The specifics of the US Senate's latest attempt to repeal and replace the Affordable Care Act (ACA) could evolve before any vote, but the basic outline of the "Graham-Cassidy" (or "Cassidy-Graham") legislation raises enough concern that APTA opposed the bill this week.

"APTA is open to ACA reform but opposed to eliminating essential health benefits and access for millions," APTA said via Twitter and Facebook on Wednesday. "APTA is opposed to Graham-Cassidy."

To underline its position, APTA is joining 2 patient/provider groups, the Coalition to Preserve Rehabilitation and the Disability and Rehabilitation Research Coalition, in letters opposing Graham-Cassidy. APTA also has enabled members to contact their senators via the Legislative Action Center and APTA Action app to urge caution before removing various patient protections provided in the ACA.

"APTA is committed to working with Congress to improve health care, including potential reforms to the ACA, but not at the expense of decreasing access for millions of Americans," said Justin Elliott, APTA's vice president of governmental affairs.

This is consistent with APTA's position dating back to March, when APTA raised concern that the House of Representatives' American Health Care Act legislation would "create unneeded barriers to care and reduce the access to care for millions of Americans." In May and July, APTA opposed the Senate's American Health Care Act and Better Care Reconciliation Act, respectively.

Among APTA's concerns in these repeal-and-replace efforts has been the elimination of the ACA's essential health benefits, which include habilitation and rehabilitation services, and the potential to adversely affect millions of Americans who rely on Medicaid. APTA has long advocated for access to adequate, affordable, and quality health care services for all Americans, and the association says these repeal-and-replace bills challenge those principles (.pdf).

The Graham-Cassidy legislation is expected to be brought to the Senate floor next week.