March 8, 2017

The Honorable Greg Walden The Honorable Kevin Brady

Chair Chair

Energy and Commerce Committee Ways and Means Committee

U.S. House of Representatives U.S. House of Representatives

Washington DC 20515 Washington DC 20515

The Honorable Frank Pallone The Honorable Richard Neal

Ranking Member Ranking Member

Energy and Commerce Committee Ways and Means Committee

U.S. House of Representatives U.S. House of Representatives

Washington DC 20515 Washington DC 20515

Dear Chairmen Walden and Brady, Ranking Members Pallone and Neal:

Representing the interests of our nation’s more than 3.6 million registered nurses, the American Nurses

Association (ANA) respectfully wishes to express its opposition to the recently released American Health Care

Act (AHCA) as written.

The American Health Care Act threatens health care affordability, access, and delivery for individuals across the

nation. In its current form, the bill changes Medicaid to a per capita cap funding model, eliminates the Prevention

and Public Health Fund, restricts millions of women from access to critical health services, and repeals income

based subsidies that millions of people rely on. These changes in no way will improve care for the American

people.

ANA also remains troubled by the absence of testimony from non-partisan experts, such as the Congressional

Budget Office (CBO), Medicaid and CHIP Payment and Access Commission (MACPAC), the Medicare Payment

Advisory Committee (MedPAC) or the Government Accountability Office (GAO). Input from these and other

non-partisan experts would shed light on the potential long-term economic and health consequences of the

legislation. Any legislation that would fundamentally alter health-care delivery and deeply impact patients and

providers deserves thoughtful, deliberate and transparent consideration. ANA strongly urges Congress to allow

opportunity for considered public and stakeholder feedback in the face of reforms that would have a far-reaching

and personal impact on the lives of millions of people.

Nurses work in virtually every health care setting, providing expert, compassionate care for people throughout all

stages of life. As the organization representing the nation’s largest group of health care professionals and its most

trusted profession, ANA asks Congress to keep our patients’ access to affordable, quality care foremost in their

discussions over how to improve our nation’s health care system. ANA stands ready to work with Congress as a

constructive voice and positive force for improving health care delivery, coverage, and affordability for the

American people.

Sincerely,

Pamela F. Cipriano, PhD, RN, FAAN

President, American Nurses Association

cc: The Honorable Speaker Paul Ryan

The Honorable Minority Leader Nancy Pelosi

The Honorable Majority Leader Mitch McConnell

The Honorable Minority Leader Charles Schumer

The Honorable Lamar Alexander

Chair, Senate Health, Education, Labor and Pensions Committee

The Honorable Patty Murray

Ranking Member, Senate Health, Education, Labor and Pensions Committee

The Honorable Orrin Hatch

Chair, Senate Finance Committee

The Honorable Ron Wyden

Ranking Member, Senate Finance Committee