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Graham-Cassidy Amendment Could Jeopardize Healthcare Access for Americans Living with Rheumatic Diseases

WASHINGTON, D.C. – The American College of Rheumatology (ACR) today issued the following statement outlining its concerns with the Graham-Cassidy legislation in the U.S. Senate.

Amid the ongoing debate over the future of the Affordable Care Act, the American College of Rheumatology has been a consistent advocate for effective, affordable, and accessible healthcare for the 54 million Americans living with rheumatic diseases. Throughout this process, the ACR has outlined specific provisions that would need to be included in any replacement plan to ensure that Americans suffering from chronic, painful, and debilitating rheumatologic conditions continue to receive necessary healthcare.

After reviewing the Senate’s latest replacement plan, we believe the Graham-Cassidy legislation does not sufficiently protect our patients from discrimination based on pre-existing conditions and is too lenient in allowing states to waive the ACA’s essential health benefit requirements.

We are concerned that replacing the ACA’s premium tax credits and cost-sharing subsidies with a discretionary formula that allocates block grants to states could result in less funding for individuals to purchase health insurance on the individual market. It is also possible that states could use these discretionary funds for healthcare purposes beyond subsidizing coverage, which would further jeopardize our patients’ access to affordable, meaningful coverage.

While the Graham-Cassidy legislation technically leaves the current pre-existing condition ban unchanged, it could provide states the ability to allow insurers not to cover the costs associated with some conditions. We believe that the legislation’s current stipulation – that any state waiver application include a description of how the state intends to cover those with pre-existing conditions – is not strong enough to ensure adequate protections, as the specifics are left undefined.

Additionally, the ACR is concerned that giving states the ability to change what qualifies as an essential health benefit has the potential to weaken patient protections that are guaranteed under the current law. If these provisions are waived, healthcare coverage could become unaffordable for Americans living with rheumatic diseases and other pre-existing conditions. Furthermore, the amendment allows insurers to charge older customers up to five times as much as they charge younger customers, a significant break from the ACA’s three-to-one ratio that could make healthcare cost-prohibitive for many of our older patients.

The ACR stands ready to work with lawmakers to address these concerns and encourages Senate leaders to engage in bipartisan reform efforts in order to ensure continued access to vital rheumatology healthcare services.

Jocelyn Givens
404-633-3777, ext. 810


The American College of Rheumatology (ACR) is the nation’s leading advocacy organization for the rheumatology care community, representing more than 9,500 rheumatologists and rheumatology health professionals. As an ethically driven, professional membership organization committed to improving healthcare for Americans living with rheumatic diseases, the ACR advocates for high-quality, high-value policies and reforms that will ensure safe, effective, affordable and accessible rheumatology care.

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