BALTIMORE, MD (March 7, 2017) – Baltimore City Health Commissioner Dr. Leana Wen today issued the following statement in response to a bill that aims to replace the Affordable Care Act:

“The recently issued proposal would be detrimental to the health and well-being of millions of Americans. It is fiscally irresponsible and dangerous to national security. This ‘replacement plan’ will roll back gains made to improve health and affect generations to come.

“There are six particularly concerning provisions with drastic consequences to health:

“First, the bill punishes those with lower wages by eliminating subsidies to help pay for insurance coverage based on a person’s income. As a physician who has practiced medicine before and after the Affordable Care Act, I have seen patients forced to make the impossible choice between basic needs, including food and housing, and critical medications. I have seen the consequences when people are forced to pay for this 'choice' with their lives.

“The policy also drives more people to use emergency departments as a source of primary care, which is an inappropriate safety net as patients wait until they are very ill and their care becomes unnecessarily expensive. 

“Second, placing a cap on Medicaid spending, while also limiting the amount states can pay per person, will lead to inevitable cuts in coverage and will hurt those who are the most vulnerable—including seniors, women, children, people with low incomes and individuals with disabilities.

“Medicaid expansions have improved access treatment for those with the disease of addiction. At a time of a public health epidemic where tens of thousands of Americans are dying of overdose each year, the last thing we should do is to reduce coverage. For a patient with the disease of addiction, there is no margin of error. Losing coverage today could mean overdosing and dying tomorrow. 

“Third, the bill replaces the individual mandate with one effectively requiring continuous coverage, penalizing those whose coverage lapses. Simultaneously, the bill would remove penalties if companies did not provide affordable insurance options. This moves the burden away from business and insurance companies and places it instead on individuals. With fewer affordable options, this proposal would increase the likelihood of a person’s coverage lapsing, and thus their risk of financial consequences. It would punish individuals retrospectively who are already ill, rather than prospectively rewarding people who invest in prevention.

“Fourth, it strips important community resources, such as Planned Parenthood, of federal funding. These organizations offer critical reproductive health services such as mammograms, pap smears, and annual exams. Blocking access to them would harm women, families, and children.

“Fifth, the proposal eliminates the requirement that health plans provide hospitalization, maternity care, and mental health services, among other benefits, known as the essential health benefits rule. In Baltimore and across the country, this would affect the affordability of critical health care services and eradicates the funding stream for preventive visits that we know help to avoid high-cost health issues in the long-term.

“Finally, the bill cuts the Prevention and Public Health Fund, which constitutes nearly one-seventh of the Centers for Disease Control and Prevention’s budget. These funds are used to prevent diseases such as hypertension, cancer, and diabetes, which are drivers of the major causes of death in the United States. They also help ensure that our nation is prepared against emerging threats such as bioterrorism, Ebola and other infectious diseases. Cutting these funds will hurt patients’ health in the short-term and compromise national security in the long-term.

“I urge our elected officials to consider the impact of this ‘replacement’ plan on the health and well-being of our nation. Millions of Americans, and many generations to come, depend on us to safeguard life.”