Health and Science

American Medical Association opposes Obamacare repeal bill, citing coverage losses by millions of Americans

Key Points
  • The nation's largest group of doctors opposes the Graham-Cassidy bill to repeal and replace much of Obamacare.
  • Other groups of patients, providers and senior Americans also are against the bill.
  • Alaska Sen. Lisa Murkowski, whose opposition to a prior repeal bill doomed it to defeat, has yet to decide how to vote on Graham-Cassidy.
A staffer places a sign that says "Trumpcare Again?" with a "no" symbol over it, before a news conference with Senate Minority Leader Sen. Chuck Schumer of N.Y., Monday, Sept. 18, 2017, on Capitol Hill in Washington.
Jacquelyn Martin | AP

The American Medical Association on Tuesday urged the Senate to reject the last-ditch Republican bill that would repeal and replace key parts of Obamacare, saying it would cause "millions" of Americans to lose affordable health insurance coverage.

Also weighing in against the Graham-Cassidy bill was the National Council for Behavioral Health, which represents more than 2,000 mental health and addiction treatment groups.

"This bill may go by a different name than previous efforts to reshape the health care system, but it maintains—and even worsens—the devastating provisions from those bills that led to a massive constituent outcry earlier this summer," said Linda Rosenberg, president and CEO of the NCBH.

"It's the same pig with different lipstick," Rosenberg said.

The moves by the AMA — the largest physicians' lobbying group — and the NCBH came a day after a group of 16 organizations which represent patients and medical providers lined up to oppose the so-called Graham-Cassidy bill, as did the Association for Community Affiliated Plans, a group of health insurance providers.

"Similar to proposals that were considered in the Senate in July, we believe the Graham-Cassidy Amendment would result in millions of Americans losing their health insurance coverage, destabilize health insurance markets, and decrease access to affordable coverage and care," wrote AMA Executive Vice President and CEO Dr. James L. Madara in a letter to Senate Majority Leader Mitch McConnell, R-Ky., and Minority Leader Chuck Schumer, D-N.Y.

""We sincerely urge the Senate to take short-term measures to stabilize the health insurance market by continuing to fund cost sharing reduction payments," Madara wrote.

Those CSR payments reimburse insurers for discounts to out-of-pocket health charges they must offer by law to millions of Obamacare customers. The Trump administration has threatened to stop paying those funds to insurers, which has led to higher proposed premiums for 2018.

The 16 other groups in a signed statement said Graham-Cassidy "will negatively impact patients' access to adequate and affordable health coverage and care."

"This bill would limit funding for the Medicaid program, roll back important essential health benefit protections, and potentially open the door to annual and lifetime caps on coverage, endangering access to critical care for millions of Americans," the groups said.

"Our organizations urge senators to oppose this legislation."

The groups include the American Cancer Society Cancer Action Network, the American Diabetes Association, the American Heart Association, the American Lung Association, the Arthritis Foundation, the National Health Council and the March of Dimes.

In their statement, the organizations said they strongly supported bipartisan legislation that would stabilize the individual health insurance market, as a committee led by Sen. Lamar Alexander, R-Tenn., has been considering.

The statement comes days after AARP, the powerful lobby group representing older Americans, came out against Graham-Cassidy, as it has against prior Republican Obamacare repeal legislation.


GOP leaders who want to pass Graham-Cassidy face a Sept. 30 deadline for final approval of the bill because the legislation is being fast-tracked through a process known as budget reconciliation.

The Senate parliamentarian has ruled that the budget resolution that authorized passage of Obamacare repeal through reconciliation expires at the end of September.

Republicans, who hold a 52-seat majority in the Senate, need at least 50 GOP senators to vote for the bill for it to win passage. No Democrat or independent is expected to support the legislation.

On Tuesday, Alaska Gov. Bill Walker said he had concerns about how the bill would affect Medicaid, the joint federal-state health coverage program for primarily poor people.

"Given Alaska's current fiscal challenges, any proposal to shift federal costs to the states would likely result in drastic cuts to our Medicaid program," Walker said, according to the Fairbanks Daily News-Miner.

The governor said he believed states should have a chance to comment on how Graham-Cassidy could affect health care for their residents, according to the newspaper.

Alaska's senators include Lisa Murkowski, one of three Republicans whose opposition to a prior Obamacare repeal bill led to its defeat in a vote in late July. The other two were Susan Collins of Maine, and John McCain of Arizona.

Murkowski has not yet said if she will vote for or against Graham-Cassidy. But on Monday she said she has a "number of concerns" about the bill.

According to the News-Miner, Alaska's other senator, Republican Daniel Sullivan, also has not taken a position on the bill.

Collins and McCain likewise have not said how they will vote. Rand Paul, the Republican senator from Kentucky who supported the prior, failed repeal bill, said he will not vote for Graham-Cassidy.

On Monday, Louisiana's secretary of health, Dr. Rebekah Gee, wrote the bill's co-sponsor, Sen. Bill Cassidy, R-La., and warned that "the harm to Louisiana from this legislation far outweighs any benefit."


Gee noted that in the past year, Louisiana has provided Medicaid coverage to an additional 433,000 state residents as a result of adoption of expanded Medicaid eligibility standards under Obamacare.

She wrote that those people have received "more than one hundred thousand primary care visits, tens of thousands of screenings for cancer, and thousands of new mental health services."

"These treatments have said lives," Gee wrote. "Because this bill eliminates Medicaid expansion in 2020, all of our efforts would end, and thousands of Louisiana citizens would lose coverage and access to critical health care services."