for all Americans – regardless of income or pre-existing conditions. The American Lung Association urges the Senate to reject the American Health Care Act and instead take into account the needs of the millions of Americans with lung disease, cancer and other healthcare needs. The American Lung Association stands by,ready to work with the U.S. Senate on healthcare legislation that will improve lung health and prevent lung disease."

In addition, the American Lung Association Public Policy Agenda for the 2017-2018 U.S. Congress can be found online at http://www.lung.org/get-involved/become-an-advocate/public-policy-agenda.html.

1.21. American Medical Association Statement

Listed next is the statement from the American Medical Association (AMA) regarding the passage of the American Health Care Act by the United States House of Representatives on May 4, 2017. The AMA press release containing this statement can be found online at https://www.ama-assn.org/ama-statement-house-passage-american-health-care-act.

“The bill passed by the House today will result in millions of Americans losing access to quality, affordable health insurance and those with pre-existing health conditions face the possibility of going back to the time when insurers could charge them premiums that made access to coverage out of the question. Action is needed, however, to improve the current health care insurance system. The AMA urges the Senate and the Administration to work with physician, patient, hospital and other provider groups to craft bipartisan solutions so all American families can access affordable and meaningful coverage, while preserving the safety net for vulnerable populations.”

The AMA “Patients Before Politics” web page at https://www.patientsbeforepolitics.org/ presents detailed suggestions regarding the health care objectives listed next.

Objective 1. Ensure that individuals currently covered do not become uninsured and take steps toward achieving coverage and access for all Americans.

Objective 2. Maintain key insurance market reforms, such as coverage for pre-existing conditions, guaranteed issue, banning lifetime benefit caps and parental coverage for young adults.

Objective 3. Stabilize and strengthen the individual insurance market.

Objective 4. Ensure that low and moderate income patients are able to secure affordable and adequate coverage.

Objective 5. Ensure that Medicaid, CHIP, and other safety net programs are adequately funded.

Objective 6. Reduce regulatory burdens that detract from patient care and increase costs.

Objective 7. Incorporate common sense medical liability reforms.

Objective 8. Provide greater cost transparency throughout the health care system.

Objective 9. Continue the advancement of delivery reforms and new physician-led payment models to achieve good outcomes, high quality and lower spending trends.

1.22. American Medical Women's Association Statement

Listed next is the statement from the American Medical Women’s Association regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The press release containing this statement can be found online at https://www.amwa-doc.org/news/urge-your-senators-not-to-repeal-the-affordable-care-act/.

Help preserve affordable healthcare for millions of Americans. Preserve coverage of essential health services – such as maternal and newborn care, cancer treatment, prescription drugs, and more – and maintain affordable healthcare for millions of people with pre-existing conditions. Call your senators at 202-224-3121 and urge Congress NOT to repeal the Affordable Care Act.

These are some of the details of the new Republican proposal:

Eliminates the ACA’s guarantee of affordable coverage for people with preexisting conditions, allowing insurance companies to charge people as much as they want.

Strips healthcare from 24 million Americans and raises premiums by 20 percent.

Eliminates the guarantee that insurance companies cover maternity care, cancer treatments, and substance abuse care.

Increases out-of-pocket costs for older Americans by as much as $12,900 and allows health insurance companies to charge older Americans more in general.

Cuts Medicaid by $880 billion and ends the program as we know it, which will lead to the rationing of care for children, seniors, and people with disabilities.

Ends Medicaid expansion, meaning 11 million working families, children, people with disabilities, and seniors would lose their insurance.

Eliminates federal funding for Planned Parenthood, putting care for 2.5 million patients nationwide at risk.

Disproportionately hurts Americans living in rural areas.

In addition, the American Medical Women’s Association “Position Paper on Health Care for All” can be found online at https://www.amwa-doc.org/wp-content/uploads/2013/12/Health_Care_for_All1.pdf.

1.23. American Network of Community Options and Resources

1.24. American Nurses Association Statement

Listed next is the statement from the American Nurses Association (ANA) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The ANA press release containing this statement can be found online at http://nursingworld.org/FunctionalMenuCategories/MediaResources/PressReleases/ANA-Disappointed-with-the-Passage-of-the-AHCA.html.

The American Nurses Association (ANA) strongly opposed the American Health Care Act (AHCA) and is deeply disappointed with the passage of this legislation by the United States House of Representatives.

ANA, which represents the interests of more than 3.6 million registered nurses, has expressed serious concerns throughout negotiations about the critical impact the AHCA would have on the 24 million people who stand to lose insurance coverage if the bill becomes law.

“Over the past several weeks, nurses from across the country expressed their strong disapproval of this bill which would negatively impact the health of the nation,” said ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN. “Today, Congress not only ignored the voice of the nation’s most honest and ethical profession and largest group of health care professionals, it also ignored the almost 15 million people in the United States with pre-existing conditions who will now have no protection from insurer discrimination.”

As it is currently written, the AHCA would cut Medicaid funding by $880 billion over 10 years, dramatically increase premiums on seniors, restrict millions of women from access to health care, weaken the sustainability of Medicare, and repeal income-based subsidies that have made it possible for millions of families to buy health insurance. In addition, states would have the option to waive essential health benefit protections that prevent insurance companies from charging individuals with pre-existing conditions significantly more for coverage. Even worse, insurers could decline coverage for substance abuse treatment, maternity care, and preventive services. Late efforts to stabilize the bill’s risk pools for more than 15 million people with pre-existing conditions were wholly inadequate and will leave the nation’s sickest vulnerable.

As this legislation moves to the United States Senate, ANA urges the Senate to allow for opportunities for thoughtful, public feedback in the face of reforms that would have such a far-reaching and personal impact across the nation.

ANA asks the Senate to oppose AHCA in its current form, and stands ready to work with Senators to protect and improve health care access, quality and affordability for all.

Also, the ANA has for decades been advocating for health care reforms that would guarantee access to high-quality health care for all. Details regarding the following ANA Principles for Health System Transformation can be found online at http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/HealthSystemReform:

* Ensure universal access to a standard package of essential health care services for all citizens and residents;

* Optimize primary, community-based and preventive services while supporting the cost-effective use of innovative, technology-driven, acute, hospital-based services;

* Encourage mechanisms to stimulate economical use of health care services while supporting those who do not have the means to share in costs; and

* Ensure a sufficient supply of a skilled workforce dedicated to providing high quality health care services.

1.25. American Osteopathic Association Statement

Listed next is the joint statement from the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Congress of Obstetricians and Gynecologists, American Osteopathic Association, and American Psychiatric Association regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The joint press release containing this statement can be found online.

Our organizations, which represent over 560,000 physicians and medical students, are deeply disappointed that the U.S. House of Representatives today passed the American Health Care Act (AHCA), an inherently flawed bill that would do great harm to our patients. We urge the Senate to promptly put aside the AHCA, and instead work with our organizations to achieve real bipartisan solutions to improve affordability, access, and coverage for all.

Our members are the frontline physicians who provide physical and mental health care services to millions of patients each day. We provide care to children, the aged, those with chronic conditions, people battling addiction, and the many individuals who are seeking prevention and wellness services in an attempt to be healthier. Our members see firsthand the important role that health care coverage and access to affordable, high quality care plays in people’s lives and their pursuit of better health and well-being. They also recall those days when insurers discriminated against patients based on the patient’s age, gender, or health conditions, and when those with mental health and substance use disorders had no coverage at all.

Before and throughout the AHCA debate, our organizations continually offered constructive ideas on achieving agreement on legislation consistent with our shared principles. Regrettably, the AHCA, as amended and passed by the House, violates our principles, dramatically increasing costs for older individuals, resulting in millions of people losing their health care coverage, and returning to a system that allows insurers to discriminate against people with pre-existing conditions. We also oppose the AHCA’s Medicaid cuts, including: capping and cutting the federal government’s contribution to Medicaid, sunsetting federal funding for Medicaid expansion, and eliminating Medicaid coverage of essential benefits.

We call on the U.S. Senate to do the right thing for patients, first, by not taking up the AHCA in any form, and second by working to achieve real bipartisan solutions to ensure that coverage remains affordable; stabilizing the individual market; ensuring long-term, adequate funding for the CHIP program; making primary, preventive, and mental health and substance use services more readily available to all Americans; lowering the costs of pharmaceutical treatments; reforming our medical liability laws; and reducing the administrative and regulatory burdens that add costs and take our time away from our patients. We stand ready to assist the Congress on achieving these and other necessary improvements.

In additions, these six physician organizations have issued detailed joint recommendations for health care reform that include Maintain Coverage, Protect Patient-Centered Insurance Reforms, and System Reforms: see http://www.osteopathic.org/inside-aoa/news-and-publications/media-center/2017-news-releases/Pages/5-4-joint-principles-aafp-aap-acp-acog-apa-aoa.aspx.

1.26. American Psychiatric Association Statement

1.27. American Psychological Association

1.28. Association for Community Affiliated Plans

1.29. Association of American Medical Colleges

1.30. Association of American Physicians and Surgeons

1.31. Autism Society

1.32. Autistic Self Advocacy Network

1.33. Catholic Health Association of the United States Statement

Listed next is the statement from the Catholic Health Association of the United States (CHA) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The CHA press release containing this statement can be found online at https://www.chausa.org/newsroom/overview/2017/05/04/cha-statement-on-passage-of-the-american-health-care-act.

The Catholic Health Association is deeply disappointed with today’s vote in the House of Representatives to approve legislation that threatens the health coverage millions of Americans have gained through the Affordable Care Act. In addition, the proposed restructuring and cuts to Medicaid in the American Health Care Act will have devastating consequences for the many poor and vulnerable populations who rely on the program. The most recent amendments to the bill did nothing to alleviate those concerns, and in fact have made the legislation even more troubling by jeopardizing important protections for those with pre-existing conditions.

As this legislation moves now to the Senate, CHA will continue to work with lawmakers to address these issues. And on behalf of those we serve in Catholic health care, we will continue to advocate a health care system in which accessible and affordable health coverage is available for everyone.

In addition, detailed information regarding the CHA “Affordable Care Act” Focus Area can be accessed online at https://www.chausa.org/affordable-care-act/overview.

1.34. Children's Hospital Association Statement

Listed next is the statement from the Children’s Hospital Association regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The press release containing this statement can be found online at https://www.childrenshospitals.org/Newsroom/Press-Releases/2017/Childrens-Hospitals-to-Senate-AHCA-Fails-Kids-Reject-the-Bill.

Today, the U.S. House of Representatives voted to approve the American Health Care Act (AHCA), putting the health of more than 30 million children who rely on Medicaid at risk. The AHCA drastically cuts Medicaid and does not protect coverage, benefits and access to care for children. As the Senate considers the bill, children’s hospitals urge senators to reject the House bill.

The AHCA as passed by the House would be disastrous for our nation’s children. The bill cuts state health care budgets by more than $800 billion over 10 years — children could see their health care cut by tens of billions of dollars. Other changes contained in the bill would make the health care system worse for children, not better.

On behalf of our nation’s children’s hospitals and the patients and families they serve, Children’s Hospital Association asks the Senate to safeguard Medicaid for children. Now is the time to protect our children — the future of our nation.

In addition, the Children’s Hospital Association has a detailed Issues Brief on the subject of “The Case for Investing in Child Health as a Matter of Our Nation’s Security, Economy and Well-being” available online.

1.35. Children's Rights

1.36. Christopher & Dana Reeve Foundation

1.37. Coalition to Stop Opioid Overdose

1.38. Cystic Fibrosis Foundation Statement

Listed next is the statement from the Cystic Fibrosis Foundation regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The press release containing this statement can be found online at https://www.cff.org/News/News-Archive/2017/House-of-Representatives-Passes-Health-Care-Reform-Legislation/.

Today, the U.S. House of Representatives voted to pass the American Health Care Act (AHCA). This is the first step in a multi-step process. The Senate will consider the legislation next and is expected to make significant changes to the bill.

“The American Health Care Act, as passed by the House today, is woefully inadequate for people with cystic fibrosis,” said Preston W. Campbell, M.D., president and chief executive officer of the Cystic Fibrosis Foundation. “The people who would be most severely impacted by this legislation seem to have been forgotten in the health care debate and we implore the Senate to do better for people living with chronic and life-threatening diseases, including people with CF.”

The AHCA would repeal some provisions of the Affordable Care Act and enact the following changes that are extremely concerning for people with cystic fibrosis:

Allow states to let insurers charge higher prices to people with pre-existing conditions

Eliminate Medicaid coverage for millions of Americans and alter the program's financing structure in a way that puts coverage of new and innovative treatments at risk

Allow states to waive the guarantee of essential health benefits, segmenting the market into plans for sick people and plans for healthy people, and likely driving up the cost of plans that provide more robust benefits

Provide inadequate funds to help people with intensive health care needs get coverage through the individual market

Open the door for states to bring back high-risk pools, which are an unacceptable and unreliable option for health insurance

Result in health plans covering a lower share of patients' medical expenses, on average, which means higher out-of-pocket costs for individuals

Give young people less financial assistance to purchase a plan through the individual insurance market than older individuals, which could leave younger people with CF without enough support to purchase a plan that covers the breadth of their specialty care

Effectively remove protections against annual and lifetime caps, even for the millions of Americans with employer-sponsored insurance

Since the AHCA was introduced, the Foundation has been outspoken about its opposition to the bill and how it would negatively affect our community's ability to access high-quality, specialized CF care. Most recently, we joined seven other leading patient advocacy groups to issue a statement reinforcing that the latest amendment still failed to protect people with pre-existing conditions.

Learn more about how we have engaged with the current administration and Congress on this topic and visit our advocacy action center to get involved. As this bill moves to the Senate, we will continue our advocacy to ensure that people with CF have access to the care and treatments they need to stay healthy.

In addition, the priorities for the cystic fibrosis community in health care reform can be found online at https://www.cff.org/Get-Involved/Advocate/Health-Care-Reform/Priorities-for-the-CF-Community-in-Health-Care-Reform/.

1.39. Endocrine Society Statement

Listed next is the statement from the Endocrine Society regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The press release containing this statement can be found online at https://www.endocrine.org/news-room/current-press-releases/endocrine-society-gravely-disappointed-in-house-passage-of-american-health-care-act.

The United States House of Representatives today passed the American Health Care Act (AHCA), a piece of legislation intended to replace the Affordable Care Act. The Society opposed the legislation which would make coverage more expensive — if not out of reach — for poor and sick Americans.

The AHCA does not meet the Society’s core health reform principles to guarantee health insurance coverage with no life-time or annual caps or pre-existing condition exclusions; provide an option for young adults to remain on their parent’s insurance until age 26; protect against unreasonable out-of-pocket costs; and ensure access to preventive health services and women’s reproductive healthcare.

The AHCA would impact the most vulnerable by granting states the right to determine which essential health benefits must be covered by insurers in their state, ultimately stripping away protections for people with pre-existing conditions and allowing insurers to charge them substantially more, effectively denying coverage due to high costs.

The additional $8 billion included in the AHCA to set up high-risk pools to protect people with pre-existing conditions will not be nearly enough to cover enrollees in the individual market who have a pre-existing condition.

Now that the AHCA has been approved by the House, it will go to the Senate for consideration. It is not clear, however, if the legislation will comply with Senate rules that block consideration if it would significantly increase the federal deficit beyond a ten-year term or is an “extraneous matter” as set forth in the Budget Act. The Society will continue to advocate for its core principles and encourages others to contact their Senators to make their voices heard.

In addition, the January 2017 Endocrine Society statement on “Priorities for Health System Reform” can be accessed online at https://www.endocrine.org/advocacy-and-outreach/society-statements.

1.40. Families USA

1.41. HIV Medicine Association Statement

Listed next is the statement from the HIV Medicine Association (HIVMA) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The HIVMA press release containing this statement can be found online at http://www.hivma.org/Passage_AHCA/.

We are disheartened by today’s passage of the American Health Care Act by the U.S. House of Representatives and deeply concerned about its negative impact on patients with HIV. The AHCA dismantles key health reforms that have been pivotal to ending discriminatory practices that previously locked patients with HIV out of the individual insurance market and that guaranteed access to coverage for key services, including prescription drugs and mental health and substance use treatment. The bill’s retreat in supporting healthcare access under Medicaid for individuals who are low income and disabled stands to do the most harm, particularly to the 42% of patients with HIV who count on the Medicaid program. HIV is an infectious disease, and we know that “treatment is prevention.” In other words, the best way to prevent HIV is to keep in care and on treatment those who are infected. By decreasing access to HIV care and treatment, the AHCA may worsen the HIV epidemic in the US at a time when new infections were beginning to go down.

We urge the Senate to reject the AHCA and work to improve rather than worsen access to health coverage and healthcare through meaningful interventions that will stabilize the individual health insurance market and that maintain our nation’s federal commitment to the Medicaid program. Our country cannot be great if we do not make it a priority for everyone, including persons with HIV, to have access to health care.

In addition, the HIVMA 2017 Policy Agenda can be found online at http://www.hivma.org/uploadedFiles/HIVMA/Policy_and_Advocacy/Current_Topics_and_Issues/2017%20Priorities%20HIVMA%20Board.pdf.

1.42. Juvenile Diabetes Research Foundation

1.43. March of Dimes

Listed next is the statement from the March of Dimes regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The press release containing this statement can be found online at http://www.marchofdimes.org/news/statement-of-stacey-d-stewart-president-march-of-dimes-on-house-passage-of-the-american-health-care-act.aspx.

“The March of Dimes is profoundly disappointed in today’s House passage of the American Health Care Act, a bill expected to eliminate health insurance coverage for 24 million Americans, including millions of women, children and families.

“The American Health Care Act fails to serve the needs of pregnant women, mothers, and babies across our nation. The March of Dimes estimates 6.5 million low-income women of childbearing age will lose coverage, denying them the ability to get healthy before they get pregnant. Classifying pregnancy as a pre-existing condition – and charging exorbitant rates for maternity benefits -- would effectively put medical care out of reach for millions of women at a time when they need it most. Many Americans could find that their health plans are specifically written to exclude the care they are most likely to need. This is not the solution to our health system’s challenges that women and families are asking for.

“The American Health Care Act fails to protect too many Americans: pregnant women, couples considering starting a family, and infants born preterm or with birth defects, among many others. With House passage of this bill, the responsibility now falls to the Senate to take a more measured, evidence-informed approach. Senators should solicit the meaningful input of stakeholders across the entire health care system and use that expertise to develop a plan with targeted solutions to the specific problems identified. The March of Dimes looks forward to working with Senators on both sides of the aisle to develop a proposal that will ensure quality, affordable health coverage for all Americans.”

In addition, the March of Dimes “Access to Care Fact Sheet” can be found online at http://www.marchofdimes.org/March-of-Dimes-Access-to-Care-Fact-Sheet-February-2017.pdf.

1.44. National Association of Social Workers

1.45. National Council on Aging

1.46. National Disability Rights Network

1.47. National Multiple Sclerosis Society Statement

Listed next is the statement from the National Multiple Sclerosis Society regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The press release containing this statement can be found online at http://www.nationalmssociety.org/About-the-Society/News/National-MS-Society-Disappointed-with-House.

The National MS Society is bitterly disappointed by the outcome of today’s House vote in support of the American Health Care Act. People living with MS and their families will be significantly harmed if the American Health Care Act becomes law, and will surely be among those to lose coverage and care as tax credits are slashed, Medicaid is weakened, and protections for people with pre-existing conditions are eroded. The Society has and will continue to advocate for improvements to health coverage that meet the needs of people with MS.

Bari Talente, Exec VP of Advocacy for the Society stated “This vote brings uncertainty for people with MS and others with pre-existing conditions whose wellbeing--and sometimes, lives--depend on affordable and comprehensive coverage. The Society is extremely disappointed to see the House pass legislation that jeopardizes coverage and care for those with MS and relies on underfunded and failed insurance experiments -- like high-risk pools. This measure will increase the number of uninsured Americans by more than 20 million and substantially weaken Medicaid. That is unacceptable and moves our country backwards, not forward.”

People with MS can only live their best lives with the assurance of access to prescription drugs that delay disease progression and disability, rehabilitation therapies to help maintain function and prevent falls, symptom management, professional medical and mental health services, mobility devices and more. These are components of high quality MS care that are currently included in the essential health benefits now put at risk by the American Health Care Act (AHCA). Also at risk are critical protections including annual caps on out-of-pocket costs, plus prohibitions against lifetime and annual caps on benefits.

Changes to Medicaid—including changing its financing structure to a per capita cap and phasing out Medicaid expansion—are estimated to reduce support for Medicaid by $880 billion over 10 years. Cuts of this magnitude will force states to cut eligibility, services or provider payments – all of which will likely harm access to MS care for Medicaid enrollees and hospital-based MS clinics.

We now turn to the Senate in the hope they will act responsibly and swiftly to preserve the individual health insurance market and Medicaid program. We stand ready to work with the Senate and urge them to consider the real experiences and perspectives of people who rely on America’s health insurance system and deserve better than the American Health Care Act.

In addition, the National Multiple Sclerosis Society “Access to High Quality MS Healthcare Principles” can be found online.

1.48. National Nurses United

1.49. National Organization for Rare Disorders Statement

Listed next is the statement from the National Organization for Rare Disorders (NORD) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The NORD press release containing this statement can be found online at https://rarediseases.org/nord-issues-statement-house-passes-american-health-care-act/.

“Today the House of Representatives passed American Health Care Act (AHCA). We are very disappointed the House pursued and passed this legislation, and we will continue to do everything we can to prevent this legislation as it is currently written from being enacted.

The AHCA jeopardizes the health and wellbeing of rare disease patients across the country. The bill allows states to opt-out of critical pre-existing conditions protections, including the prohibition on annual and lifetime caps and community rating.

Community rating prohibits insurers from charging individuals higher premiums based on health status. Without a community rating, pre-existing conditions protections are rendered moot, as insurance companies will once again be capable of charging higher premiums to those with pre-existing health conditions. Community rating is essential to maintaining access to quality and affordable healthcare coverage for rare disease patients.

In addition, the bill allows states to set their own Essential Health Benefits (EHB) categories rather than complying with the ten Federal EHB categories. Both the prohibition on annual and lifetime caps as well as the maximum out-of-pocket caps apply only to the EHB categories. If the EHBs are turned over to states, states could choose to allow insurers to once again set annual and lifetime caps on medically necessary services for rare disease patients by only mandating coverage of certain EHBs. States could also allow insurers to set prohibitive cost-sharing amounts without any out of pocket cap. We strongly oppose this measure as it is unacceptable to once again expose rare disease patients to these draconian caps and cost-sharing requirements.

Under the AHCA, federal funding of Medicaid would be substantially weakened by per capita caps and block grants, resulting in states potentially delaying or outright refusing coverage for necessary care under Medicaid. Rare disease patients seeking expanded Medicaid coverage would be turned away after 2019, and additional Federal assistance for the 1915(k) Community First Choice program would be removed. Many rare diseases are financially catastrophic with families often having no choice but to become single-income households because either an adult is sick, or a parent must stop working in order to become a sick child’s primary caregiver.

We remain unconvinced that the continuous coverage proposal will adequately incentivize healthy individuals to enter the market to stabilize premiums, or that the tax credit structure will provide enough assistance to low-income individuals with rare diseases seeking coverage.

We have said throughout this process that we are committed to assisting Congress and the Administration as they navigate ACA repeal and replace. We remain committed today to ensuring that Congress enacts legislation that improves the health and wellbeing of rare disease patients across the country. With continued dialogue and collaboration, we hope to be able to support legislation that improves the lives and wellbeing of rare disease patients.”

In addition, the NORD statements about “Ensuring Access to Affordable Treatment” can be accessed online at https://rarediseases.org/advocate/policy-priorities/issues/.

1.50. National Physicians Alliance Statement

Listed next is the statement from the National Physicians Alliance (NPA) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The NPA press release containing this statement can be found online at http://npalliance.org/blog/2017/05/04/national-physicians-alliance-statement-american-health-care-act-vote/.

The American Health Care Act (AHCA), passed today by the House of Representatives, will lead to 24 million fewer insured Americans, eliminate protections for those with preexisting conditions, gut coverage requirements by eliminating essential health benefits and end Medicaid as we know it.

“As physicians, we know how that this legislation will devastate millions of our patients, increase costs of healthcare and significantly hinder our ability to fight disease. The last-minute changes to this bill only made it worse and the high-risk pools will do little to address the millions of Americans who will face drastically higher premiums simply because of preexisting condition”, said Dr. Manan Trivedi, President of the National Physicians Alliance.

“We urge the Senate to stand up for their constituents and oppose this legislation.”

In addition, the NPA has the following Fact Sheets available online at http://npalliance.org/equitable-affordable-health-care-for-all/secure-health-care-for-all/:

* The New American Health Care Act: Dangerous Changes for Patients, Communities, and our Country;

* Affordable Care Act Repeal: Impact on Patients & Communities;

* Medicaid Block Grants: Unhealthy for Patients, States, and Our Nation; and

* ACA Impact on Opioid Use Disorder..

1.51. Physicians for Reproductive Health Statement

Listed next is the blog statement from the Physicians for Reproductive Health regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. This blog statement be found online at https://prh.org/press-releases/ahca-direct-attack-reproductive-health-care/.

“Today, Congress and the Trump administration directly attacked reproductive health care. Despite outcry from across the nation, the House voted to pass the American Health Care Act (AHCA) and take insurance coverage away from 24 million people. President Trump also signed an executive order that would make it easier for employers to deny contraception coverage to their employees.

The AHCA removes many of the provisions that currently ensure Americans have access to affordable health care, weakens protections for patients with pre-existing conditions, reduces coverage of essential health services, and increases premium costs. It decimates the Medicaid program, taking away health care from millions of Americans and disproportionately impacting low-income women and women of color. It is appalling that the House would push forward legislation that offers no significant improvements to the bill that was rejected just last month—and that they would rush to pass the bill without a thorough analysis from the Congressional Budget Office.

The AHCA is also a targeted attack against reproductive health. It blocks Medicaid patients from using their insurance at Planned Parenthood health centers, which are the only source of health care for many Americans, as well as an essential provider of family planning services that help avert unintended pregnancies. The bill allows states to opt out of covering essential medical benefits including maternity care, which is one of the highest medical expenses families can incur. It includes financial disincentives for private insurance plans to cover abortion care, which is a fundamental, necessary component of reproductive health care.

This bill is part of a larger campaign by this administration to attack reproductive health care. Particularly in light of today’s executive order that uses religious freedom as a cover for allowing employers to deny contraceptive coverage, there is a clear pattern of politicians trying to make it as difficult as possible for people to access vital reproductive health services.

I am terrified for my patients and for the health of this country. As a physician, I know that patients and families suffer when they are unable to obtain comprehensive, compassionate health care. Congress should be ashamed to pass legislation that puts health care out of reach for millions of Americans. As this bill moves on to the Senate for consideration, physicians must continue to fight for the health and well-being of all of our patients.”

In addition, information about the “Patients Reproductive Health Act” supported by the Physicians for Reproductive Health can be found online at http://www.ppawi.org/issues/current-issues-legislation/2016prha.cmsx.

1.52. Planned Parenthood

1.53. WomenHeart: The National Coalition for Woman With Heart Disease Statement

Listed next is the statement from the WomenHeart: The National Coalition for Women with Heart Disease regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The WomenHeart press release containing this statement can be found online at http://c.ymcdn.com/sites/www.womenheart.org/resource/resmgr/press_releases/2017_Response_to_AHCA_-_FINA.pdf.

WomenHeart: The National Coalition for Women with Heart Disease is opposed to The American Health Care Act, because it does not improve access to quality, affordable healthcare for women with heart disease.

“Heart disease is the number one killer of women in America. Access to primary, specialty, subspecialty, and public health care, with a full range of essential health benefits, is fundamental to addressing this national health issue,” said Mary McGowan, CEO of WomenHeart. “If women with heart disease receive the prevention, care, treatment and rehabilitation they need, avoidable costs will be minimized, and patients will live longer and healthier lives. On behalf of the nearly 48 million women living with or at risk for heart disease, we ask our elected officials to put aside political differences and do what is best for patients."

In addition, the WomenHeart policy recommendations to improve access to health care for women with heart disease can be found online at http://www.womenheart.org/?page=takeaction_principle.

The twenty advocacy groups listed next support the version of the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017.

1.54. American Center for Law and Justice Statement

Listed next is the statement from the American Center for Law and Justice regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. This statement can be found online at https://aclj.org/obamacare/breaking-house-votes-to-repeal-obamacare-defund-planned-parenthood-fight-moves-to-the-senate.

The House of Representatives has just voted to repeal ObamaCare and defund Planned Parenthood.

This is a tremendous pro-life, pro-freedom victory for all Americans. We’ve been fighting for this for the better part of a decade.

We're very pleased that the House has followed through with one of President Trump's key promises to America: the repeal and replacement of Obamacare. We have advocated for an ObamaCare repeal for a long time, and today the House acted – your voice was heard.

With the passage of the replacement bill, we have also taken a big step toward defunding Big Abortion. The measure that has just cleared the House defunds Planned Parenthood – ending the payment of hundreds of millions of dollars a year in taxpayer funds to this abortion giant. With the passage in the House, our attention now turns to the Senate, where a new battle begins. We remain committed to ensuring that Americans receive health coverage they can afford and bringing an end to the long-standing use of taxpayer dollars to fund Planned Parenthood.

Here are some of the basics (we will have more detailed analysis in the days ahead).

First, the bill repeals ObamaCare, gutting the pro-abortion, anti-freedom healthcare debacle as much as possible through the reconciliation process (more on that below). It takes the ballooning, costly IRS tax/penalties down to $0 – effectively crippling the individual mandate and the employer mandate and beginning the process of dismantling the abortion-pill mandate (something further dismantled by today’s religious liberty Executive order).

The bill also provides critical opt-out provisions to States allowing them to opt out of a lot of the worst features of ObamaCare. The bill also provides the most significant entitlement reform we’ve ever seen, giving the states far more power over Medicaid spending.

Second, the bill defunds Planned Parenthood. It takes nearly a half a billion dollars – your money that for years you have been forced to subsidize the largest abortion provider in the nation – away from the abortion mill. ... Planned Parenthood gets more than $527 million in federal funding, the vast majority of which comes through Medicaid reimbursements. Under the terms of this bill, Planned Parenthood would be prohibited from receiving those taxpayer dollars.

While the House vote is a tremendous, long-awaited victory, the fight is far from over. Now the fight moves to the U.S. Senate.

Because this measure was passed through something called the reconciliation process, the Senate only needs a majority vote – it is filibuster proof – to put this critical legislation on the President’s desk. ... The advantage of budget reconciliation for major legislation (such as the Clinton-era welfare reform or ObamaCare) is that it makes the legislation filibuster-proof and only requires 51 votes in the Senate. This is why President Obama used it to pass ObamaCare initially, which means that that the Trump Administration, Speaker Ryan, and Leader McConnell can use the same process to repeal ObamaCare.

It is time for leadership in the Senate. It is time for action. The process to get to this point has been tenuous. The Senate must immediately take this bill up and pass legislation that both houses can agree on to repeal pro-abortion ObamaCare and defund Planned Parenthood.

The time for posturing and postponement is over. It is time to lead. It’s time to keep a sacred promise to the American people.

In addition, the American Center for Law and Justice statement "The Obama Administration’s Obamacare Deception Threatens America" can be found online at https://aclj.org/obamacare/the-obama-administrations-obamacare-deception-threatens-america.

1.55. American Conservative Union Statement

Listed next is the statement from the American Conservative Union regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. This statement can be found online at http://conservative.org/acu-statement-american-health-care-act-ahca/.

Over the past six weeks since the American Health Care Act (AHCA) was withdrawn, there have been some positive developments in crafting legislation that will allow Americans to choose health insurance that best fits their needs.

Positive aspects of the bill include the elimination of the individual and employer mandates, the elimination of most of the numerous taxes imposed under Obamacare, reforming the Medicaid payment system and the option of Medicaid block grants to states, a proposal long championed by conservatives, and blocking federal funding for Planned Parenthood, diminishing support of the abortion industry with tax dollars.

Conservatives have played a leading role in drafting amendments to the bill, including one that allows the states to lessen the heavy hand of federal mandates through the waiver process.

Although flaws remain, including the delay in implementing parts of the bill until 2020 and a new penalty for lapsed coverage, the good features of the bill also remain.

This is still the first step in the process and changes will inevitably be made in the Senate and in a conference committee after that. It is imperative that the House take action to fulfill promises made to voters. It is even more evident now than in March that Obamacare is an abject failure and this is probably the one chance Congress will have to repeal and replace it. We urge conservatives to support this bill in the House.

In addition, another American Conservative Union statement on healthcare can be found online at http://conservative.org/acu-statement-upcoming-house-healthcare-vote/.

1.56. Americans for Tax Reform Statement

Listed next is the statement from the Americans for Tax Reform regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. This statement can be found online at http://www.atr.org/americans-tax-reform-will-rate-vote-ahca-hr-1628-0.

Americans for Tax Reform WILL RATE a vote for passage of the American Health Care Act as a pro-taxpayer vote

ATR urges a YES vote

“The American Health Care Act is a $1 trillion tax cut and a $1.1 trillion spending cut over the next decade. It's passage makes fundamental tax reform possible this year. The AHCA block grants Medicaid and expands Health Savings Accounts. It will ensure states are able to implement a healthcare system that best fits their needs. The bill is a giant step forward in lowering taxes and reforming our nation's health care system,” said Grover Norquist, president of Americans for Tax Reform.

The American Health Care Act (HR 1628) being voted on today abolishes the following taxes imposed by Obama and the Democrat party in 2010 as part of Obamacare:

-Abolishes the Obamacare Individual Mandate Tax which hits 8 million Americans each year. This is part of a $270 billion tax cut.

-Abolishes the Obamacare Employer Mandate Tax. This is part of a $270 billion tax cut.

-Abolishes Obamacare’s Medicine Cabinet Tax which hits 20 million Americans with Health Savings Accounts and 30 million Americans with Flexible Spending Accounts. This is a $6 billion tax cut.

-Abolishes Obamacare’s Flexible Spending Account tax on 30 million Americans. This is a $20 billion tax cut.

-Abolishes Obamacare’s Chronic Care Tax on 10 million Americans with high out of pocket medical expenses. This is a $126 billion tax cut.

-Abolishes Obamacare’s HSA withdrawal tax. This is a $100 million tax cut.

-Abolishes Obamacare’s 10% excise tax on small businesses with indoor tanning services. This is a $600 million tax cut.

-Abolishes the Obamacare health insurance tax. This is a $145 billion tax cut.

-Abolishes the Obamacare 3.8% surtax on investment income. This is a $172 billion tax cut.

-Abolishes the Obamacare medical device tax. This is a $20 billion tax cut.

-Abolishes the Obamacare tax on prescription medicine. This is a $28 billion tax cut.

-Abolishes the Obamacare tax on retiree prescription drug coverage. This is a $2 billion tax cut.

The AHCA Also Has Big League Spending Cuts:

Under AHCA, by 2021 federal spending on healthcare as a percentage of GDP is reduced from 6.9% to 6.3%. As time goes by, the spending reduction gets larger.

Under AHCA, by 2027 total federal spending as a percentage of GDP is reduced from 23.4% to 22.4%.

“In addition to abolishing Obamacare’s taxes, the AHCA reduces the total size of government permanently,” said Norquist.

Also, the Americans for Tax Reform statement "CBO Uses Failed Model to Score AHCA" can be found online at http://www.atr.org/cbo-uses-failed-model-score-ahca.

1.57. Associated General Contractors of America Statement

Listed next is the statement from the Associated General Contractors of America (AGC) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. This AGC statement can be found online at http://advocacy.agc.org/house-passes-health-care-bill-begins-repeal-process-of-affordable-care-act/.

This week, the U.S. House of Representatives passed the American Health Care Act (AHCA) after months of heated and contentious negotiations among Republicans and the administration on the process of repealing the Affordable Care Act (ACA). AGC originally opposed the ACA because we did not believe that it created a framework to reduce health care costs, but instead increased new compliance and complexity problems for employers. The reforms provided in the AHCA will reduce complexity and compliance problems for employers and help reduce the cost of health care so employers can maintain and expand the health care benefits they offer their employees.

AGC has long supported the employer-provided health care model while, at the same time, ensuring that it is easy and affordable for employers to provide coverage to their employees. AGC supports increased flexibility to offer construction employers the ability to expand coverage to their employees and limit the financial hardships of purchasing health care services and the repealing of onerous taxes will lead to health insurance premium savings.

The outlook for Senate action remains uncertain. However, if a repeal bill does pass the Senate it would likely be different than the bill that passed the House today, which would lead to further changes and compromises before being signed into law. Today’s vote starts the repeal process but changes to the law remain in the works.

1.58. Association of Mature American Citizens Statement

Listed next is the statement from the Association of Mature American Citizens (AMAC) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. This AMAC statement can be found online at https://amac.us/wont-rest-american-health-care-act-law-says-amac/.

Dan Weber, president of the Association of Mature American Citizens, warns that “liberals in Congress will continue to sabotage efforts to repeal and replace Obamacare. They see President Obama’s so-called Affordable Care Act as a first step toward a single-payer system which is, itself, a first step toward the creation of a socialist state here in the U.S.”

Self-declared socialist Senator Bernie Sanders is as outspoken a proponent of single-payer health care coverage as he is a booster of the movement to convert America into a socialist country, says Weber.

However, the AMAC chief adds, neither universal health insurance nor the restructuring of our political system is in the cards. As health policy expert Dr. Timothy Callaghan put it: “Americans, and conservatives in particular, have a strong belief in classical liberalism and the idea that the government should play a limited role in society.”

The argument that single-payer health care works in other countries such as England, Canada and France is bogus, Weber says. There are numerous reports of the failings of their systems. Britain’s Care Quality Commission says that country’s health system is on the verge of collapse. Meanwhile, government spending for healthcare in France is over budget by billions of Euros each year and some say that universal health care there cannot survive.

“So much for the cost benefits of single-payer insurance. What about issues such as the fewer health care options that would be available under universal healthcare,” says the head of America’s most powerful conservative senior advocacy organization. “Choice is important. We don’t want the government to dictate how we receive care, nor do we want the government to tell us how much care we get before it decides to pull the plug.”

Paul Krugman is an economist and a liberal but not so much a supporter of universal health care. He points out that in order to have a single-payer system that might work, we would need to keep costs down. And that would mean we’d have to “say no to patients, telling them that they can’t always have the treatment they want.”

A few years back Michael Tanner at the Cato Institute produced a paper in which he showed that Universal Health Care [is] Not Best Option. First and foremost he noted that “universal health insurance does not necessarily mean universal access to health care. In practice, many countries promise universal coverage but ration care or have extremely long waiting lists for treatment. Those countries that have single-payer systems or systems heavily weighted toward government control are the most likely to face waiting lists, rationing, restrictions on the choice of physician, and other barriers to care.”

If Congressional liberals get their way, Weber concludes, we could likely end up with the kind of rationed health care that Tanner talked about. “We would have to forget not only about keeping our doctors and keeping our choices, we’d also have to forget about keeping our health. And that is why AMAC will not rest until the American Health Care Act is the law of the land and ultimately succeeds in repealing and replacing Obamacare.”

In addition, the AMAC statement "CBO Is Wrong And Its Numbers Shouldn’t Deter Needed Reform" can be found online at https://amac.us/cbo-wrong-numbers-shouldnt-deter-needed-reform/.

1.59. Catholic Medical Association Statement

Listed next is the statement from the Catholic Medical Association (CMA) regarding the American Health Care Act as released by the House Republicans on March 6, 2017. This CMA statement can be found online at http://www.cathmed.org/wp-content/uploads/2017/03/PR-NewAmerHlthCareAct-Draft5-030817.pdf.

The Act proposes to improve patient-physician relationships and health care for Americans. It will dismantle Obamacare’s damaging taxes and mandates, and aims to deliver quality, affordable options based on what patients and families truly need. Under Obamacare, premiums increased dramatically; contraceptive mandates led to significant lawsuits; and nearly 1/3 of all U.S. counties now have only one insurer offering plans on their state’s exchange.

The new legislation removes individual and employer mandate penalties, which forced millions of people into expensive, inadequate plans. It expands Health Savings Accounts (HSAs), nearly doubling the amount of money people can contribute, and broadening how people can use them. It provides a monthly tax credit—between $2,000 and $14,000 a year—for low- and middle-income individuals and families who don’t receive insurance through work or a government program. It protects patients by prohibiting health insurers from denying coverage based on pre-existing conditions. It is expected the new plan will decrease premiums and enhance health care options for Americans, by allowing more innovation and competition in the health care market.

For Medicaid, there will be a stable transition period where the previous expansion will continue until 2020. It will then move to a "per capita allotment" so states can best serve patients most in need. Also, anyone then without work/government program-obtained insurance can obtain advanceable, refundable tax credits to access coverage. The CMA would support a final bill that provides and does not deny coverage for indigent patients.

The new Act does not fund abortion, staying consistent with the bipartisan Hyde Amendment. Obamacare subsidized abortion; this bill provides monthly healthcare tax credits, with provisions that prevent these credits from being used to fund abortion. However, there are pro-life concerns that the Senate may use strict budget rules to strip out such provisions banning funding for abortion. The CMA urges all members of Congress to ensure the protection of unborn babies in the final bill and that it not be turned into a political bargaining chip in any way.

There is much work remaining for Congress and the administration, including markups of the bill, compiling a final product, and voting. The CMA applauds the release of the American Health Care Act, and hopes that the final bill will defend the lives of the unborn, protect conscience rights, preserve the patient-doctor relationship, and give Americans a health care proposal that builds a culture of life and recognizes God’s design for marriage and the family.

In addition, the CMA position on health care reform can be found online at http://www.cathmed.org/programs-resources/health-care-policy/health-care-reform/.

1.60. Center of the American Experiment Statement

Listed next is the statement from the Center of the American Experiment regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. This statement can be found online at https://www.americanexperiment.org/2017/05/republicans-take-critical-first-step-protect-health-insurance-coverage-millions/.

After a couple of false starts, Republicans in the U.S. House passed a bill to follow through on their promise to repeal and replace Obamacare.

Getting this bill passed was a critical first step in saving health coverage for the millions of Americans who are experiencing the collapse of the individual health insurance market under the weight of Obamacare’s regulations.

Several state insurance markets are in the throes of a death spiral—a situation where a market implodes after cycles of rising premiums prompt healthy people to abandon the market, leaving behind an unsustainably sick and expensive pool.

The benchmark plan the Kaiser Family Foundation uses to compare premiums across states shows eighteen states experienced double-digit premium increases in the past year. Since 2014, fifteen states experienced a 50 percent or higher increase and five states posted a jump exceeding 100 percent. Markets cannot sustain this level of premium increases.

In the last day, news surfaced of even more trouble stirring in state insurance markets. Aetna announced it will no longer serve the Virginia market. Already, people living in 1 in 3 counties in America have only one insurer available. Aetna’s departure from Virginia could add another 27 counties to this list.

Going down to one insurer is bad enough, but several counties in Iowa may have no insurance options in 2018. Last month Aetna and Wellmark Blue Cross & Blue Shield announced they would pull out of the market in 2018 and Medica just threatened to follow suit. the Des Moines Register reports that “the carriers’ exit could leave more than 70,000 Iowans who buy their own coverage without any options for 2018.”

The rise in premiums and the decline in choice across so many state individual insurance markets in 2017 represents a watershed moment. Many of these markets now look nothing like they did before Obamacare, which goes to show Obamacare isn’t just failing, it’s failed. Republicans have no choice but to fix it.

Unfortunately, the next leg of the road to getting a good bill to President Trump’s desk looks even bumpier than this first. The Senate has a much thinner majority and includes four members who have already published a letter stating they “will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states.”

While the House dealt with divisions between moderates and conservatives over how to protect people with pre-existing conditions, the letter from the four senators suggests the Senate will now need to address divisions over how to cover low-income households.

Though the road ahead will be difficult, Republicans do seem to be catching on to the urgency and the necessity of getting a good bill passed. With each new announcement of an insurer abandoning a state market, the road to repeal and replace should get smoother.

In addition, the Center of the American Experiment statement "CBO score of House GOP healthcare bill wrong on the impact of state waivers" can be found online at https://www.americanexperiment.org/2017/05/cbo-score-house-gop-healthcare-bill-wrong-on-the-impact-of-state-waivers/.

1.61. Concerned Women for America Statement

Listed next is the statement from the Concerned Women for America regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. This statement can be found online at https://concernedwomen.org/capitol-hill-brief-new-health-care-bill-protects-life/.

Friends, the day has arrived! We are at the cusp of defunding Planned Parenthood and repealing big parts of ObamaCare, creating an environment for quality patient care for all Americans.

The health care bill going through congress right now is not perfect, but it is a dramatic improvement on the ObamaCare disaster.

And I can assure you of this: It explicitly protects life in unprecedented ways, unlike ObamaCare with its abortion mandate.

Many lives will be saved by this legislation as millions of your tax dollars are diverted away from Planned Parenthood’s abortion promotion and towards Federally Qualified Healthcare Centers.

That is why big abortion’s most powerful voices are trying to stop it.

In addition, the Concerned Women for America statement "Capitol Hill Brief - Support the New Health Care Bill" can be found online at https://concernedwomen.org/capitol-hill-brief-support-the-new-health-care-bill/.

1.62. Council for Citizens Against Government Waste Statement

Listed next is the statement from the Citizens Against Government Waste (CCAGW) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. This CCAGW statement can be found online at https://www.ccagw.org/media/press-releases/council-citizens-against-government-waste-celebrates-house-passage-american.

The Council for Citizens Against Government Waste (CCAGW) applauded passage by the House of Representatives of H.R. 1628, the American Health Care Act (AHCA), which is the first major step in repealing and replacing the Patient Protection and Affordable Care Act (Obamacare).

CCAGW President Tom Schatz said, “On behalf of CCAGW’s more than one million members and supporters, I am pleased that House Republicans reached an agreement and made good on their promise to repeal and replace Obamacare. For seven long years, Obamacare has plagued Americans with dreadful mandates and taxes, which have caused premiums and deductibles to skyrocket, while insurers have been fleeing from the marketplace. Taxpayers can delight in the hope that the Senate will soon do its part so that America’s long healthcare nightmare will end.”

The AHCA includes numerous pro-taxpayer reforms, including repeal of the individual mandate and the employer mandate penalty taxes, along with the termination of taxes on medical devices, pharmaceuticals, and health insurance, all of which have driven up costs. The bill grants states unprecedented flexibility to be “laboratories of democracy” in how they serve the needs of low-income citizens, individuals with special health needs, and those with pre-existing conditions, while also providing financial stability to the healthcare system.

The bill also accomplishes the most substantial reforms to Medicaid since the program was enacted in 1965. It halts further fiscally irresponsible Medicaid expansion, and modernizes financing of the program by utilizing block grants, which would allow states to innovate and deliver better healthcare for their citizens.

The House also passed H.R. 2192, which ensures that members of Congress and their staff are no longer exempt from Obamacare, and will be subject to the same system as everyone else.

In addition, the CCAGW statement "That CBO Score for the American Health Care Act" can be found online at https://www.cagw.org/swineline/cbo-score-american-health-care-act.

1.63. Family Research Council Statement

Listed next is the statement from the Family Research Council regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The press release containing this statement can be found online at http://www.frc.org/newsroom/family-research-council-praises-house-for-defunding-planned-parenthood-replacing-obamacare.

Today the U.S. House of Representatives passed the American Health Care Act of 2017 (AHCA). AHCA, for one year, would eliminate more than $390 million (over 86%) of over $450 million in annual federal funding to Planned Parenthood, from all mandatory spending programs. This is identical to the provision ruled to comply with the Senate’s Byrd Rule in 2015. AHCA also redirects funding to community health centers which outnumber Planned Parenthood facilities 20 to 1 and offer a wider array of health care services, but not abortion. AHCA also repeals Obamacare abortion subsidies, adds reforms to give states more flexibility and lower costs, and provides families more options.

Family Research Council (FRC) announced last month that it would score in favor of the American Health Care Act. This was the first time FRC has announced a plan to score a health care related bill in the new Congress.

Family Research Council President Tony Perkins released the following statement:

“Today is a day that should and will be remembered. The House GOP today fulfilled its nearly decade old promise to pass a bill that replaces Obamacare with a law that is pro-life and reduces premium costs for the American people.

“We are proud of the House Freedom Caucus for working diligently in coalition with conservative groups and others to make this day possible. After entrusting the GOP with authority to lead the country based upon their campaign promises, the House GOP has made good on turning promises into policy. Now it is time for the Senate to follow in the House’s footsteps and pass the AHCA, so that this vital legislation can be signed into law by President Trump who understands the value of every person, born and unborn.

“As a nation, we are without excuse in paying for abortion on demand in Obamacare and subsidizing Planned Parenthood's gruesome trafficking of baby body parts and its inhumane treatment of mothers and their unborn children.

“I look forward to even more pro-life gains under the Trump administration, as we continue to move toward once again being a nation where all human life is welcomed into the world and protected under our laws,” Perkins concluded.

In addition, the Family Research Council press release titled "Family Research Council Announces a Score in Favor of Latest GOP Health Care Bill" can be found online at http://www.frc.org/newsroom/family-research-council-announces-a-score-in-favor-of-latest-gop-health-care-bill.

1.64. FreedomWorks Statement

Listed next is the statement from FreedomWorks regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The press release containing this statement can be found online at http://www.freedomworks.org/content/not-full-or-strong-repeal-obamacare.

FreedomWorks President Adam Brandon released the following statement on the healthcare bill:

“While we’re pleased to see the American Health Care Act move forward, allowing the House the chance to move on to other priorities such as fundamental tax reform, this bill falls short of Republicans’ promises to fully repeal ObamaCare. No one should kid themselves into believing otherwise.

“House conservatives, including the Freedom Caucus, were dealt a tough hand. They were the few members of the House who were ready to stick by their guns and repeal every word of ObamaCare, as almost all members of the conference did in 2011, 2012, 2013, and 2015. Unfortunately, conservatives inside and outside of Congress learned that those past votes didn’t matter, and most House Republicans sought to protect aspects of ObamaCare.

“Aspects of this bill, including the modernization of Medicaid and expansion of HSAs are positives, the drama could have been avoided if House Republican leadership had sought more input from conservatives. The inclusion of the MacArthur-Meadows amendment is a small step in the right direction. FreedomWorks and our activists are working to improve the bill as it moves to the Senate.”

In addition, the FreedomWorks position "Build a Better Bill: GOP Senate Must Save ObamaCare Repeal Once Again" can be found online at http://www.freedomworks.org/content/build-better-bill-gop-senate-must-save-obamacare-repeal-once-again.

1.65. Independent Women's Voice Statement

Listed next is the statement from the Independent Women’s Voice regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The press release containing this statement can be found online at http://iwv.org/detail.php?c=2803515&t=Statement%3A-There-is-Much-to-Like-About-the-Revised-American-Health-Care-Act.

“ObamaCare -- like it or not -- is heading toward a certain disaster. Many exchanges are now dysfunctional as insurers are exiting, leaving fewer and fewer quality affordable choices in too many parts of the country. The latest amended healthcare bill on Capitol Hill is the first step in a three phase plan to address this coming collapse and Americans’ important concerns about pre-existing conditions, high costs and fewer choices.

“There is much to like about the updated bill: It gives states a chance to opt out of some of ObamaCare's worst regulatory provisions that drive up costs and limit options. It repeals the law's burdensome tax increases and mandates. It restructures and modernizes the Medicaid program, which is in dire need of reform to ensure that those who need assistance have access to quality health care.

“With the most recent amendments, the American Health Care Act would enable states to make deregulations that would allow consumers to buy insurance policies that fit their family's needs and budget, even policies that don't fit ObamaCare's one-size-fits-all "Essential Health Benefits." These states could also see dramatically lower average premiums by allowing insurers to price policies according to risk. The bill would also provide that states participate in high-risk pools, which will offer a safety net to anyone who faces unaffordable premiums due to a health condition."

In addition, the Health Care Policy Guide of the Independent Women’s Voice is available online at http://iwv.org/iwv-healthcare.php.

1.66. National Association of Wholesale Distributors Statement

Listed next is the statement from the National Association of Wholesale Distributors (NAW) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The NAW press release containing this statement can be found online at https://www.naw.org/nawnews/news_article.php?articleid=817.

Dirk Van Dongen, President of the National Association of Wholesaler-Distributors (NAW), issued the following statement following passage by the House of Representatives of the American Health Care Act:

“I want to commend on behalf of the 40,000 employers affiliated with NAW, the President and Vice President of the United States, the Speaker of the House and the members of the elected House leadership for their success in winning a hard-fought victory in the legislative effort to rescue the American people from a failing health care law. Despite its good intentions, the Affordable Care Act has given us a health care system that is overly burdened by government mandates and taxes, already high and rising premiums and out-of-pocket costs, and access to care that is becoming increasing limited.

“With the passage of the American Health Care Act, the House has taken an important step toward a more market-oriented, patient-centered system and with it, higher quality, lower cost and enhanced access.

“There is considerably more work to do, and I urge the Senate to follow suit as quickly as possible. The time has come to bring our nation’s seven-year experiment with the Affordable Care Act to its conclusion.”

In addition, a recent NAW issue brief on healthcare can be found online at https://www.naw.org/govrelations/issue.php?articleid=811.

1.67. National Federation of Independent Businesses Statement

Listed next is the statement from the National Federation of Independent Businesses (NFIB) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The NFIB press release containing this statement can be found online at http://www.nfib.com/content/press-release/healthcare/nfib-ahca-paves-way-for-health-care-that-works-for-small-business/.

The National Federation of Independent Business (NFIB) today issued the following statement on behalf of President and CEO Juanita Duggan thanking members of the House of Representatives for passing the American Health Care Act (AHCA):

“Passage of the American Health Care Act is a crucial first step toward health-care reform that works for small business. It repeals many of the Obamacare taxes, repeals the mandates, and clears the way for additional reforms to make health care affordable, flexible, and predictable.

“Small business owners have been waiting for repeal for many years. As predicted during NFIB’s landmark lawsuit to overturn Obamacare in the Supreme Court, our members’ costs have skyrocketed and choices for employers and employees were destroyed. Now that the House has kept its promise, we urge the Senate to pass the measure as soon as possible.

“The House must now address tax reform, another critical small business problem that has been neglected for decades. Small businesses need tax reform that creates parity between small and large corporations and reduces rates.”

In addition, the NFIB "Affordable Care Act Repeal and Replace Principles" can be found online at http://www.nfib.com/content/issues/healthcare/nfib-affordable-care-act-repeal-and-replace-principles/.

1.68. National Retail Foundation Statement

Listed next is the statement from the National Retail Foundation (NRF) regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The NRF press release containing this statement can be found online at https://nrf.com/media/press-releases/retailers-welcome-house-action-repeal-obamacare.

The National Retail Federation today applauded the House for passing the American Health Care Act, legislation that would repeal the Affordable Care Act.

“Nothing in health care is ever easy or simple, but the House has shown its commitment to closing the book on Obamacare,” NRF Senior Vice President for Government Relations David French said. “The American Health Care Act is not perfect, but if we are going to get to a health care system that works without mandates and stifling regulation, the process has to start somewhere. This bill is an important milestone on that journey.”

...

Among other actions supported by NRF, the legislation would effectively repeal the ACA’s employer mandate that businesses provide health insurance to full-time workers. While budget reconciliation does not allow the mandate to be repealed outright, the bill would reduce the penalties for non-compliance to zero.

The legislation would also delay the so-called Cadillac Tax on high-value health plans until 2026, and would repeal its health insurance tax, medical device tax and pharmaceutical tax permanently. It would also increase flexibility for health savings accounts and would take a substantial first step toward Medicaid reform.

NRF opposed passage of Obamacare and has sought its repeal, while working with Congress to mitigate the impact of its most onerous provisions. Rather than lowering costs, the controversial law emphasizes mandates that have driven up health insurance expenses for both employers and employees.

In addition, the recent NRF "A Lot of Work Ahead’ For Health Care Reform" press release can be found online at https://nrf.com/media/press-releases/retailers-lot-of-work-ahead-health-care-reform.

1.69. National Right to Life Statement

Listed next is a letter from the National Right to Life regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The letter can be found online at http://www.nrlc.org/federal/ahca/nrlc-letter-to-congress-urging-yes-vote-on-american-health-care-act/.

RE: NRLC urges “yes” vote on the American Health Care Act to repeal and replace portions of the Obama health care law.

Dear Member of Congress:

The National Right to Life Committee (NRLC), the federation of state right-to-life organizations, strongly supports H.R. 1628, the American Health Care Act, and urges your support when this measure comes before the House of Representatives today. The American Health Care Act contains the following essential provisions:1) prevents federal tax credits from being used for plans that pay for abortions, 2) preserves non-taxed employer-provided health plans, 3) postpones the “Cadillac tax” until 2026 and 4) eliminates roughly 89% of federal Planned Parenthood funding for the next year.

This legislation would eliminate multiple abortion-subsidizing and abortion-expanding provisions of Public Law 111-148, the “Patient Protection and Affordable Care Act” (PPACA).

As enacted, the PPACA contains multiple provisions authorizing federal subsidies for abortion, and abortion-expanding regulatory mandates. A 2014 GAO report revealed that over 1,000 federally subsidized plans nationwide were covering elective abortion. The American Health Care Act would repeal the provisions of law that created this system, and prohibit any future federal tax credits from subsidizing the purchase of plans that cover elective abortion, thereby restoring the longstanding principles of the Hyde Amendment with respect to federally funded health coverage.

NRLC also strongly supports the language in the bill that would block, for one year, most federal payments to affiliates of the Planned Parenthood Federation of America (PPFA). It would close the largest pipeline for federal funding of Planned Parenthood, Medicaid, and apply as well to the CHIP and the Title V and Title XX block grant programs, thus covering roughly 89% of all federal funds to Planned Parenthood. The amounts denied to Planned Parenthood, in effect, are reallocated to community health centers. Over one-third of all abortions in the U.S. are performed at PPFA-affiliated facilities. ...

In addition, the American Health Care Act retains employer-paid health insurance as a fully untaxed benefit. The American Health Care Act postpones the “Cadillac tax” which is designed to create a tax disincentive to suppress private, nongovernmental health care spending beyond a governmentally imposed limit. It is critical that Americans have access to quality life-saving healthcare to preserve their lives, care that will not be rationed more each year.

NRLC intends to include the roll call on passage of the American Health Care Act in our scorecard of key right-to-life roll calls of the 115th Congress.

Thank you for your consideration of the position of National Right to Life on this matter of grave importance to our organization.

Sincerely,

Carol Tobias
President
David N. O’Steen, Ph.D.
Executive Director
Jennifer Popik, J.D.
Legislative Director

In addition, the March 2014 National Right to Life report "The Affordable Care Act and Health Care Access in the United States" can be found online at http://www.nrlc.org/uploads/communications/healthcarereport2014.pdf.

1.70. National Taxpayers Union Statement

Listed next is the statement from the National Taxpayers Union regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The press release containing this statement can be found online at http://www.ntu.org/governmentbytes/detail/health-care-bill-passage-a-win-for-taxpayers.

“House passage of the American Health Care Act is a big win for taxpayers and health care consumers. This is the first major step toward repealing Obamacare and replacing it with a market-based system that puts consumers in charge of their health care decisions. We look forward to seeing this process move forward as the bill heads to the Senate where it will hopefully be improved and passed,” stated Brandon Arnold, Executive Vice President.

In addition, a March 15, 2017, National Taxpayers Union "Open Letter to Congress" that lists specific reasons for supporting the American Health Care Act can be found online at http://www.ntu.org/governmentbytes/detail/open-letter-to-congress-coalition-supports-american-health-care-act.

1.71. Small Business & Entrepreneurship Council Statement

Listed next is the statement from the Small Business & Entrepreneurship Council regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The press release containing this statement can be found online at http://sbecouncil.org/2017/05/04/kerrigan-statement-on-u-s-house-passage-of-health-care-reform/.

Small Business & Entrepreneurship Council (SBE Council) president & CEO Karen Kerrigan released the following statement following passage of the American Health Care Act (AHCA) by the U.S. House:

“America’s small businesses and their employees have been burdened by Obamacare’s excessive costs, dwindling choices, and for many, the loss of health care plans that provided flexibility and health care security. Many are paying much more in monthly higher premiums and out-of-pocket costs, yet have less access to care. It’s unfortunate that the opponents of fixing Obamacare refuse to see or acknowledge the damage.

“Passage of the American Health Care Act by the U.S. House today is the first step in re-reforming a system that works for small businesses, their employees and all health care consumers. Now, the U.S. Senate must make this a priority. The burden of Obamacare and its high premiums, onerous taxes, and market damage are standing in the way of small business growth. Small businesses needs relief and affordable choices in order to grow, create jobs, invest with confidence, and compete in today’s economy. The AHCA is a solid reform package and we look forward to working with Senate leaders to ensure reform efforts align with the needs, and address the key concerns, of our entrepreneurs and small businesses.”

In addition, other detailed positions of the Small Business & Entrepreneurship Council regarding the American Health Care Act can be found online at http://sbecouncil.org/2017/03/07/american-health-care-act-and-small-business-house-is-moving-to-repeal-and-replace-obamacare/.

1.72. Taxpayers Protection Alliance Statement

Listed next is the statement from the Taxpayers Protection Alliance regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The press release containing this statement can be found online at https://www.protectingtaxpayers.org/useruploads/files/tpa_pr_ahca_may_2017.pdf.

Today, the Taxpayers Protection Alliance (TPA) released a statement after passage of the American Health Care Act (AHCA) in the House of Representatives. The Bill now moves to the Senate.

TPA President David Williams reacted with the following in response to the passage of the AHCA saying, "After more than seven years of Obamacare distorting the healthcare market, increasing costs, and wreaking havoc on the economy with burdensome taxes and regulations, Congress finally took a major step forward in addressing the problems facing the healthcare system."

Williams also noted that passage in the House is only the beginning to fully correct the mistakes of Obamacare. "TPA is hopeful that the Senate will improve the legislation so the Senate, House and White House can come together in order to fully repeal and replace Obamacare."

Williams Finished by saying, "The American Health Care Act provides the first meaningful reform on entitlements in decades and gives states more control, provides immediate tax relief to millions of Americans, provides regulatory relief to businesses all across the country, and provides a path forward to move away from the unsustainable status quo in healthcare today."

In addition, the Taxpayers Protection Alliance statement "The Cure for Healthcare Reform Begins with Repealing Obamacare" can be found online at https://www.protectingtaxpayers.org/blog/a/view/the-cure-for-healthcare-reform-begins-with-repealing-obamacare.

1.73. U.S. Chamber of Commerce Statement

Listed next is the statement from the U.S. Chamber of Commerce regarding the American Health Care Act that was passed by the United States House of Representatives on May 4, 2017. The press release containing this statement can be found online at https://www.uschamber.com/press-release/us-chamber-president-congratulates-house-passing-health-care-bill.

“We congratulate the U.S. House of Representatives for passing the ‘American Health Care Act’ and taking an important step forward from an unsustainable health care system that is saddling Americans with higher costs and uncertain coverage options.

“This bill contains important reforms that will lower costs and pull back on job killing tax hikes that have been stifling economic growth across the country.

“We look forward to working with the U.S. Senate and President Trump to move this important legislation forward.”

In addition, the U.S. Chamber of Commerce sent the following “Key Vote Letter” to the members of the U.S. House of Representatives on May 3, 2017 (see https://www.uschamber.com/sites/default/files/170503_kv_americanhealthcareact_house.pdf):

“TO THE MEMBERS OF THE U.S. HOUSE OF REPRESENTATIVES:

“The U.S. Chamber of Commerce supports the American Health Care Act (AHCA). The Chamber will consider including votes on, or in relation to, this bill—including votes on the Rule—in our annual How They Voted scorecard. Passage of this bill is important on its merits. Beyond the essential policy changes that this bill would advance, this bill must also be passed to enable Congress to move on to address other Chamber priorities, including tax reform, infrastructure legislation, and other important issues.

“Critically important provisions in this bill would repeal a substantial number of the most harmful provisions in the Affordable Care Act (ACA). The bill would repeal the health insurance tax, the medical device tax, and the tax on prescription medications. The bill also would repeal restrictions on the use of, and limitations on contributions to, health savings accounts and flexible spending accounts and the penalties associated with the employer mandate.

“Just as importantly, the AHCA would preserve the longstanding tax treatment of employer sponsored coverage through which 177 million individuals receive their health care coverage. The Chamber is also pleased that the bill would delay the 40 percent “Cadillac” tax; the Chamber looks forward to working with Congress to eventually repeal this tax completely. The tax relief provided by this legislation is critical to economic growth.

“Due to the tremendous harm that these particular taxes will cause employers and employees alike, the Chamber urges you to support this bill and repeal the provisions in the ACA that are threatening to undermine the employer-sponsored health care system. While the Chamber recognizes that further improvements need to be made, passage of this legislation is absolutely critical to restore choice, flexibility, and innovation to America’s health care markets.

“The Chamber looks forward to working with Congress, the Administration, and other interested parties to advance these and other much-needed health care reform priorities.”

This page was last updated on 07/29/17.