Part B Insider (Multispecialty) Coding Alert

Physician Notes:

House Offers Up Its Answer to the ACA Repeal

Published on Tue Mar 21, 2017

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AMA and others find fault with the American Health Care Act.

As the Affordable Care Act comes to a halt, House Republicans push forward their take on healthcare with big changes and a few leftovers. The new American Health Care Act promises to end insurance requirements and put a heavy load of the legislation on a revamp of Medicaid — but it keeps a few popular pieces from Obamacare like the ban on denying insurance coverage to people with pre-existing conditions and on lifetime coverage caps, and the provision allowing people to remain on their parents’ insurance until age 26.

What’s In: If you have a pre-existing condition, the new plan will still cover it. The same goes for coverage up until age 26 under your parents’ insurance. Insurers still can’t set limits on coverage and must still provide “10 essential health benefits, including maternity care and preventive services,” a New York Times article from March 6 said.

What’s Out: Employers are no longer required to offer coverage for their employees, and people are no longer required to get insurance if they can afford it. The popular cost-sharing subsidy that helps fill in the gaps with co-pays and deductibles will be phased out by 2020.

Read the full text of the bill here: https://energycommerce.house.gov/sites/republicans.energycommerce.house.gov/files/documents/AmericanHealthCareAct.pdf.

HHS response: “On behalf of the Trump Administration, I am writing in support of the reconciliation recommendations recently released for consideration by your Committees. Together, they align with the President’s goal of rescuing Americans from the failures of the Affordable Care Act,” said Thomas E. Price, MD, HHS Secretary in an open letter to Greg Walden, House Committee on Energy & Commerce Chairman and Kevin Brady, House Committee on Ways & Means Chairman.

Price’s endorsement comes as no surprise — he was a vocal critic of the ACA since its inception as the former House Rep from Georgia. “These proposals offer patient-centered solutions that will provide all Americans with access to affordable, quality healthcare, promote innovation, and offer peace of mind for those with pre-existing conditions,” Price said. Read the letter in its entirety here: https://www.hhs.gov/about/news/2017/03/07/secretary-price-supports-house-efforts-repeal-and-replace-obamacare.html.

AMA rebuttal: As medical groups across the nation weighed in against the new legislation, the American Medical Association (AMA), a supporter of Secretary Price’s nomination, advised the feds to go slowly because this swift decision, which it called “critically flawed,” could have far-reaching effects, endangering the health and welfare of Americans.

“As you consider this legislation over the coming days and weeks, we hope that you will keep utmost 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,” said James L. Madara, MD, CEO of the American Medical Association (AMA) in a letter to the two House committee leaders.

With many of the alterations aimed at Medicaid and the promise to push much of the responsibility on the states for implementation of the new plan, the jury is out on how quick the transition from the ACA to the American Health Care Act will be.

Resource: To take a look at the New York Times article, https://www.nytimes.com/interactive/2017/03/06/us/politics/republican-obamacare-replacement.html.