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Tuesday Oct 10, 2017

Reviewing a Strange, Historic Week in Washington

"We only have one rule on this team: E.L.E. -- Everybody love everybody."

-- Will Ferrell as Jackie Moon in Semi-Pro

The past few months have been difficult for our country, our fellow Americans and for many family physicians. The devastation and loss resulting from natural disasters in Puerto Rico, Texas and Florida have left hundreds of thousands of people homeless, and far too many continue to lack access to the basic necessities of life. Many members of the AAFP family have been impacted by these events and are in the process of rebuilding their personal and professional lives. 

[Capitol in storm]

On Oct. 1, we witnessed the horrific event in Las Vegas that resulted in 59 deaths and more than 500 people being injured. It is still unknown how many people inside our family of family medicine were affected by this event, but I do know that a significant number of family physicians rushed to local hospitals and other care settings to care for the injured.

These events will leave permanent scars on our nation. We at the AAFP extend our thoughts to those impacted by these events, and we also have extended a helping hand to those who need assistance in these difficult times. The AAFP Foundation has raised more than $100,000 to help those who have felt the ill effects of the 2017 hurricane season. Please visit the AAFP Foundation website(www.aafpfoundation.org) to learn how you can contribute your time, financial resources and needed supplies to people affected by these events.

Meanwhile, more than a dozen of our constituent chapters have raised nearly $60,000 to help AAFP members in Puerto Rico buy generators, phones and supplies as the island recovers from Hurricane Maria. People wishing to contribute to this effort should visit the Indiana AFP's website(www.in-afp.org).

The past few weeks, my mind has been drawn to the powerful words of Pope Pius XII who said this about the United States and its citizens: "The American people have a great genius for splendid and unselfish actions."

I hope that each of us can live up to that standard and that this description of our country remains applicable for decades to come.

Now, let's move on to advocacy.

In my Sept. 26 post, I stated that the final week of September was shaping up to be "one for the history books." In hindsight, I may have underestimated its significance.

For most of 2017, Congress has been engaged in a constant debate about the future of the Patient Protection and Affordable Care Act (ACA). As you recall, the House of Representatives, after a few bumps, approved the American Health Care Act (AHCA) on May 4. Any momentum for repeal was dashed in the early morning hours of July 28, when the Senate dramatically rejected the Better Care Reconciliation Act, an amendment to the House-approved AHCA.

After that historic vote, Senate Republicans were in a frantic race against the calendar to develop and vote on ACA repeal legislation before the end of the fiscal year on Sept 30. Why, you ask? Well, at 11:59 p.m. on Sept. 30, the Senate lost the procedural protections provided under so-called reconciliation rules that would have allowed ACA repeal legislation to be approved based on a simple majority of 51 votes.

During the summer congressional recess, Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., developed a proposal that they described as the "last, best chance to repeal Obamacare." They were later joined by Dean Heller, R-Nev., and Ron Johnson, R-Wis. On Sept. 26, Senate leaders decided not to pursue a vote as proposed by the Graham-Cassidy-Heller-Johnson amendment to the AHCA. In a matter of minutes, nine months of legislative tussling came to a sudden and unceremonious conclusion.

Unless future budgets include reconciliation instructions aimed at repealing and replacing the ACA, future repeal and replace votes will require 60 votes in the Senate.

While Graham-Cassidy was a major event, it was not the most significant health policy event of the week. On Sept. 29, HHS Secretary Tom Price, M.D., suddenly resigned(thehill.com), and family physician and AAFP member Don Wright, M.D.(www.hhs.gov), was named acting secretary of HHS.

Price's resignation sent shockwaves through the health policy world, and the true impact of his tenure and departure will not be known for several months. We at the AAFP are most interested in how this change in leadership will affect a number of our priorities, including the implementation of the Medicare Access and CHIP Reauthorization Act and efforts to reduce administrative burden on practicing family physicians.

Finally, there was one event that was not controversial, partisan or shocking. It was, in fact, a welcome occasion. On Sept. 28, Rep. Steve Scalise, R-La., returned(www.washingtonpost.com) to the Capitol, 15 weeks after being shot during an early morning baseball practice. He gave a moving speech(www.cnn.com) to a full chamber of his colleagues.

There is still much work to do in 2017. Specifically, we continue to press Congress to reauthorize and fund the Teaching Health Center Graduate Medical Education (THCGME) program. The program received a three-month extension in September, but its long-term stability remains in question. We are working hard to ensure that the program is reauthorized and funded.

Last week, AAFP President Mike Munger, M.D., President-elect John Cullen, M.D., and Board Chair John Meigs, M.D., were in Washington, pushing for the continuation of the THCGME program, as well as the National Health Service Corps and other AAFP priorities. We will continue to work hard on these items, but we could use your help. Please communicate your support for the THCGME program either by calling your members of Congress at (202) 224-3121 or by using our Speak Out tool.

Wonk Hard

For those of you who have an interest in health policy and hearing experts discuss the most timely health policy issues in the nation, I invite you to join us at the AAFP State Legislative Conference Nov. 2-4 in Dallas. This is a great opportunity to learn and connect with your colleagues, so please register to attend.

Posted at 07:00AM Oct 10, 2017 by Shawn Martin

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ABOUT THE AUTHOR



Shawn Martin, AAFP Senior Vice President of Advocacy, Practice Advancement and Policy.

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