AANA President Nimmo Speaks About American Health Care Act

​On Thursday May 4, 2017 the U.S. House of Representatives passed the American Health Care Act (AHCA). The legislation repeals major provisions of the Affordable Care Act (ACA), including the individual and employer mandates; ACA subsidies; tax increases associated with the ACA; and the Prevention and Public Health fund. In place of these provisions, the legislation provides tax credits, expands Health Savings Accounts, freezes Medicaid expansion, and establishes a stability fund. The AHCA was passed using the budget reconciliation process, which allows Congress to use an expedited procedure when considering legislation and only requires a simple majority (51 votes) to pass the U.S. Senate.
Like most other healthcare professional associations, the AANA believes that the legislation must ensure adequate safeguards for individuals with pre-existing conditions. The AHCA creates a $15 billion risk sharing program to help states lower premiums for health coverage offered in the individual marketplace. Under the AHCA, individuals with pre-existing conditions will be able to remain in the traditional individual marketplace, and insurers are reimbursed for policyholders with high costs. However, the AANA is concerned that these individuals will lose coverage and face higher premiums than under current law.
The AANA also believes that the legislation must protect critical Essential Health Benefits to ensure patients have access to the full range of services and providers, including CRNAs. The goal of the Essential Health Benefits requirement was to help balance access, comprehensiveness, quality improvement and affordability for consumers purchasing health coverage. However, the AHCA allows states the option of applying for waivers from Essential Health Benefits. A waiver application would be approved after 60 days unless the Secretary of Health and Human Services notifies a state of the reason for denial. Essential Health Benefits are necessary to ensure health coverage for patients; eliminating them would create an access to care issue across the United States and actually return the healthcare system to its pre-ACA condition when such benefits were hard to find and often unaffordable in individual insurance plans.
Finally, the AANA remains vigilant to ensure that the legislation preserves Provider Nondiscrimination language enacted by Congress in 2010. This language, which currently remains in the AHCA, prohibits health plans from discriminating against qualified licensed healthcare professionals, such as CRNAs, solely on the basis of their licensure. Provider Nondiscrimination promotes competition and consumer choice as well as patient access to care, all while respecting local control of healthcare systems.
While the AANA has concerns with these provisions in the AHCA, we understand that the version which passed the House of Representatives will not be the final product. We remain committed to working with Congress and the Trump Administration as they consider changes to healthcare legislation that expand patient access to high quality coverage and services that individuals, employers and our country can afford.
CRNAs are vital to resolving the challenges facing our nation’s healthcare system. The AANA will continue its work to ensure CRNAs are fully recognized and utilized in order to achieve the three pillars of healthcare reform, including access, reduced costs, and high quality care. To that end, CRNAs and SRNAs are encouraged to click here (AANA member login required) to contact their US Senators regarding our concerns with the AHCA as currently written. An all member grassroots action alert will be sent separately next week. Please take a few minutes to participate in this critical advocacy effort.