Washington Update - June 23, 2017

On the Horizon

  • The Senate is expected to take up health reform bill before the Independence Day recess.


Washington Update - Full Report

Download this week's report(3 page PDF).

Take Action

Tell the Senate to Reject the Better Care Reconciliation Act

The Senate's bill to replace the Affordable Care Act would strip health care coverage from millions of Americans and leave millions more facing dramatically higher costs. Family physicians must make their voices heard now! The AAFP urges the Senate to reject this legislation and pass common-sense reforms to preserve coverage for all Americans. The best way to make a meaningful impact is to call your Senators today. Please click here to find your Senators’ contact information and a script you can you to make your voice heard!

U.S. Congress

Senate Republican Health Bill Threatens Cuts to Coverage and Higher Costs

The AAFP sent a letter on June 21 to the U.S. Senate anticipating the release of the Better Care Reconciliation Act (BCRA) reiterating our principles and opposition to a process that will cause harm to millions of patients. The Senate Budget Committee posted(www.budget.senate.gov) the draft(www.budget.senate.gov) of the bill and a section-by-section summary(www.budget.senate.gov) prepared by the Congressional Research Service.

Coalition Letter to Senate Leadership on the AHCA

On June 21, the AAFP joined a coalition letter with the Partnership for Medicaid urging Senate leaders to consider the American Health Care Act (AHCA) through an open, transparent, “regular order” process in the Senate. The letter expresses concern over the absence of committee hearings or markups in the current process over the AHCA.

Coalition Letter to Congressional Leaders Regarding CHIP Funding

On June 12, 1200 organizations, including AAFP and 13 state AAFP chapters, sent a letter urging Congress to take quick action on long-term Children’s Health Insurance Program funding. Currently, 8.9 million children rely on CHIP for health coverage. CHIP funding is set to expire on September 30, 2017, and a new long-term extension is urgent as state budgets for Fiscal Year 2018 are counting on CHIP to continue.

AAFP Discusses Physician Burnout Crisis with House Doctors Caucus

Clif Knight, MD, FAAFP, AAFP’s Senior Vice President, Education, participated in a round-table discussion in Washington, DC with the House Doctors Caucus on the problem of physician burnout. Joining Dr. Knight were representatives of the American College of Emergency Physicians, the American Academy of Neurology, and the American Urology Association. AAFP was invited to participate by Rep. Phil Roe, MD (R-TN), who is an OB-GYN.

Family Physicians Participate in Opioid Summit

The AAFP partnered with the Institute for Medicaid Innovation (IMI) on a June 22 Opioid Summit in the Russell Senate Office Building. Assistant Professor of Family and Community Medicine at Temple University David O’Gurek, MD spoke on a panel entitled “Women, Babies, and the Opioid Epidemic: Opportunities in Medicaid,” and retired family physician and Current National Advisory Board Chair for the IMI, Judy Chamberlain, delivered the closing remarks.

Congressional Diabetes Caucus Co-Chairs Ask for Dialogue on Insulin Prices

On June 22, Reps. Diana DeGette (D-CO) and Tom Reed (R-NY), co-chairs of the Congressional Diabetes Caucus, wrote letters(degette.house.gov) to the chief executives of the Pharmaceutical Researchers and Manufacturers Association of America, America Health Insurance Plans, and Pharmaceutical Care Management Association regarding the price of insulin products. The organizations represent the nation’s largest associations representing insurance companies, drug manufacturers, and pharmacy benefit managers. The letter asked the officials for a meeting to discuss the causes of price spikes and to develop policy solutions. The co-chairs’ letter indicated that average insulin prices have tripled between 2002 and 2013.

Centering on the States

Bills of Interest

Following are a few bills that may be of interest:

  • Medicaid Expansion – The Ohio General Assembly is considering a state budget(www.legislature.ohio.gov) which puts a freeze on Medicaid expansion enrollment, starting July 1, 2018. The legislation also includes work requirements. This bill is an Ohio AFP priority bill.
  • Medicaid Payment The California legislature passed a state budget(www.ebudget.ca.gov) that increases Medi-Cal physician payment. The budget directs a portion of the tax money raised by Proposition 56, an increase in tobacco taxes, to be used to improve Medi-Cal payment. This is a California AFP priority.
  • Medicaid Reform – Nevada Gov. Brian Sandoval (R) has vetoed legislation(www.leg.state.nv.us) which would have allowed any individual to buy into Medicaid, which would have made this the first state to approve a “public option.”
  • Scope of Practice – The Wisconsin legislature is debating legislation(docs.legis.wisconsin.gov) which would allow chiropractors to perform pre-participation physical evaluation for student athletes. This bill is a Wisconsin AFP priority bill.

AAFP Individual Fact Sheets Available for State Impact of AHCA

The AAFP Center for State Policy has updated the individual state fact sheets regarding health care reform to include state impacts of the AHCA. The resources include data on the loss of coverage, premium and cost-sharing increases, employment impacts, and other useful statistics regarding the AHCA. To view this resource, visit our policy makers website and click your state on the health landscape map.

Bipartisan Governor Involvement with the AHCA

On June 16, Govs. Charles Baker (R-MA), Steve Bullock (D-MT), John Bel Edwards (D-LA), John Hickenlooper (D-CO), John Kasich (R-OH), Brian Sandoval (R-NV), and Tom Wolf (D-PA) sent a letter(gallery.mailchimp.com) to Senate leadership expressing criticisms of the AHCA’s Medicaid provisions and requesting bipartisan cooperation in health care reform.

On June 20, the National Governor’s Association released a summary(www.nga.org) of the shared priorities from the Governors’ Bipartisan Health Reform Learning Network. The Network, launched in March 2017, includes 13 states – with six Republican governors and seven Democratic governors. The private health insurance priorities include market stabilization, statue authority and flexibility, and affordability and accessibility of health insurance. The Medicaid priorities include financing and flexibility, delivery and payment system reform, and predictability for states. The public health priorities include essential funding and the opioid crisis.

Executive Branch

CMS releases 2018 proposed rule regarding the Quality Payment Program

On June 20, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule(s3.amazonaws.com) regarding the 2018 Quality Payment Program. The agency also published a press release(www.cms.gov) and a detailed fact sheet(www.cms.gov). In an AAFP statement released after the proposed rule was put on display, the Academy expressed encouragement “that CMS has published its 2018 Updates to the Quality Payment Program.” The proposed regulation will improve the ability of family physicians to participate successfully in payment reforms envisioned by the bipartisan Medicare Access and CHIP Reauthorization Act (MACRA).” AAFP News released a related article. Comments on the regulation are due to CMS on August 21 and the AAFP is reviewing the proposed changes and will formally comment on this major regulation.

Comments Sent Regarding NAFTA and Public Health Measures

On June 12, the AAFP and other organizations sent a letter to the Office of the United States Trade Representative. The letter discussed efforts to renegotiate and modernize the North American Free Trade Agreement (NAFTA) and urged the office to ensure that the revised agreement provides the protections necessary to enable all countries that are party to the agreement to adopt public health measures to protect their citizens from the death and disease caused by tobacco products without facing the risk of litigation by the tobacco companies.

Sign on Letter sent to HUD on Smokefree Housing

On June 14, the AAFP and others sent a letter to the Department of Housing and Urban Development in response to a request for comment on “Reducing Regulatory Burden.” The letter reiterated support for the HUD rule finalized last year that implements smokefree policies in government-owned public housing as this policy will help improve the health of public housing residents. Furthermore, the letter pointed out that the final rule is innovative, effective, and is not excessively burdensome to implement.