This comes a month after an initial proposal, the American Health Care Act (AHCA), was withdrawn at the last minute as it failed to garner sufficient support. We are extremely concerned about various components of the current proposal – even more so than about last month’s proposal – particularly the following:

• Potential for states to dramatically raise costs for people with preexisting conditions. The new bill technically maintains the ACA provision that prevents insurers from denying coverage to people with preexisting conditions. However, it allows states to waive many of the other requirements of the bill if doing so will lower premiums on average, increase the number of insured people, or if it were to advance the “public interest of the state.” Most worryingly, this means that while states can’t deny coverage outright to people with preexisting conditions, they are able to waive any requirement that people with preexisting conditions are charged the same premiums as people without preexisting conditions. As long as states establish “high risk pools” they will be able to make coverage drastically more expensive for people with preexisting conditions like diabetes.
• The potential loss of investment in preventive medicine. In March of 2016, Medicare made the landmark decision to reimburse for diabetes prevention programs for qualifying enrollees because of the demonstrated cost-effectiveness of such programs. One of the biggest concerns in the days before the AHCA bill was withdrawn was the risk that prevention would no longer be considered an “essential health benefit,” and lose funding as a result. This again becomes a major concern with the newly proposed bill.

If the new “TrumpCare” passes, we fear that these two components alone would lead to extremely negative consequences for the diabetes community in the United States – a community of nearly 30 million, plus another 86 million living with prediabetes. We fully acknowledge that there is room for major improvements to the ACA, but this new proposal, which could drastically raise costs for so many Americans, isn’t the solution. Now is the time for research, deliberation, and precaution given that the health of millions is on the line.