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Congress and the new administration are now tackling possible changes to our complex health system, and their decisions will affect patients in Michigan and the entire country. As America’s doctors, we know from experience and evidence that people without health insurance tend to live sicker and die younger.

In Michigan, the Affordable Care Act has slashed the number of residents without health insurance from 1.2 million in 2010 to about 600,000 in 2015, according to the U.S. Census Bureau. Furthermore, by expanding Medicaid to low-income Michiganians between the ages of 19 and 64, more than 180,000 people who would not have had coverage gained it. The gains under Medicaid expansion are critical and are supported by leaders in both political parties, including Gov. Rick Snyder.

Consumers also are benefiting from insurance market reforms such as preventing coverage denials to patients with pre-existing conditions and allowing young adults to remain on their parents’ plans. Still, there is much room for improvement in our health care system. With premiums jumping 16.7 percent this year in Michigan, we believe there is insufficient choice and competition in the insurance marketplace.

The American Medical Association strongly believes that — before Congress takes any action that might affect coverage for the 20 million newly insured Americans — policymakers should lay out in advance, and in sufficient detail, a plan so all stakeholders can compare any new concepts with the current policy. We must go into this process eyes wide open about what is at stake and how proposed changes will affect our health system. It is critical that we not take a step backward in terms of patient access to quality care.

With a proud nonpartisan history of working to solve health care challenges, the AMA has sought to advance the national conversation about health system reform because America’s physicians witness the consequences of federal, state and private- sector policies on a daily basis. In doctors’ offices across the country, we have heard from concerned patients, and as we work on health system reform, we urge policymakers to be thoughtful in their approach and strive to achieve the following goals:

Ensure that individuals currently covered do not become uninsured, and take steps toward coverage and access for all Americans;

Stabilize and strengthen the individual insurance market;

Maintain key insurance market reforms such as the ability to obtain insurance notwithstanding pre-existing conditions;

Ensure that low and moderate income patients are able to secure affordable, meaningful coverage;

Ensure that Medicaid, CHIP and other vital safety net programs are adequately funded;

Reduce regulatory burdens that detract from patient care and increase costs;

Provide greater cost transparency throughout the health care system; and

Continue the advancement of delivery reforms and new physician-led payment models to achieve better outcomes, high quality and lower spending trends.

Health care is most effective when it is adaptive, quality-driven, and values access to care as well as affordable coverage for all. As Congress and the administration embark on this process, it is critical that they preserve the successes of the current system, make improvements that benefit Michiganders, and strive to promote more efficient, effective care to improve the health of our nation.

Andrew W. Gurman, MD, is president of the American Medical Association.

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