text: Groups say the approach of the Republicans' plan moves away from prevention, which had been a chief aim of the Affordable Care Act. A large cut to the CDC would leave the future of the Diabetes Prevention Program unclear.
  In the past week, 2 leading organizations involved in health science and advocacy have come out against the American Health Care Act (AHCA), the bill initiated by the House Republicans that the Congressional Budget Office (CBO) said yesterday would cause 24 million Americans to lose coverage by 2026.
  Last week, the American Diabetes Association, which represents the interests of nearly 30 million people in the United States who have type 1 and type 2 diabetes and an estimated 86 million with prediabetes, sent a letter to the House of Representatives expressing deep concerns with the AHCA as written, particularly with the changes to Medicaid.
  At a minimum, the letter said, "No one should lose health insurance coverage as a result of the ACA repeal and replacement plan," and the AHCA should not make it harder to get coverage based on health status or income.
  Today, in light of the new CBO findings and other factors, the American College of Preventive Medicine has come out strongly against the AHCA. In its statement, the college noted the following:
  · The bill eliminates essential health benefits for some Medicaid plans
  · It cuts the Prevention and Public Health Fund, resulting in a 12% budget cut to the CDC. "Such a massive cut would result in a 50% reduction to CDC's immunization program, which provides direct support to states and local communities to strengthen their vaccine and immunization infrastructure," the statement reads.
  · The cuts would leave the country ill-prepared for outbreaks of infectious disease, like Zika, and would cripple the ability of hospitals to respond.
  Letters from both the ADA and the college note that the Affordable Care Act represented a step forward in emphasizing preventing chronic disease instead of treating it after the fact, and the AHCA moves the healthcare system in the wrong direction.
  The ADA letter says the loss of the Prevention and Public Health Fund would cripple diabetes prevention just when those efforts are beginning to flourish. "This repeal would be a drastic step backwards for diabetes prevention and would leave a funding gap for essential public health programs including those at CDC's Division of Diabetes Translation," the ADA letter states.
  Of critical importance, the CDC is responsible for recognizing programs that are qualified to provide the Diabetes Prevention Program (DPP), and CDC recognition is needed for Medicare reimbursement under CMS' most recent plans. Medicare reimbursement is set to begin for DPP on January 1, 2018.
  Both letters took issue with the change from premium subsidies for low-income persons in favor of tax credits, which, they said, might not be enough to help those at lower incomes stay covered, even if they could purchase policies with less generous benefits.