What Does Research Tell Us About Health Care Policy?
Over the next few weeks, the Senate will be considering a bill known as the Better Care Reconciliation Act (BCRA). This bill aims to repeal major portions of the Affordable Care Act (also known as Obamacare) and making major cuts to Medicaid.
While the debate over health care has gotten caught up in partisan politics, the bottom line is that this bill has been crafted without sufficient input from experts in medicine, public health, or patient advocacy. It shows.
As part of the legislative process, the nonpartisan Congressional Budget Office (CBO) produced an analysis of the potential impacts of BCRA. The CBO found that the bill will result in 22 million more uninsured Americans by 2026. In addition, the proposed legislation would eliminate the Prevention and Public Health Fund.
So why does this matter to the scientific community and the March for Science?
We believe knowledge should help guide policies to promote a better world, and in this case the evidence says BCRA is a bad idea. Health economists, doctors, and other experts have all outlined the negative impacts of this proposal. In fact, the science has been clear for more than a decade: those who are uninsured face worse care, are more likely to get sick, and have higher mortality rates than those with coverage. This bill would make the problem worse, not better.
Likewise, funding for prevention and public health is not only effective, it is essential to communities across the country, especially those facing outbreaks of diseases like the Zika virus.
We’ve put together some resources below that show just how far from evidence-based policy-making this bill is.
If you want to take action and speak out against BCRA, now is the time to attend a town hall or call your Senator (202-224-3121).
Background and Research
In 2002, the Institute of Medicine conducted a comprehensive review of the impacts of uninsurance and concluded that working-age Americans without health insurance “are more likely to: Receive too little medical care and receive it too late; Be sicker and die sooner; Receive poorer care when they are in the hospital even for acute situations
like a motor vehicle crash.”
This week, researchers updated the IOM’s data and strengthened their claims, finding that the uninsured have higher mortality rates than those who have health insurance coverage.
The largest association of medical professionals in the country, the American Medical Association, came out in strong opposition to the Senate bill, arguing that it violates medical professional’s code to “first, do no harm.”
The American Public Health Association, an organization that promotes health policies backed by science, opposes the Senate bill, noting that it would eliminate the Prevention and Public Health Fund, a critical source of funding for responding to threats like Zika and Ebola.
Researchers at UCLA studied the impact of the Affordable Care Act on vulnerable populations, concluding that expanded Medicaid programs in many states resulted in coverage for millions more of our most vulnerable populations. However, that progress is at risk with the Senate health care bill. According to the CBO, the bill would cut $772 million from Medicaid, leaving 15 million more without health insurance.
Atul Gawande, a surgeon and health policy expert, joined together with two leading experts to publish a review in the New England Journal of Medicine of the role health care coverage plays in the health of Americans. They concluded that “arguing that health insurance coverage doesn’t improve health is simply inconsistent with the evidence” and noted numerous ramifications of not having health coverage.
40 prominent economists, including 6 Nobel prize winners, wrote a letter to Senate leaders opposing BCRA, calling it “a giant step in the wrong direction.”