Academy Letter Opposing Cassidy-Graham Proposal

September 15, 2017

The Honorable Mitch McConnell
Majority Leader
United States Senate
S-230 U.S. Capitol
Washington, DC 20510

The Honorable Charles Schumer
Minority Leader
United States Senate
S-221 U.S. Capitol
Washington, DC 20510

Dear Majority Leader McConnell and Minority Leader Schumer:

The Academy of Nutrition and Dietetics, the nation's largest organization of food and nutrition professionals representing registered dietitian nutritionists (RDNs), nutrition and dietetics technician, registered (NDTRs), and other nutrition professionals, knows that nutrition services save money, improve chronic disease outcomes and save lives. For that reason, the Academy continues to strongly oppose the American Health Care Act (H.R. 1628), as amended by the Graham-Cassidy proposal on September 13, 2017.

As it stands, the Senate discussion draft would eliminate investments in prevention and public health, reverse advancements made in disease prevention and chronic care management, and according to nonpartisan analysis of the underlying bill, would result in the loss of health care coverage for at least 22 million Americans.1

The Academy opposes the repeal of the Prevention and Public Health Fund, which would remove vital resources that are effective in improving health across the country. The Prevention Fund provides critical support for nutrition interventions led by nutrition professionals to improve community health, and these jobs will be gone without this critical investment.

The Academy also opposes the provisions that would allow states to block grant or utilize per capita caps for Medicaid spending, drastically reducing access to preventive services and to home and community-based services (HCBS). This reduction in Medicaid spending will result in fewer opportunities for patients to have access to vital nutrition services provided by registered dietitian nutritionists for disease prevention and treatment.

Additionally, allowing states to opt out of requiring that health plans cover the Essential Health Benefits would reduce access to these cost-saving services; allow insurers to charge people higher premiums based on pre-existing conditions like nutrition-related diseases, including diabetes and heart disease; and increase out-of-pocket costs for vulnerable older adults.

Finally, the Graham-Cassidy amendment to H.R. 1628 fails to meet the Academy's five tenets of health care:

  • The health of all Americans should improve as a result of our health policy choices. Sufficient resources must be made available to ensure optimal health.
  • Access to quality health care is a right that must be extended to all Americans.
  • Nutrition services, from pre-conception through end of life, are an essential component of comprehensive health care.
  • Stable, sufficient and reliable funding is necessary for our health care system to provide everyone access to a core package of benefits.
  • Health care must be patient-centered.

For these reasons, the Academy of Nutrition and Dietetics strongly urges the Senate to oppose passage of the current version of the bill.

The Academy urges the Senate to continue the bipartisan work of the Senate Health, Education, Labor and Pensions Committee to draft common-sense reforms that would improve access to quality and affordable health care for all Americans. The Academy continues to offer to work with you to improve the nutrition and health of the country.


Donna S. Martin, EdS, RDN, LD, SNS, FAND
President, 2017-2018

1 Congressional Budget Office