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Letter from the Frontline Physician Coalition to All Members of the United States Senate

The AOA joins the American Academy of Family Physicians, American Academy of Pediatrics, American Congress of Obstetricians and Gynecologists, American College of Physicians, and American Psychiatric Association in urging Senate leaders to oppose the Better Care Reconciliation Act.

By AOA Media Team


Letter from the Frontline Physician Coalition: American Osteopathic Association, American Academy of Family Physicians, American Academy of Pediatrics, American Congress of Obstetricians and Gynecologists, American College of Physicians, and American Psychiatric Association.

June 28, 2017

Dear Senator:

Our organizations, which represent over 560,000 physicians and medical students nationally, write to express our strongest opposition to the Better Care Reconciliation Act (BCRA). This legislation fails millions of people, especially children, pregnant women, older adults, and the elderly. It fails millions more who depend on current laws that prevent them from being discriminated against due to their gender, sex, or health condition (pre-existing condition). Regrettably, this legislation also fails our health care system and would destabilize – if not cause a death spiral – in our insurance market.  According to the Congressional Budget Office (CBO), 22 million more people would be uninsured in 2026 under BCRA compared to current law. 

As organizations that represent the frontline physicians who provide the overwhelming majority of care to our nation’s children, pregnant women, adults and elderly for a full-range of physical, mental and behavioral health conditions, we ask you to reject the BCRA and its policies by voting no.

Our health care system is not perfect and there are reforms that should be pursued – especially those that reduce the cost of health care. Despite its known shortcomings, the Affordable Care Act made demonstrable improvements to our national health care system and positively impacted numerous people in your state. Most notably, the ACA made affordable health care coverage available to millions of previously uninsured individuals. 

Medicaid plays an important role in covering your state's most vulnerable patients: seniors and adults and children with disabilities, especially those with long-term care needs. 537,736 children, 56,300 seniors and 185,700 people with disabilities rely on Kentucky's Medicaid program for their coverage. One way the ACA achieved such significant reductions in the number of uninsured was through expanding Medicaid eligibility to millions of children, adults, seniors, and people with disabilities across the country. In Kentucky, 443,300 newly-eligible people were enrolled in Medicaid during the January-March 2016 period as a result of expansion.

Our nation faces a terrible opioid epidemic that continues to take lives and ruin families and communities. In Kentucky, 21 of every 100,000 people died as a result of an opioid overdose in 2015. Medicaid plays a crucial part in helping those with opioid use disorder get the treatment they need. For example, Medicaid funded 44.2 percent of buprenorphine medications in Kentucky, a vital evidence-based treatment for opioid use disorder. However, health coverage for thousands of Kentuckians will be lost if the Medicaid expansion is eliminated and per capita caps place harsh restrictions on funding.

According to the Urban Institute, Medicaid enrollment for the nonelderly population would drop by 47.9 percent in Kentucky if the state phased out Medicaid expansion and reduced enrollment for other Medicaid beneficiaries to compensate for Medicaid expansion funding and per capita cuts under the American Health Care Act. The outcome would be more dire under the Senate health care bill, which would result in deeper cuts to the Medicaid program.

Each day the physicians we represent provide health care to patients in communities large and small, urban and rural, rich and poor. Our members see the real-life consequences of being uninsured or underinsured. Each day our physicians guide patients through the best and worst moments of their lives. Today, our physicians are not guiding their patients, they are standing up and speaking out on their behalf. They are asking you to stand up for their patients. They are asking you to stand up for affordable health care coverage for all Americans. They are asking you to stand up against discrimination in insurance markets. 

The more than 560,000 physicians we represent are asking you to stand with patients and their physicians and reject this flawed policy. We expect you to vote no on the Better Care Reconciliation Act.


American Osteopathic Association
American Academy of Family Physicians
American Academy of Pediatrics
American Congress of Obstetricians & Gynecologists
American College of Physicians
American Psychiatric Association