Most Physicians Dislike House Bill to Replace ACA, Poll Says

May 15, 2017

Major medical societies denounced the passage of a House bill last week that largely repeals and replaces the Affordable Care Act (ACA). Most rank-and-file physicians dislike the legislation as well, at least according to a poll by the recruiting firm Merritt Hawkins.

The survey of roughly 1100 physicians, conducted by email on May 9, found that 58% had a very negative impression of the bill, called the American Health Care Act (AHCA). Another 8% had a somewhat negative impression.

Physicians' Impression of the AHCA — Not So Good

Very positive 12%
Somewhat positive 14%
Neither positive or negative 7%
Somewhat negative 8%
Very negative 58%

Source: Merritt Hawkins


Merritt Hawkins didn't ask physicians what they praised or panned about the AHCA. However, there wasn't any doubt as to why organized medicine, and primary-care societies in particular, objected to the bill. Groups ranging from the American Medical Association to the American College of Cardiology said the AHCA would roll back gains in insurance coverage achieved under the ACA.

Among other things, the AHCA would replace the ACA's income-based premium subsidies for health plans sold on insurance exchanges with premiums based on age, which generally translate into less help for the poor. In addition, the AHCA would cut off federal funding for expanded Medicaid eligibility in 31 states by 2020 and limit regular contributions to state programs — which are now open-ended — on a per-capita basis. The Congressional Budget Office (CBO) estimates that such belt-tightening moves would reduce federal spending on Medicaid by $880 billion over 10 years. All in all, the number of uninsured Americans would be 24 million higher by 2026 under the AHCA than if the ACA remains in effect, according to the CBO.

Merritt Hawkins noted in a news release that the AHCA is even more unpopular among physicians than the ACA. Last year, the company asked physicians in a survey to give the ACA an overall grade as a vehicle for healthcare reform. Roughly 48% chose a grade of D or F, compared with the

66% of physicians who feel somewhat or very negative about the AHCA.

The stage for healthcare reform 2.0 now shifts to the Senate, where Republicans intend to incorporate parts of the AHCA into a bill of their own making. When a Senate bill might come up for a vote is anybody's guess, but Republican leaders as well as the Trump administration are predicting sometime this summer. If the bill passes, the Senate and the House then would have to hammer out compromise legislation, especially if the Senate tries to keep more people covered through Medicaid and the insurance exchanges.

Follow Robert Lowes on Twitter @LowesRobert


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