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American Medical Association: Republican health bill violates “do no harm” standard

The biggest doctors’ lobby argues that the bill violates that standard “on many levels.”

Andrew Prokop is a senior politics correspondent at Vox, covering the White House, elections, and political scandals and investigations. He’s worked at Vox since the site’s launch in 2014, and before that, he worked as a research assistant at the New Yorker’s Washington, DC, bureau.

The biggest doctors’ lobby in the United States came out strongly against Senate Republicans’ health care bill on Monday.

The American Medical Association declared its opposition to the bill in a letter from its executive vice president and CEO, James Madara. A vote on the bill, which was introduced late last week, could come this week.

“Medicine has long operated under the precept of Primum non nocere, or ‘first, do no harm,’” Madara writes. “The draft legislation violates that standard on many levels.”

According to the letter, the AMA is unhappy with both the Senate bill’s alterations to the individual insurance markets and its restructuring of Medicaid into a “per capita cap” system (one where the federal government will no longer be required to pay all enrollees’ medical bills).

Regarding the individual markets, Madara writes, “It seems highly likely that a combination of smaller subsidies resulting from lower benchmarks and the increased likelihood of waivers of important protections such as required benefits, actuarial value standards, and out of pocket spending limits will expose low and middle income patients to higher costs and greater difficulty in affording care.”

And on Medicaid, he argues, “The Senate proposal to artificially limit the growth of Medicaid expenditures below even the rate of medical inflation threatens to limit states' ability to address the health care needs of their most vulnerable citizens.”

Many major medical lobbies have been strangely taciturn about a bill that would move hundreds of millions of dollars of federal spending out of the health care system. Even after this, it remains to be seen whether the AMA will go all out to try to kill this bill — say, by trying to mobilize its hundreds of thousands of members.

Here’s the full letter: