The U.S. House of Representatives is scheduled to vote tomorrow (Thursday, May 4) on H.R. 1628, an amended version of the American Health Care Act (AHCA), meant to repeal and replace the Affordable Care Act (ACA). 

In response, the California Dental Association (CDA) and the California Medical Association (CMA) warned that the amended AHCA would worsen medical and dental coverage and access to care for Californians. 

“This new, but unimproved, version of the AHCA would still cause 24 million Americans to lose health care coverage, including more than 3 million Californians,” said CMA President Ruth Haskins, M.D. “Medi-Cal patients, rural Californians and those with pre-existing conditions would be the hardest hit under the AHCA.” 

“Low-income and rural Californians will be negatively affected by this latest attempt to fix the ACA,” said John L. Blake, D.D.S., chair of the CDA Government Affairs Council. "Physicians and dentists in California have worked diligently over the last several years to bring these and other vulnerable populations incrementally better care and greater access. This would undo the progress we have made at great effort and expense, as well as further deny basic care to millions.” 

The MacArthur Amendment would allow insurers in states that obtain waivers to:

• Stop providing essential health benefits, such as dental, maternity and mental health coverage.


• Reestablish annual and lifetime limits on benefits, such as chemotherapy.


• Charge more for sick patients with pre-existing conditions. Because those patients would ultimately be priced out of the insurance market, it requires states to establish high-risk pools without adequate funding. This would end insurance protections for patients with pre-existing conditions and cause more people to become uninsured. 

“CMA and CDA strongly support the pre-existing condition protections in the ACA, and the AHCA would erode these important protections by pushing sick Californians into underfunded high-risk pools. It’s irresponsible policy because it shifts an even greater financial burden to states, local governments and health care providers for uncompensated care.” 

CDA and CMA’s other concerns with the AHCA remain:

• Causes 24 million more Americans (3-4 million more Californians) to be uninsured, which includes 50 percent of rural Californians.


• Cuts Medicaid by $880 billion ($24 billion in California), which would result in increasingly poor access to care for Medicaid patients.


• Does not increase Medicaid payment rates to ensure access to dentists and physicians.


• Makes insurance unaffordable for low- to moderate-income families by eliminating the income-based tax credits.

“We cannot afford to go back to a time when Californians with pre-existing health conditions were priced out of the market, stuck on waiting lists for care, or told that they were not covered for life-saving treatments. We urge congressional leaders to engage with physicians, dentists and other experts on the front lines caring for patients to develop a proposal that protects health care coverage for our most vulnerable populations, addresses affordability, and improves patient access to health care providers.” 

Background information on high-risk pools can be found here and here. 

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The California Medical Association represents the state’s physicians with more than 43,000 members in all modes of practice and specialties. CMA is dedicated to the health of all patients in California. For more information, please follow CMA on Facebook, Twitter and YouTube. 

The California Dental Association is the non-profit organization representing organized dentistry in California. Founded in 1870, CDA is committed to the success of our members in service to their patients and the public. CDA also contributes to the oral health of Californians through various comprehensive programs and advocacy. CDA’s membership consists of more than 27,000 dentists, making it the largest constituent of the American Dental Association. For more information, visit cda.org.