AAN Issues Statements on Health Care Reform Efforts
September 20, 2017
The AAN opposes the legislation proposed by Senators Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV), and Ron Johnson (R-WI) to repeal and replace the Affordable Care Act. The bill's provisions to eliminate the Medicaid expansion and provide a block grant to states would limit access to care for neurology patients. In addition, the bill proposes per-capita federal funding for Medicaid, similar to the Better Care Reconciliation Act proposed earlier this year, which may not adequately cover the costs associated with many neurologic conditions. Also similar to previously proposed legislation is the provision to allow states to waive essential health care benefits, which will diminish protections for those with pre-existing conditions.
The AAN reaffirms its first Principles for Health Care Delivery: “Access to high quality health care and preventative care through insurance coverage for all, including those most vulnerable to health care disparities, regardless of pre-existing conditions” and urges the US Senate to improve this bill.
June 23, 2017
The AAN opposes the newly released discussion draft, the Better Care Reconciliation Act (BCRA) of 2017, introduced in the US Senate. This updated version of the House-passed American Health Care Act would leave neurology patients with less access to health care coverage and weaken key consumer protections. This bill currently falls far short of the goals outlined in the AAN's Principles for Health Care Delivery.
The proposed restructuring of the Medicaid program will result in unacceptable losses of insurance coverage for people least able to afford other means of care. Further, provisions potentially allowing states to waive essential health benefits will erode the protections gained for those with pre-existing conditions under the Affordable Care Act (ACA). Cuts to existing federal subsidies for marketplace insurance plans will further limit access. There are also no provisions to address regulatory burdens impacting physicians and patient care. The AAN strongly urges members of the US Senate to improve this bill to ensure that vulnerable populations―including those with chronic disease―are not left without access to high quality health care.
May 4, 2017
The House of Representatives passed the amended American Health Care Act (AHCA) by a slim majority. Although the amended legislation has not been fully analyzed or scored by the Congressional Budget Office (CBO), it is clear that the proposed changes jeopardize protection for individuals with pre-existing conditions and do not fully address the AAN's concerns about access to health insurance coverage. The AAN joins other medical groups in opposing the legislation as it conflicts with our Principles for Health Care Delivery. The AAN will actively monitor the legislation as it advances to the Senate, and will continue to advocate for amendments that ensure Americans with neurologic conditions have access to the neurologists they need.
March 24, 2017
The House of Representatives leadership avoided a vote on the American Health Care Act (AHCA) after it became clear that the bill was not supported by a majority of the chamber. It is unclear whether House leadership will propose an alternative version of this legislation, but if they do, the AAN will continue to advocate for significant reforms to better align any proposal with the AAN's Principles for Health Care Delivery. This includes ensuring that Americans with neurologic conditions have access to the neurologists they need.
March 17, 2017
Dear Members of the AAN,
Last November, I wrote to you saying that the American Academy of Neurology would advocate for neurology and the patients we care for as changes to the Affordable Care Act were considered by Congress. Toward that end, the AAN adopted Principles for Health Care Delivery to guide us as new proposals were considered. Foremost in our principles is the need to preserve access to high-quality health care. After careful review of the American Health Care Act (AHCA), we have concluded this legislation does not do enough to ensure continued access to health insurance coverage for millions of Americans. Further, this proposal does not weigh in on other priorities such as the value of cognitive care, medical liability reform, easing practice burdens, and securing access to care in all settings, although these provisions may be addressed in subsequent legislation.
While encouraged by the retention of provisions to protect those with pre-existing conditions, estimates of drastic reductions of individuals covered by health insurance conflict with the AAN's principles for health care delivery. As such, the AAN cannot support the American Health Care Act as currently written. We look forward to working with Congress to enact legislation to ensure that Americans with neurologic conditions have health insurance and increased access to the neurologists they need in addition to meeting the goals outlined in the AAN's principles.
Look for additional context and analysis of developments in Capitol Hill Report, emailed to you the second and fourth Monday of every month.
Terrence L. Cascino, MD, FAAN
President, American Academy of Neurology