Chapters' Legislative Priorities

Increased Access, Physician Payment Top the List

By Leslie Champlin
1/17/2007

Increasing health care coverage, raising physician payment, safeguarding or expanding scope of practice, and promoting public health initiatives top constituent chapters' legislative priorities for the current legislative session, according to a 2007 survey of AAFP chapters.

With 95 percent of chapters having responded to the survey thus far, Diana Ewert, AAFP senior manager for state government relations, said the results show that more chapters are taking on an increasing number of issues. The trend, she added, demonstrates members' stronger focus on public advocacy on state and national issues.

"The number of states responding to our request for chapter legislative priorities is indicative of member awareness of the increasing need for advocacy both locally and nationally," said Ewert. "A key indicator is the number of chapters that are taking on or increasing the number of issues they address in a given year. Chapters are increasing their own advocacy programs, recognizing the member imperative that we need to be there, that we need to be doing this."

The survey asked chapters to list their top five legislative issues. The most frequently cited issues can be categorized into five distinct areas:

access to care -- includes comprehensive health system reform or expanding Medicaid or State Children's Health Insurance Programs to increase access to health care;
managed care and physician payment -- includes such "line items" as fair contracting, downcoding and bundling of claims, prompt payment, balance billing, and assignment of benefits;
scope of practice -- includes such issues as pharmacist collaborative practice, prescriptive authority for nonphysicians, expansion of chiropractic and lay midwifery, and naturopathic licensure; and
public health -- includes tobacco use cessation and smoke-free environments, vaccine distribution, obesity, and preparation for pandemic influenza, disaster or emergencies.

Some priorities are natural extensions of Academy and chapter policies, according to Ewert. For example, chapters that have active Tar Wars programs most logically would become involved in legislation promoting tobacco-free environments.

Public health and access to care also "are huge interest areas," said Ewert. Likewise, ongoing scope-of-practice issues -- as well as new concerns spurred by the growth of retail health clinics -- remain high priorities.

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