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June 23, 2017

What health care stakeholders are saying about the Senate bill

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Health care provider and public health groups on Thursday almost unanimously criticized the Senate's draft health reform bill, saying the proposed changes to the Medicaid program would result in larger cuts to federal funding than the House-approved American Health Care Act, which also had faced backlash from industry stakeholders.

The Senate's health care bill just dropped. Here's what you need to know.

Provider groups voice strong opposition

Hospital groups—including the American Hospital Association (AHA), the Federation of American Hospitals (FAH), and America's Essential Hospitals (AEH)—said they strongly oppose the bill.

AHA in a statement urged senators to "go back to the drawing board" and took aim at the draft bill's Medicaid provisions, saying, "Medicaid cuts of this magnitude are unsustainable and will increase costs to individuals with private insurance."

FAH in a statement said it is "deeply concerned" with the proposal, adding that it "does not sufficiently meet" the group's "health reform core principles: maintain coverage levels, reasonable Medicaid structural reforms, sustain affordable, high quality individual coverage, protect employer-sponsored insurance and roll back untenable cuts to hospital reimbursement."

The Catholic Health Association (CHA) called the draft bill "devastating," saying, "Despite claims that the Senate would start over and develop its own legislation, there is very little that differs from the House bill," which the association also opposes. CHA said, "The small tweaks made in the newly released Senate bill do not change the fact that millions will lose their health care especially through a complete restructuring and deep federal funding reduction to the Medicaid program."

The American College of Physicians (ACP) in a letter to Senate Majority Leader Mitch McConnell (R-Ky.) and Senate Minority Leader Chuck Schumer (D-N.Y.) raised concerns about the Senate bill's Medicaid changes, which it wrote goes beyond the "radical" changes in the House-approved AHCA, as well as the proposal to allow waivers that allowing states to opt out of the ACA's essential health benefits requirements.  ACP concluded, "We strongly urge that the Senate move away from the fundamentally flawed and harmful policies that would result from the BCRA."

The American Academy of Pediatrics in a statement said the bill's Medicaid provision "fails children." AAP took aim at what it called "misleading 'protections' for children" in Medicaid, saying, "A 'carve-out' for some children determined to be 'disabled' does little to protect their coverage when the base program providing the coverage is stripped of its funding."

The Children's Hospital Association in a statement said the draft bill "is a major step backward for children and their health," saying it goes even further than the House-approved AHCA in cutting federal Medicaid funding by tying the funding to a slower growth rate.

The American Psychiatric Association (APA) said the proposal "falls short of providing needed mental health care benefits and protections to those most vulnerable." APA President-Elect Altha Stewart said, "Eliminating requirements for coverage of key benefits, including mental health and substance use disorders and other patient protections that are part of the Affordable Care Act, will have detrimental impacts for millions."

The American Psychological Association President Antonio Puente called the draft bill "extremely disappointing." He said, "Medicaid is a critical backstop of coverage for mental health treatment, and for millions of older Americans, children and individuals with disabilities. If the goal is to cover more people, why slash Medicaid when it is already much more cost-effective than private sector plans?"

The National Council for Behavioral Health in a statement called the Senate proposal "a draconian restructuring and gutting of Medicaid," which "covers 20 percent of Americans and is one of the primary payers of addiction and mental health treatment in the [United States]." The group said it would leave "vulnerable individuals—like people with addictions—out in the cold."

Advocacy groups warn of detrimental effects

The American Cancer Society Cancer Action Network President Chris Hansen in a statement said, "Preliminary analysis of the Senate bill released today shows the proposal could greatly harm millions of cancer patients, survivors and those at risk for the disease."

The American Lung Association warned that the draft bill's Medicaid cuts would "lead to more asthma attacks."

AARP in a statement criticized the bill for imposing "an 'Age Tax' on older adults," which "would allow insurance companies to charge older Americans five times more for coverage than everyone else while reducing tax credits that help make insurance more affordable."

Some industry groups mum on Senate draft bill  

However, other health care sectors were largely quite on the draft bill.

Kristine Grow, spokesperson for America's Health Insurance Plans said it would "continue to analyze the bill, consistent with our previous positions."

A spokesperson for PhRMA said, "As this process moves forward, we will work with policymakers to ensure there is a competitive market that provides patients with access" to medications and encourages more drug development.

Hospital, insurer stocks gain on Senate bill

In related news, hospital and insurer stocks on Thursday posted sharp gains following the release of the Senate's draft reform bill.

Overall, the S&P 500 health care sector gained 1.2 percent on Thursday, bringing its overall gains for the week to about 4 percent.

According to Modern Healthcare, Tenet Healthcare's shares on Thursday went up 7 percent, from $1.22 to $18.90, while Community Health System's shares rose by 5 percent, to $9.27. And HCA's shares jumped 2.5 percent, while shares of LifePoint Health increased 3 percent and Universal Health Services' shares rose by 2 percent.

Similarly, among health insurers, shares of Aetna were up 0.7 percent, shares of Anthem were up 1 percent, shares of Centene were up 3.6 percent, and shares of Humana were up about 2 percent for the day before closing flat, Modern Healthcare reports. Meanwhile, UnitedHealth Group's shares increased 0.9 percent, and shares of Molina Healthcare increased 2.6 percent.

(Barkholz, Modern Healthcare, 6/22; Krauskopf, Reuters, 6/22; Shell, USA Today, 6/22; Rockoff, Wall Street Journal, 6/22; Diamond, "Pulse," Politico, 6/23; American Psychiatric Association release, 6/22; American Academy of Family Physicians release, 6/22; American Psychological Association release, 6/22; Children's Hospital Association release, 6/22; American College of Physicians letter, 6/22; American Cancer Society Cancer Action Network release, 6/22; American Lung Association release, 6/22; National Council for Behavioral Health release, 6/22; AARP release, 6/22; American Hospital Association release, 6/22; Federation of American Hospitals release, 6/22; Catholic Health Association release, 6/22; American Academy of Pediatrics release, 6/22).

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