There was a flurry of activity in the Senate featuring the dramatic return of Sen. John McCain, R-Arizona, days after being diagnosed with glioblastoma, a tie-breaking vote cast by Vice President Mike Pence, and much speculation over what will happen next.

A likely scenario includes the introduction of a "skinny repeal" that would eliminate some the mandates and taxes included in the Affordable Care Act (ACA). Last year, the Congressional Budget Office (CBO) projected repealing the individual insurance mandate would result in some 15 million more people being uninsured by 2026. This includes some 2 million who would lose employment-based coverage, 6 million fewer buying insurance from the insurance exchange marketplace, and 7 million fewer covered by Medicaid.

The AMA has asked senators to consider the impact proposed legislation would have on the health of all Americans. The Association has maintained that Senate efforts must not increase the number of Americans without health insurance, further weaken the individual insurance market, undermine critical safety net programs, or make it harder for low- and moderate-income Americans to obtain quality, affordable health insurance.

"To date, the amendments proposed to repeal or replace the Affordable Care Act fail to meet these basic requirements and would harm vulnerable patients in every state," said AMA President David O. Barbe, MD, MHA, adding that a potential partial repeal would be no different.

"There has been considerable speculation regarding a so-called 'skinny package' that would primarily eliminate penalties related to the individual and employer mandates and provide tax cuts to device manufactures and the health insurance industry," Dr. Barbe explained. "Eliminating the mandate to obtain coverage only exacerbates the affordability problem that critics say they want to address. Instead, it leads to adverse selection that would increase premiums and destabilize the individual market."

Read more at AMA Wire®.

• July 27, 2017: National Advocacy Update
• July 27, 2017: State Advocacy Update