Legislation of this gravity demands transparency and should have benefit of the normal legislative process to allow for public hearings with feedback from patients and consumers groups as well as providers on the front lines. Forcing a rapid decision without the input from key non-partisan entities 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) is irresponsible or could be interpreted as deceitful. Comments made by Secretary Price to the White House Press following release of the proposed legislation appear to suggest reversing progress by allowing states to set higher insurance rates for women, and reestablishing state high risk pools for people with pre-existing conditions, provisions that could be detrimental. Replacement of Medicaid expansion with capped block grants and uncertain funding for subsidies, should raise serious doubts about the credibility of the claims that this legislation will improve access or quality of care for the American people.

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