P eople with kidney disease are medically complex, and kidney disease may have an impact on the development of therapies to treat the many comorbidities affecting this population. Cardiovascular disease is a common and significant comorbidity among these patients, and individuals with kidney disease make up a sizeable proportion (30% to 60%) of patients with cardiovascular disease (1, 2). Yet, patients with kidney disease have often been excluded from cardiovascular clinical trials (1–4), thus limiting the evidence to guide treatment recommendations of cardiovascular disease for these patients.
Following the Trail of the Affordable Care Act Debate: Part 16
American Society of Nephrology (ASN) President Eleanor D. Lederer, MD, FASN, has issued a response to the release on Thursday, July 13, of a revised version of the Better Care Reconciliation Act (BCRA) that is intended to repeal and replace the Affordable Care Act (ACA). Dr. Lederer states “Unfortunately, the revised bill fails to address significant shortcomings present in the original bill and will adversely impact the health of millions of Americans, including those with kidney diseases.”
Reflecting the concerns the American Society of Nephrology (ASN) has been raising regarding healthcare reform efforts in recent weeks, the society is encouraging ASN members to contact their Senators and ask them to “Vote No” in the upcoming debate.
On Tuesday, July 25, the Senate will vote on opening debate on a healthcare repeal bill that will adversely impact the health of millions of Americans, including those with kidney diseases.
Republican efforts to repeal the Affordable Care Act (ACA) broke onto the scene again this Wednesday May 24th. The rollercoaster of news and rumors around those efforts once again bring uncertainty to the lives of patients, physicians, and insurers nationwide.
All news is not good news
In our last installment, we detailed the seemingly unlikely passage of the American Health Care Act (AHCA) – the House Republican bill to repeal and replace the ACA. Contrary to Speaker Paul Ryan’s own preferred procedure in the House, AHCA was passed without a new score from the Congressional Budget Office (CBO), which was needed to account for changes made to the bill since the previous CBO score was published. You can read about the last score in Part 6 of our series.
In our last installment, we tried to ground the conversation by laying out how Republican health care ideas impact you. You can review Part 10 of our series here. Simultaneously, in the last Affordable Care Act (ACA) repeal update in Kidney News, we reviewed the Three Phases of the repeal effort as outlined by Health and Human Services (HHS) Secretary Tom Price:
1) Direct repeal of the ACA 2) Review of 192 ACA-specific HHS rules 3) Later, subsequent legislation as required
This week we catch up again on points 1 and 2 above.
1. Direct ACA Repeal
As you may recall, the American Health Care Act (AHCA), has been sent to the Senate for review. Republican Senators have been meeting in closed-door sessions over the past few weeks trying to piece together a bill that can garner fifty votes.
There are many issues that do not yet have consensus solutions and the battle lines are similar to what we observed in the House. However, Senate leadership began laying out policy options this week. Here are four of the principle stumbling blocks:
Summertime is vacation time! This week we are taking a brief field trip from Washington to explore the problems facing state individual healthcare marketplaces around the country.
Improving the number of people covered by insurance was one of the stated goals of the Affordable Care Act (ACA). Today, nearly half (49%) of all Americans receive health insurance from their employer. Government programs like Medicare and Medicaid cover another 36%. Only 7% of Americans are in the individual (also called non-group) marketplace.
Senate Republicans today released the Better Care Reconciliation Act, S. 1628, their plan to repeal and replace the Affordable Care Act (ACA), also known as Obamacare. This is the Senate’s response to the American Health Care Act (AHCA), which the House passed in early May. Like the House bill, the legislation is designed to repeal or revise portions of Obamacare, a law that congressional Republicans have opposed since its passage seven years ago.
Today, the American Society of Nephrology (ASN) voiced its concerns to the leadership of the US Senate that “the Better Care Reconciliation Act (the Senate version of Affordable Care Act repeal) passage would negatively impact millions of patients, particularly those with kidney failure, advanced kidney diseases, and other chronic illnesses.” You can read the letter here and a statement from ASN President Eleanor Lederer here.
We’ve been here before – a secret bill has been released with a looming timeline to vote, only to be pulled at the last minute.
That is the story of the Better Care Reconciliation Act this week in the Senate and it sounds eerily similar to what happened over the spring with the House’s American Health Care Act.
Both bills are designed to repeal and replace the Affordable Care Act (ACA). Both bills faced opposition from all sides and had to be suddenly and unceremoniously removed from the voting schedule. Although the House version was resurrected a month later to be passed by a slim majority.
As we promised last week in our inaugural “Following the Trail,” we are going to keep you on track with the ACA repeal/repair/replace debate. We’ll review key events and introduce you to a new player, Seema Verma.