Most US doctors oppose President Donald Trump’s bid to repeal Barack Obama’s signature health care reform law, saying it needs to be fixed rather than eliminated, a study released Wednesday found.
The report in the New England Journal of Medicine was based on a survey of 426 physicians randomly selected from the American Medical Association’s Physician Masterfile, a database of more than 1.4 million doctors, residents and medical students in the United States.
“What we heard is that the majority of primary care physicians are open to changes in the law but overwhelmingly opposed full repeal,” said lead author Craig Pollack, associate professor of medicine at the Johns Hopkins University School of Medicine.
Just 15% of responding physicians supported complete repeal of the Affordable Care Act of 2010.
Meanwhile, 74% of respondents favoured making changes, “such as creating a public option like Medicare to compete with private plans, paying physicians for value rather than volume and increasing the use of health savings accounts,” said the report.
Just 29% of doctors were in favour of increasing the use of high-deductible health plans, whereby patients pay lower monthly fees for insurance but may have to pay thousands out of pocket annually for medical services until they meet their deductible.
One of Trump’s first actions as president was to sign on January 20 an executive order aimed at limiting the “burden” of the Obamacare health law.
During the signing in the Oval Office, Trump’s chief of staff Reince Priebus described the order as aimed at “minimizing the economic burden” of the Affordable Care Act, “pending repeal.”
Doing away with Barack Obama’s signature domestic achievement is a top priority for Republicans, who control both chambers of Congress.
Doctors in the survey were asked about their political affiliation, and 38% of those who voted for Trump said they supported repealing the law. No Democrats supported a complete repeal.
The overall 15% of doctors favoring repeal is lower than the 26% of the general public that feels the same, according to a recent Kaiser Family Foundation poll.
“Primary care physicians are on the front lines of health care -- they are physicians that patients know best and turn to first when they are sick,” said Pollack.
“With primary care physicians often helping patients navigate challenges with their insurance, it is critical to understand their perspectives on the repeal of the act.”
Most doctors expressed support for parts of the law that have increased health insurance coverage, adding some 20 million people who previously did not have health care.
A total of 95% said they support a ban on denying coverage or charging higher prices on the basis of pre-existing conditions.
Another 88% supported allowing young adults to remain on their parents’ plan until age 26. A large majority of doctors also favored tax credits and subsidies to small businesses and individuals.
“We don’t yet know what provisions may be repealed or modified, but we have started to see signs of what could be coming,” said co-author David Grande, assistant professor of medicine at the University of Pennsylvania Perelman School of Medicine.
“And what has been absent in the conversation so far is how physicians feel the law has impacted their patients’ and the care they are able to deliver.”