Now that the Senate has stepped away from the Better Care Reconciliation Act (BCRA), the AAFP is asking legislators to work together across the aisle on legislation that prioritizes primary care, expands health care access and stabilizes the health insurance market.
The Academy sent a letter to Senate leaders(3 page PDF) on July 17 asking that debate on the BCRA be set aside, and that's just what occurred several hours later after Sens. Jerry Moran, R-Kan., and Mike Lee, R-Utah, declared that they would not support the legislation.
The letter, signed by AAFP Board Chair Wanda Filer, M.D., M.B.A., of York, Pa., lays out what legislators should do next to improve the nation's health care system: "Move forward with bipartisan solutions that build on our historical successes and return our health care debate to one focused on increasing access to affordable and meaningful health care coverage."
The AAFP said debate on health care legislation should approach the issue from the perspective of individual patients and populations. Legislative efforts related to health care have been mostly ideological in recent years, but the letter reminded senators that this has not always been the case.
"Historically, we have focused our efforts on how best to improve the health care system in an effort to improve the lives of individuals impacted by such policies," the letter stated. It cited successes stretching back 70 years that included establishment of the Medicare, Medicaid and Children's Health Insurance programs -- all of which expanded access to populations in need.
"While we may disagree on the underlying policies, we should collectively celebrate our success in expanding health care coverage to tens of millions of people and redouble our efforts to provide more affordable coverage to those that still lack it," the letter continued. "The AAFP believes our mutual goal is to ensure that every individual has health care coverage, a policy that the AAFP has promoted since 1989."
The Academy offered several policy recommendations to expand access, control costs and improve physicians' compensation.
Key in this list is a proposal for standard primary care benefits for those with high-deductible plans that would be free of cost-sharing requirements. These benefits should include primary care, prevention and wellness, and care management services. Patients would select their primary care physician or be assigned one if they do not make a choice. In addition, all Medicaid plans would be required to pay primary care physicians at a rate equal to or greater than Medicare fee-for-service.
Other recommendations in the letter include
- opening Medicare Advantage to those ages 55-64 years who purchase insurance in the individual market;
- requiring insurers to offer plans on the health insurance marketplaces of any states where they engage with a state or federal health program;
- making permanent and fully funding cost-sharing reduction subsidies; and
- increasing investments in primary care physician education and training.
"It is time to move beyond our current health care debate that is focused on repealing major portions of current law and seek bipartisan policies that build on our collective successes, address ongoing challenges, and improve our health care system for current and future citizens," the letter stated.