HLC Newsletter

Statement by Mary R. Grealy, President, Healthcare Leadership Council on the Proposed American Health Care Act


“Promising ideas….can become a structure that provides improved health security for millions of Americans”

The need to improve our nation’s system of healthcare coverage is indisputable.  The current health insurance exchanges, created under the Affordable Care Act, do not have the stability the nation requires, as exemplified by a growing number of insurers deeming the exchanges not economically viable and more consumers finding coverage to be unaffordable.  The question is not whether change is necessary, but how best to achieve greater accessibility and affordability.

The proposed American Health Care Act offers promising ideas that, through the legislative and regulatory processes, can become a structure that provides improved health security for millions of Americans.

We are strongly supportive of the use of advanceable, refundable tax credits – that were first employed under the George W. Bush administration as part of the Trade Adjustment Assistance Act – to make health coverage more affordable, and we encourage measures to make these credits more generous for those at lower-income levels, especially during the transition period.  We believe the health insurance market will be made more stable and accessible by the AHCA’s continuous coverage requirements and by extending insurers’ flexibility to create a greater range of plan options to meet consumers’ needs and states of health.  Another improvement we applaud is the creation of a Patient and State Stability Fund to support coverage affordability for our most vulnerable citizens.  This fund should be made permanent and supported with broad-based, stable funding.

On Medicaid, the AHCA calls for a transition to per-capita grants to states to manage their own Medicaid programs.  We believe this approach can encourage greater state flexibility to craft Medicaid programs that emphasize wellness, disease prevention, and enrollee engagement.  This model, however, must be actuarially sound and adequately funded to meet the needs of patients, healthcare providers, and states.  There must be safeguards to ensure that these funds are used to provide services that will improve the health status of Medicaid-eligible Americans. We applaud the restoration of Disproportionate Share Hospital payments for those hospitals serving vulnerable populations.

The tax provisions in the AHCA – the repeal of counterproductive taxes on multiple health sectors, the repeal of the tax increase on health savings accounts, and the repeal of limitations on contributions to flexible spending and health savings accounts – are strong steps in a positive direction.

We believe Congress must ensure a stable transition to this new health coverage framework, continuing both the current cost-sharing subsidies and ACA Medicaid expansion until 2020.

No one would argue that the AHCA, in its current form, is a perfect mechanism to improve American healthcare.  It does, though, provide an innovative foundation from which to build a pro-patient, pro-consumer health coverage system.  We look forward to working with the administration and Congress to ensure that optimal outcome to this process.