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Friday Jan 12, 2018

Primary Care Needs Congress' Attention Right Now

It's been more than 100 days since Congress allowed stable funding for the Children's Health Insurance Program (CHIP) to expire. Despite bipartisan support for the program -- and a new, reduced cost estimate for the program from the Congressional Budget Office(thehill.com) -- legislators appear to be no closer to a long-term solution than they were in September.

Representatives from the AAFP and five other physician organizations meet with Sen. Doug Jones, D-Ala. (center, at end of table). The Academy and its counterparts voiced support for primary care programs that need stable funding during Jan. 10 meetings on Capitol Hill.

CHIP reauthorization has always been a bipartisan issue, but it's never been easy to achieve. This level of legislative negligence, however, is unacceptable, and children and their families will suffer the health and financial consequences of uncertain coverage if Congress does not act soon.

Congress passed a short-term spending bill in December that was intended to keep the program going through March, but the reality is that several states will run out of money this month(ccf.georgetown.edu) unless legislators reach an agreement on the future of the program.

Since its inception in 1997, CHIP has helped reduce the number of uninsured U.S. children by nearly 70 percent.(2 page PDF) The program covers roughly 9 million children and 370,000 pregnant women. The potential loss of coverage threatens not only the health of those patients, but the financial stability of the physicians and practices who provide their care.

Representatives from the AAFP and five other physician organizations were on Capitol Hill Jan. 10 to meet with members of Congress. Collectively, our organizations -- the AAFP, American Academy of Pediatrics, American College of Physicians, American College of Obstetricians and Gynecologists, American Osteopathic Association, and American Psychiatric Association -- represent 560,000 frontline physicians and medical students, and we made it clear to legislators that this program is vital to the health of our communities.

You can help amplify that message by using the AAFP's Speak Out resources to tell your legislators why CHIP is important to children and families in your state.

In addition to CHIP, our discussions with legislators from both parties also included advocating for renewed investment in teaching health centers, community health centers and the National Health Service Corps (NHSC). Like CHIP, these programs are operating on funding from a short-term bill through the end of March. That lack of stability is outrageous given that one in 12 Americans receives their primary care at community health centers.

The NHSC also is vital to our underserved communities. The program places physicians and other health professionals in areas where they otherwise might be unlikely to work. Today, more than 10,000 NHSC members provide care to more than 11 million patients at more than 5,000 locations. If Congress fails to act, however, those numbers will drop dramatically.

The timing of Congress' inaction is especially a disservice to the Teaching Health Center Graduate Medical Education (THCGME) program. In the past academic year, there were about 740 primary care residents trained in 59 THC residencies in 27 states. More than 80 percent of THCs serve medically underserved communities, and those programs are doing their best to recruit and train residents who might stay and serve those areas during and beyond residency. However, short-term fixes and uncertainty about funding can make residents reluctant to choose them.

The National Resident Matching Program will issue its results March 16 -- two weeks before THC programs are set to run out of funds. The cruel irony of that timing is not lost on faculty and residents or the students hoping to enter THCs.

Congress' failure to act on CHIP, community health centers, THCs and the NHSC has created needless uncertainty for our patients and communities who need our help the most. The AAFP will continue to press legislators on these important issues. Please make your voices heard, as well.

Michael Munger, M.D., is president of the AAFP.

Posted at 01:11PM Jan 12, 2018 by Michael Munger, M.D.

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