Washington Update - May 26, 2017
Your Contribution Will Help FamMedPAC Make Our Million Dollar Goal
The PAC is already ahead of its fundraising pace of last year, and well on its way to achieving the goal of raising $1 million by the end of the 2017-18 election cycle. We are starting strong! Please do your part and donate today by visiting the FamMedPAC Donation Page(contribute.pacbuilder.com).
Family Medicine Advocacy Summit Attendees Promote Key Policies with Legislators
AAFP’s Family Medicine Advocacy Summit convened in Washington, DC on May 22 with a record attendance of more than 250 family physicians and medical students. The attendees heard from 18 political and policy experts on a wide variety of topics including health coverage reform, new payment models, the Teaching Health Center program and others. This annual meeting provides information and support so that AAFP members can coordinate their advocacy with federal legislators on issues affecting family medicine. Attendees made a total of 1686 visits with legislators and legislative staff in the House and Senate. AAFP members also contributed over $20,000 to FamMedPAC this week during the Family Medicine Advocacy Summit.
CBO Estimates that House-passed AHCA Leaves 23 Million Uninsured
The Congressional Budget Office (CBO) released an estimate(www.cbo.gov) of the effects on revenue and coverage of the American Health Care Act (HR 1628) as passed by the House of Representatives. The CBO analysis was produced jointly with the staff of the Joint Committee on Taxation (JCT) and projects that enacting the final House bill would reduce the cumulative federal deficit over the next ten years by $119 billion. CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under HR 1628 than under current law. Nineteen million more would be uninsured in 2020 and 23 million in 2026. Senate staff is expected to begin drafting a Senate bill over the Memorial Day recess.
House of Representatives Passed Nine Violence Prevention Bills
This week, the House approved nine violence prevention bills in recognition of May as National Sexual Assault and Family Violence Awareness Month. Included among the House-passed bills was The Protecting Young Athletes from Sexual Assault Act of 2017 (HR 1973(www.congress.gov)). The bill, sponsored by Rep. Susan Brooks (R-IN), would prevent the abuse of minors and amateur athletes by requiring prompt reporting of sexual abuse to law enforcement authorities. The bill was approved by a 415 to 3 vote. The House also approved the Putting Trafficking Victims First Act (HR 2473(www.congress.gov)), a bill introduced by Rep. Ann Wagner (R-MO). The legislation would improve protocols for assisting those who are trafficked. The bill provides training for law enforcement to encourage them to direct victims to social support programs instead of the criminal justice system. HR 2473 was approved by a voice vote.
Bills of Interest
Following are bills that may be of interest:
- Maintenance of Certification – So far in 2017, Georgia(www.legis.ga.gov), Maryland(mgaleg.maryland.gov), and Texas(www.legis.state.tx.us) have passed maintenance of certification legislation. This legislation would prohibit Boards from requiring any maintenance of certification related to continuing education requirements for licensure as a physician. Twelve other states introduced similar bills this year.
- Prescription Drug Abuse – Missouri remains the only state without a prescription drug monitoring program as legislation(www.house.mo.gov) failed to pass before adjournment.
- Single Payer – The New York Assembly has passed The New York Health Act(nyassembly.gov) which would establish a single payer, publicly funded health insurance program in New York. The measure now awaits consideration by the Senate. This is a New York AFP priority.
- Step Therapy – Arkansas(www.arkleg.state.ar.us), Iowa(www.legis.iowa.gov), Texas(www.legis.state.tx.us), and West Virginia(www.legis.state.wv.us) have passed step therapy legislation during 2017. This type of legislation establishes specific protocols required by a health benefit plan in connection with prescription drug coverage. There is pending legislation in 11 other states.
AAFP Urges the Senate to Maintain Financing for Medicaid
On May 23, the AAFP joined a coalition letter with the Partnership for Medicaid in response to Sen. Orrin Hatch’s (R) request for feedback on Senate health care efforts from stakeholders. The coalition letter urges the Senate to maintain the current structure of the Medicaid program and the federal financial commitment to the states in caring for our nation’s most vulnerable.
Joint Letter to Congress on CHIP – Sign-on Opportunity for Chapters
The AAFP has signed-on to a joint letter(firstfocus.org) to House and Senate leadership urging Congress to act quickly to enact a long-term extension of the Children’s Health Insurance Program (CHIP). Funding is set to expire on September 30, 2017. The AAFP has shared the opportunity to sign-on with chapters through Chexmix, but if your chapter is interested please sign-on here(form.jotform.us) by the June 1 deadline.
Trump Budget Targets AAFP Priorities
On May 23, the Trump Administration released its fiscal year (FY) 2018 budget(www.whitehouse.gov) request entitled America First - A Budget Blueprint to Make America Great Again. The AAFP responded describing the cuts as damaging to health care services, safety and research. The budget plan(www.hhs.gov) proposes to consolidate the Agency for Healthcare Research and Quality's (AHRQ) activities in a new “National Institute for Research on Safety and Quality (NIRSQ)” within the National Institutes of Health as it seeks to cut AHRQ’s appropriation from $324 million to $272 million in FY 2018. However, it highlights “critical survey activities, support for the U.S. Preventive Services Task Force, evidence-based practice centers, patient safety, investigator-initiated grants, and researcher training grants” as well as “evidence-based practice centers, addressing the opioid epidemic, and the Healthcare Cost and Utilization Project.” The budget seeks to eliminate the Title VII, Section 747 primary care training grants and nearly all of the health professions and nursing training programs administered by the Health Resources and Services Administration (HRSA). HRSA’s Rural Health programs would be cut from $156 million to $74 million, but the HRSA-administered family planning program would be level-funded.
The Administration explicitly assured that “HHS will explore opportunities for States and providers to further expand Direct Primary Care, which will support improved health outcomes for Medicaid populations.” In announcing the Medicaid Direct Primary Care Initiative, the Administration stated: “Working with States and primary care physicians, HHS will support the development of DPC practices, identify barriers to their entry into Medicaid, and outline flexibilities under existing authorities to facilitate these innovative approaches to strengthening the relationships between patients and physicians.”
It’s not just HHS under the budget ax. The budget also proposes to eliminate the Public Service Loan Forgiveness (PSLF) program arguing it unfairly favors some career choices over others and is complicated for borrowers to navigate.
AAFP Nominates Family Physician to VA’s Advisory Committee for Minority Veterans
In a letter sent May 25, the AAFP nominated Evelyn L. Lewis MD, MA, FAAFP, DABDA to serve on the Advisory Committee on Minority Veterans (ACMV). The ACMV consists of veterans who represent respective minority groups and are recognized authorities in fields pertinent to the needs of the minority group they embody.
- On May 24, the U.S. Government Accountability Office (GAO) announced(www.gao.gov) the appointment of two new members to the Medicare Payment Advisory Commission (MedPAC), as well as the reappointment of three current members. The newly appointed members are David Grabowski, PhD, Professor in the Department of Health Care Policy at Harvard Medical School, and Dana Gelb Safran, ScD, Chief Performance Measurement and Improvement Officer and Senior Vice President, Enterprise Analytics, at Blue Cross Blue Shield of Massachusetts. Their terms will expire in April 2020. The reappointed members, whose terms will also expire in April 2020, are Kathy Buto, MPA; Francis “Jay” Crosson, MD (Chair); and Warner Thomas, MBA, President and CEO of the Ochsner Health System.
- In May, CMS released a MLN Matters article(www.cms.gov) that amends the terminology used to describe locum tenens arrangements.