The influential industry organizations, which helped the Affordable Care Act pass in 2010, are particularly worried about the bill's potential impact on lower-income and vulnerable Americans. These folks have been helped by the law's expansion of Medicaid and its subsides that are more generous for those lower on the income ladder.
The GOP bill would eliminate the funding for Medicaid expansion and curtail federal support for the entire Medicaid program. Also, it would replace the Obamacare subsidies with refundable tax credits that would likely provide less assistance for lower-income policyholders who buy their own coverage.
"It appears that the effort to restructure the Medicaid program will have the effect of making significant reductions in a program that provides services to our most vulnerable populations, and already pays providers significantly less than the cost of providing care," wrote Richard J. Pollack, CEO of the American Hospital Association.
The association voiced concern about the lack of Congressional Budget Office score that would estimate the bill's impact on coverage levels.
The American Medical Association acknowledged in a letter
to two House committee leaders that "there are problems with the ACA that must be addressed." But it said cannot support the Republican effort to repeal and replace major provisions of the law.
"More than 20 million Americans currently have health care coverage due to the Affordable Care Act (ACA) and among the AMA's highest priorities for on-going health system reform efforts is to ensure that these individuals maintain that coverage," said the letter signed by James L. Madara, the CEO of the interest group, a prolific donor
to both political parties.
Other leading health care industry players opposing the bill include America's Essential Hospitals, the Federation of American Hospitals, the Association of American Medical Colleges and the Children's Hospital Association. The AARP
has also come out against the legislation.
White House spokesman Sean Spicer said Wednesday that under the GOP bill, interest groups aren't getting "paid off" the same way they did under Obamacare, leading to lower levels of support. Still, Spicer said Trump and other GOP leaders would prefer to have the groups on their side.
"We would love to have every group on board," Spicer said at his Wednesday press briefing when asked about opposition from groups like AARP and the AMA. "This isn't about trying to figure out how many special interests in Washington we can get paid off. It's about making sure that patients get the best deal."
As for AMA specifically, Spicer cited the fact that Health and Human Services Secretary Tom Price is himself a trained physician and said the bill was responsive to input from "doctors on the front lines."
Hospitals and doctors have a vested interest in making sure as many Americans as possible have insurance so they can be paid for their services. Hospitals, in particular, have been vocal supporters of Medicaid expansion on the state level since it reduces their levels of uncompensated care.