CHICAGO — In a letter to congressional leaders, the American Medical Association (AMA) today outlined provisions of the American Health Care Act that would have an adverse impact on patients and the health of the nation. Largely due to the decline in health insurance coverage the bill would likely cause, the AMA is unable to support the AHCA as drafted.

“The AMA supported health system reform legislation in 2010 because it was a significant improvement on the status quo at the time; and although it was imperfect, we continue to embrace its primary goal — making high-quality, affordable health coverage accessible to all Americans,” AMA President Andrew W. Gurman, M.D. said. “As drafted, the AHCA would result in millions of Americans losing coverage and benefits. By replacing income-based premium subsidies with age-based tax credits, the AHCA will also make coverage more expensive — if not out of reach — for poor and sick Americans. For these reasons, the AMA cannot support the AHCA as it is currently written.”

In January, the AMA released its health system reform objectives — primary among them that people who currently have insurance should not become uninsured — and were shared at the time with Members of Congress.

In today’s letter to congressional leaders, the AMA outlined several provisions within the AHCA where the legislation falls short of the objectives articulated by the AMA. These provisions include:

The AMA has long supported advanceable, refundable tax credits as a preferred method for assisting individuals in obtaining private health coverage. It is important, however, that available credits be sufficient for quality coverage. The AMA is concerned that by relating credits to age — rather than inversely related to income — the AHCA will result in greater numbers of uninsured Americans.

The AMA is concerned with the proposed rollback of Medicaid expansions, which have been highly successful in providing coverage for lower income individuals. The AMA is also concerned that changes to Medicaid could limit states’ ability to respond to changes in demand for services, including mental health and substance abuse treatment as a result of the ongoing crisis of opioid abuse and addiction.

The AMA cannot support provisions of the legislation that repeal the Prevention and Public Health Fund or that eliminate the ability of patients to receive their care from qualified providers of their choice.

The AMA does not support provisions targeting, in this specific case, affiliates of the Planned Parenthood Federation of America. Provider choice is an important element of a reformed health care system, and the AMA cannot support the precedent of restricting access to otherwise qualified providers of care for covered services.

“As you consider this legislation over the coming days and weeks, we hope that you will keep upmost in your mind the potentially life altering impact your decisions will have on millions of Americans who may see their public, individual or even employer-provided health care coverage changed or eliminated,” the AMA said in its letter. “We encourage you to ensure that low and moderate income Americans will be able to secure affordable and adequate coverage and that Medicaid, CHIP, and other safety net programs are maintained and adequately funded. And critically, we urge you to do all that is possible to ensure that those who are currently covered do not become uninsured.”