Leading healthcare and advocacy groups are urging Congress not to pass the revised Republican ObamaCare replacement bill, fearing that changes could harm those with pre-existing conditions.

The American Hospital Association (AHA), American Medical Association (AMA) and American Association of Retired Persons (AARP) all denounced the revised bill on Thursday. The groups were already opposed to the American Health Care Act (AHCA), saying that millions would lose coverage, but raised new concerns about an amendment from Rep. Tom MacArthur (R-N.J.).

“We are deeply concerned that the AHCA would result in millions of Americans losing their current health insurance coverage,” AMA President Dr. James Madara wrote in a letter. “Nothing in the MacArthur amendment remedies the shortcomings of the underlying bill.”

ADVERTISEMENT

The amendment would also allow states to apply for waivers to repeal ObamaCare’s community rating protection, which protects people with pre-existing conditions from being charged much higher premiums.

“We are particularly concerned about allowing states to waive this requirement because it will likely lead to patients losing their coverage,” Madara wrote.

The AARP says the revised bill is "even worse," warning lawmakers it intends to "let all 38 million of our members know exactly" how their representative votes on the legislation, if it makes it to the House floor.

“This harmful legislation still puts an Age Tax on older Americans and puts vulnerable populations at risk through a series of backdoor deals that attempts to shift responsibility to states,” the group said in a statement.

Under the amendment, people would still be protected if they maintain “continuous coverage,” meaning they did not have a gap in coverage. States with waivers would also have to set up high risk pools, aided by $130 billion in federal funding, to help provide coverage for sick people, but opponents argue those were tried before ObamaCare and were underfunded and did not work.

The American Hospital Association, meanwhile, pointed to a waiver in the revised bill to allow states to repeal ObamaCare’s essential health benefits, which mandate that insurance plans cover a range of health services, such as prescription drugs and mental healthcare.

“The amendment proposed this week would dramatically worsen the bill,” AHA President Rick Pollack said in a statement. “The changes included put consumer protections at greater risk by allowing states to waive the essential health benefit standards, which could leave patients without access to critical health services and increase out-of-pocket spending.”

The AHA also points out that the Congressional Budget Office estimated the bill would result in 24 million more uninsured people over a decade.

While states that waived the rule would have to put in place high risk pools for people with pre-existing conditions, the AMA warned those would be insufficient.

“There is also no certainty that the requirement for states to have some kind of reinsurance or high-risk pool mechanism to help such individuals will be sufficient to provide for affordable health insurance or prevent discrimination against individuals with certain high-cost medical conditions,” the letter states.

—Updated at 1:09 p.m.