The AAFP is urging Congress to pass a continuing resolution to end a federal government shutdown that has put the health of the public at risk and threatens to derail health care access for millions of Americans.
"At a time when the nation's health care system is undergoing dramatic change, the AAFP is dismayed that Congress has shut down the federal government over disagreement about the (Patient Protection and) Affordable Care Act -- particularly since implementation of the law will continue regardless," said AAFP President Reid Blackwelder, M.D., of Kingsport, Tenn., in a prepared statement.
According to Blackwelder, "More than 11,000 people turn 65 each day, and some 3,000 apply for disability coverage each day. Without (sufficient) staff to process their applications for Medicare, these people face a potential gap in insurance coverage and the threat of health insecurity."
- The AAFP is urging Congress to pass a continuing resolution to end a federal government shutdown.
- In a prepared statement, AAFP President Reid Blackwelder, M.D., said the shutdown has put the health of the public at risk while threatening to derail health care access for millions of Americans.
- The AAFP's Government Relations Division has put together an analysis outlining the effect of the shutdown on Medicare, Medicaid and other programs that are important to family medicine.
The shutdown will not immediately affect Medicare and Medicaid programs, so physicians are unlikely to experience payment delays in the near term, according to an analysis conducted by the AAFP's Government Relations Division. It is important to point out, however, that a significant percentage of the federal workforce has been furloughed. If the furlough lasts for several weeks or more, physicians may begin to experience delays in payment as a result of those staff reductions.
The Affordable Care Act includes an enhanced payment provision that brings Medicaid rates for primary care services up to at least Medicare levels this year and next year. According to the AAFP analysis, that provision remains in place, and those higher payments will continue. Medicare incentive payments for primary care will be paid during the shutdown, as well. In addition, meaningful use payments for the adoption of health information technology will continue.
States also have the option of expanding Medicaid eligibility to 133 percent of the federal poverty level as called for by the Affordable Care Act, and funding for that expansion is secure.
CMS will continue to process applications for new Medicare beneficiaries but at a reduced rate because 65 percent of the agency's personnel are furloughed. At the same time, most major provisions of the Affordable Care Act, including the health insurance marketplaces, remain in place because they are considered mandatory programs.
HHS has announced, however, that 92 percent of the staff at the Agency for Health Care Research and Quality are furloughed, creating serious challenges for physicians who interact with the agency.
The government shutdown also prevents agencies, including the FDA, from conducting food inspections, monitoring imports and notifying the public regarding food safety problems. It also blocks the CDC from operating its annual influenza monitoring program, FluView, and from supporting state and local health departments' infectious disease surveillance programs.
"These and other gaps in federal services put the public's health at risk," said Blackwelder. In addition, he noted, "The shutdown erodes Americans' access to future medical care by slowing the regulatory process that sets Medicare physician payment for next year."
This serves to undermine physicians' confidence in the Medicare program and adds to the destabilizing effect of an impending 24 percent cut in the physician payment rate scheduled to take effect on Jan. 1 as a result of the sustainable growth rate, Blackwelder said.
"Americans' access to safe food, public health department services and Medicare coverage should not be jeopardized by ongoing efforts to defund or delay implementation of the Affordable Care Act," Blackwelder said. "While funds for important health-related services dry up, implementation of the ACA continues with the mandatory funding embedded in the law."
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