Delegates Tackle Women's Contraceptive Choices, Special Constituencies' Congress Seats

This year's AAFP Congress of Delegates made women's contraceptive options a focus of discussion, adopting a number of resolutions aimed at safeguarding payment for those options. The delegates also adopted measures supporting ongoing representation by members of the Academy's special constituencies.

At their meeting here last week, delegates adopted resolutions supporting insurance coverage for a "full array" of contraceptive methods, including payment for intrauterine devices and other implants that prevent pregnancy and procedures for inserting them.

At the same time, delegates want the Academy to encourage Medicaid and other payers to allow annual dispensing of at least a one-year supply of contraceptives, unless a physician decides against doing so for medical or other reasons.

In a related resolution, the Congress called on the Academy to endorse the principle that "women receiving health care paid for through health plans funded by state or federal governments be provided with access to the full range of reproductive options when facing an unintended pregnancy."

But the Congress rejected a provision that the Academy advocate overturning the so-called Hyde Amendment, which bans federal funding for abortions.

Members who testified Sept. 15 before the Reference Committee on Advocacy about the Hyde Amendment resolution said the abortion issue was too divisive and the Academy should steer well clear of it.

"The Academy should be neutral," said Missouri AFP President Michael Wulfers, M.D., of Cape Girardeau, in the hearing. "Abortion splits the Academy and the country. Our (Missouri AFP) board was split 50-50 down the middle. We don't need more divisiveness."

Delegates expressed no such division regarding the Academy's special constituencies. The Congress was overwhelmingly united on measures safeguarding representation of these member groups, which include women; minorities; new physicians; international medical school graduates; and members interested in gay, lesbian, bisexual and transgender issues.

The delegates adopted resolutions continuing the National Conference of Special Constituencies, or NCSC, and the Annual Leadership Forum and extending until 2015 the six delegate and six alternate delegate seats reserved for four of the five special constituencies in the Congress. Those seats had been scheduled to sunset in 2010.

New physicians also attend the NCSC, but this group was not included in the resolutions considered. New physicians have two delegate and two alternate delegate seats in the Congress with no sunset date.

The COD agreed to retain the shared special constituency seats another five years after numerous members said in spirited testimony that the seats are vital to presenting diverse views to the Academy and to developing diverse leadership.

In the Reference Committee on Organization and Finance, Patricia Witherspoon, M.D., of Columbia, S.C., a special constituency delegate, said the opportunity to participate in the Congress is one of the "most consistent" pipelines to leadership the AAFP offers.

Arizona delegate Carlos Gonzales, M.D., of Patagonia, said he has gained many skills as he progressed from being a "new" alternate delegate a decade ago to his current status as "senior delegate from Arizona."

Pennsylvania alternate delegate Mark Burd, M.D., of Elizabethtown, said the idea behind special constituencies is to give them a boost and have them represent the diverse membership.

Colorado delegate Jeffrey Cain, M.D., of Aurora, newly elected to the AAFP Board of Directors, went even further in his testimony, declaring that "the time to retire these seats is when the makeup of the board is the same (proportionately) as the constituencies."

A provision that the Academy continue to financially support the NCSC, including travel reimbursement for chapter delegates to the NCSC, was referred to the Board of Directors. The Board also was charged with reporting on member participation in the 2009 NCSC.

The Congress also directed the Academy to