Republicans have long wanted to repeal and replace the Affordable Care Act, also known as Obamacare. The Republican-controlled Congress made a point of defunding and repealing the act several times during President Obama’s second term. However, now that they also control the White House, they’re having trouble coming up with a replacement that improves on the ACA and stays true to their free-market philosophy.
One provision of the ACA that has worked wonders is the Teaching Health Center Graduate Medical Education program. The program provides millions of dollars to fund rural teaching health centers as alternatives to the teaching hospitals located in larger cities. Research has shown that many physicians tend to practice medicine near where they graduate from their residency, and while 26 percent of hospital grads work in underserved areas, that figure is 55 percent for health center grads. Funding is set to end in September, and Congress seems to have no interest in renewing the program.
Instead, Republicans are doing what they can to remove the protections surrounding the minimum standards of care set by the ACA. An amendment added to the second version of the AHCA bill would let states opt out of requiring health plans to meet these standards, which effectively means they would no longer exist and we would see the return of the marginal plans that existed before the ACA took effect. Republicans are also looking into allowing health plans to cross state lines, which would let health insurers pull out of local markets and offer plans from the states with the weakest regulations.
Another provision would let states lift the ACA’s ban on underwriting health statuses. This means insurers would once again be able to adjust premium rates and coverage based on preexisting conditions, a system that made health care unaffordable to the ones who needed it most before the ACA.
Meanwhile, no major initiatives in the AHCA seem to address the need for reducing or simplifying the growing mountains of paperwork facing American doctors, nor their increasing levels of burnout. Still, there is a solution doctors can rely on even now: medical scribes. The scribes placed by ProScribe and other services can tackle the administrative demands of clinics, hospitals, and private practices so that physicians can spend more of their time with patients and less of their time staring at computers. Between the extra visit quality and extra patients per day, scribes can even pay for themselves.