A coalition of six physicians' groups sent a letter Wednesday to Congress critical of the latest version of the American Health Care Act, which would give states the option of scaling back Essential Health Benefits such as mental health coverage.
Under current law, all health insurance policies must contain 10 essential benefits, and there can be no annual or lifetime cap on claims in those categories. The coalition, which includes the American Psychiatric Association and the American Academy of Family Physicians, warned that eliminating those protections could prevent some individuals from receiving care and spark discriminatory coverage.
"We believe that pending legislation proposals would dramatically increase costs for older individuals, result in millions of people losing their healthcare coverage, and return to a system that allows for discrimination against people with pre-existing conditions," the letter said.
Although the draft language says the bill does not allow for discrimination based on pre-existing conditions, if insurers were allowed to charge more for policies that include chemotherapy infusion drugs, or inpatient behavioral health treatment, that could price people out of the market who need those services.
The bill would let each state decide how to regulate health insurance, as long as they could justify the departure from current patient protections.
The doctors told Congress in their letter that they could remember when people could not access mental health and substance abuse treatment.
"This experience with the healthcare system is why our organizations strongly oppose the compromises that have been recently reported," they said.
The groups, which represent more than 560,000 doctors, said if this bill became law, insurers could decline to pay for substance abuse treatment for millions, "when such services are needed more than ever to address the opioid epidemic in the United States."
The letter said the high-risk pools proposal—which some states might implement in the hopes of lowering prices for healthy customers—would be underfunded. This solution to the problems of the individual health insurance market has "been proven ineffective numerous times."
The proposed changes to plans could begin in January 2020. However, changes to prices charged to older customers in the individual market could take effect in January 2018.
"We recognize that our healthcare system is not perfect and reforms are needed," the letter concluded, but said AHCA is a flawed foundation to fix those problems.
The signatories included the American Psychiatric Association, the American College of Physicians, the American Academy of Pediatrics, the American Academy of Family Physicians, the American Osteopathic Association and the American Congress of Obstetricians and Gynecologists.
