In an April 18 letter to CMS, we offered detailed new guidance on how the agency can ensure Medicaid beneficiaries’ uninterrupted access to timely, full-person health care, including primary care and behavioral health care, while working toward badly needed fixes for low Medicaid physician payment and burdensome administrative processes. We also advocated for an accelerated transition to value-based care, improved transparency for Medicaid graduate medical education funding and permanent coverage and payment policies advancing equitable telehealth access from patients’ usual sources of care.

As we’ve talked about before in this space, pandemic-induced under- and unemployment led Medicaid and CHIP enrollment to increase by more than 8 million people, driving a significant spike in demand for primary care clinicians in the program. The Academy views Medicaid as essential to advancing health equity, increasing health coverage and facilitating access to comprehensive, person-centered primary care. We’ve generally lauded CMS’ efforts to minimize coverage gaps, but the agency acknowledges that there’s reason for our concern: Many beneficiaries could soon lose access to needed care. With that in mind, we advised that regulators should focus on

• reinstating and strengthening federal Medicaid access standards;
• instituting a robust national monitoring approach;
• implementing race, ethnicity and language data-reporting requirements;
• enhancing federal monitoring of racial, ethnic and language-based disparities;
• addressing low Medicaid payment rates and burdensome administrative processes; and
• continuing flexibility, support, technical assistance and oversight to state Medicaid agencies with the goal of minimizing coverage disruptions during eligibility redeterminations.

This advocacy complements our ongoing pressure on Congress to increase Medicaid payment rates to at least Medicare levels by passing the Kids Access to Primary Care Act (H.R. 1025) and the Ensuring Access to Primary Care for Women and Children Act (S.1833).

In fact, I encourage you to join this fight for Medicaid pay parity and I’m going to tell you how.

Add Your Voice

One way to get in on the action is to ask your members of Congress to co-sponsor the legislation I just mentioned. Use our Speak Out tool to reach your U.S. House representative and your senators.

Better Yet: Join Me in D.C. Next Week

If you haven’t already signed up for the AAFP’s Family Medicine Advocacy Summit — once again taking place in Washington, D.C., May 22-24 — it’s not too late. As you can see, we’re working on some really vital stuff. There’s always strength in numbers, especially when each of you has a unique story to tell about your practice and your patients.

This is your opportunity to join your colleagues as we make our case together on the Hill. Our priorities: increasing access to telehealth, addressing the mental health crisis and finally ensuring Medicaid payment parity. You’ll learn about these topics and how to effectively advocate for your practice while earning up to 3.75 AAFP Prescribed credits. Register here.

Just ahead of FMAS, we’re also convening an in-person State Legislative Conference, yet another chance to get involved. Expect roundtable discussions on legislative priorities, presentations from chapter leaders on advocacy successes and best practices, and featured guest speakers.

Pushing for Affordable Insulin

Here’s another vital thing we’re working toward. Last month the AAFP called on Senate leaders to take overdue action to make insulin more accessible and affordable. On March 31, the U.S. House of Representatives passed the Affordable Insulin Now Act (H.R. 6833) to cap at $35 cost-sharing under private health insurance and Medicare Part D for a one-month supply of insulin products. The AAFP endorsed this legislation and now urges swift movement of the Senate’s companion version.

I know how passionately many of you feel about this issue. The 2021 Congress of Delegates reaffirmed as current policy a resolution directing the AAFP to advocate that insurance companies and Medicare limit patients’ out-of-pocket insulin costs. A number of state chapters have helped to pass legislation capping insulin costs. The legislation we’re supporting now is consistent with AAFP policy on health care affordability and prescription drug pricing. I’m hopeful that the bipartisan support we’re seeing for it has enough momentum to pierce some lawmakers’ longstanding allergy to price caps. Every constituency would benefit from this commonsense reform.