The National Kidney Foundation has issued a statement opposing the amended Republican American Health Care Act that has been proposed by Congressman Tom MacArthur, R-N.J.

“If this bill passes, National Kidney Foundation is highly concerned that insurers in some states will be granted additional flexibility to charge higher premiums, and apply annual and lifetime limits on benefits without a limit on out-of-pocket costs for those with pre-existing conditions, including chronic kidney disease.”

The American Medical Association, which opposed the original legislation, said the amended version does not remedy the shortcomings of the underlying bill.

In a letter to the House leaders, AMA Executive Vice President and CEO James L. Madara, MD, said “The amendment does not offer a clear long-term framework for stabilizing and strengthening the individual health insurance market to ensure that low and moderate income patients are able to secure affordable and adequate coverage, nor does it ensure that Medicaid and other critical safety net programs are maintained and adequately funded.”

Both organizations expressed concern that the bill would allow states to apply for waivers on federal protections for essential health benefits, which could limit patients’ access to care and medications.

“The current ban on health status underwriting protects individuals from being discriminated against by virtue of their medical conditions,” Madara wrote. “Prior to the passage of the ACA, such individuals were routinely denied coverage and/or priced out of affordable coverage. We are particularly concerned about allowing states to waive this requirement because it will likely lead to patients losing their coverage.”

“Access to healthcare is critical to detecting and managing chronic kidney disease (CKD) earlier,” NKF said in its statement. “Earlier detection and management of CKD can often delay or prevent progression of kidney disease and the need for dialysis treatment, improve outcomes for patients and lower healthcare expenditures. NKF urges Congress to enact policies that maintain or increase the number of insured patients, which will enable earlier detection of CKD.”