Transplant Patient Access & Affordability to Care Under New Health Care Law

Monday, May 8, 2017

On May 4, 2017, the U.S. House of Representatives passed the American Health Care Act (AHCA) by a vote of 217-213. The American Society of Transplantation (AST), representing a majority of the professionals engaged in the field of solid organ transplantation, is concerned for transplant patients, donors and their families under the new House-passed health care replacement measure.

As currently drafted and passed in the House of Representatives, AST remains concerned that certain provisions within the AHCA may undercut protections for transplant patients and the most vulnerable Americans — individuals with preexisting conditions. Our Society's fear is that this fragile population of patients may be subject to premium spikes and reduced benefits when States opt out of the current law health care coverage framework. 

The CBO has estimated that this bill will result in the loss of health insurance for 24 million Americans, which would preclude their access to transplantation. Among this population, end-stage organ failure patients are one of the most vulnerable groups. Transplantation is a life-saving therapy that allows individuals to regain their health and potentially return to work. 

An ideal health care bill should: 

1.    Increase the number people insured as this is the cheapest option for health care coverage – not unreimbursed ER visits.
2.    Focus on prevention. For example, the reduction in smoking has saved countless lives, a similar reduction in obesity would do the same.
3.    Cover pre-existing conditions – the only way to make this cost effective is to expand the number of insured.
4.    Broaden insurance, so it covers what is unexpected, not what is expected.
5.    Offer a transparent free market approach, so patients are aware of what is being charged and what is being paid 
6.    Cost reduction through efficient and better care.

Although the House-passed measure does include additional funding for States to address and hopefully provide coverage to those individuals with pre-existing conditions, there appears to be little evidence at this point as to whether or not the funding levels would be adequate enough to care for this growing patient population. Transplant recipients and their families should not have to choose between their health care coverage and life's other essential necessities. Access to health care coverage only becomes a reality when the care is affordable. It is essential that the U.S. Congress address the issue of patient pre-existing conditions and affordability of care in a thoughtful and thorough manner. 

AST applauds and commends the efforts of those Members of Congress and Capitol Hill staff that have worked tirelessly for years to improve and strengthen our nation's health care delivery system. The AST and transplant community have worked successfully for many years with champions on both sides of the aisle in the upper and lower chambers of Congress. Organ transplantation and the gift of life is not a partisan or political issue. Rather it is about saving, extending and preserving life.

As the AHCA now moves over to the U.S. Senate, the AST strongly encourages Senators to ensure that those most vulnerable patient populations, to include transplant patients, are adequately addressed in any health care replacement package that moves through the upper chamber.

"The Congress must get this right for the sake of the nation's must vulnerable patient populations as well as the American taxpayer," stated AST President Ronald Gill, PhD. "Without a thorough and thoughtful policy approach to address the issue of pre-existing conditions...the negative repercussions will eventually be felt by us a people and a government," said Gill.