House Passes Health Care Bill That Reduces Patient Access; APTA Takes its Message to the Senate
The American Health Care Act (AHCA) bill that narrowly passed the House of Representatives will move on to the Senate—and so will APTA's opposition to AHCA provisions that would allow states to reduce or eliminate essential health benefit requirements, including physical therapy.
Under the AHCA, significant parts of the Affordable Care Act (ACA) would be repealed and replaced with provisions that, among other things, cap and then reduce Medicaid appropriations, eliminate subsidies in favor of tax credits for individuals who purchase insurance through the exchanges, and change "essential health benefit" (EHB) requirements—services that insurance companies must cover no matter what. Under the ACA, rehabilitation and habilitation services such as physical therapy are included in federally mandated list of EHBs, but the AHCA would allow states to apply for a waiver to create their own EHBs or eliminate them completely. The bill passed on a thin 217-213 margin (a good overview of the AHCA can be found at National Public Radio, and The Washington Post has published a useful Q-and-A piece on the bill).
In a statement issued in March when an earlier version of the AHCA surfaced, APTA President Sharon L. Dunn, PT, PhD, decried the elimination of federally mandated EHBs as part of an overall direction in the AHCA that would "create unneeded barriers to care and reduce the access to care for millions of Americans." That position was reinforced in April, when APTA signed on to a letter to Congress from a coalition of 46 national consumer, clinician, and membership groups opposing the changes to EHBs. The letter stated that "there is little doubt under this scenario that access to rehabilitation services and devices would suffer in many areas of the country."
The bill will now move on to the Senate, which can change provisions in the legislation or introduce its own version of a health care law, a possibility recently put forward by Sen Lamar Alexander, chair of the Senate Committee on Health, Education, Labor, and Pensions, and echoed by Sen Roy Blunt in an interview with ABC News.
Justin Elliott, APTA's vice president of government affairs, says that regardless of what takes shape in the Senate, APTA will continue its focus on advocating for a health care law that will ensure affordable access to care for all Americans.
"APTA is now turning to the Senate to educate members on how including provisions like EHBs not only improves the lives of millions of Americans, but actually reduces overall health care costs," Elliott said. "We want to deliver the message that APTA isn't opposed to reform of the ACA, but that reform needs to align with our policy principles that are rooted in inclusive access to care. Unfortunately, the version of the AHCA approved by the House falls short of those principles."