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ACP’s Position and Resources on Healthcare Reform - A Member's Guide

Many of you have expressed questions and concerns about ACP’s position on the health care reform legislation recently enacted. The following is an extensive set of resources to help you:

  • Two-page summary[PDF] of how key elements of the legislation compare to ACP policies and a more detailed section-by-section chart[PDF] that compares the specific provisions in the legislation with ACP policies. These provisions mirror many policies that ACP has advocated for years. They also help to illustrate how ACP’s approach to legislation is based on a thorough evaluation of a bill compared to policy, not the politics or partisanship involved.
  • ACP’s statement on the final legislation, which expresses ACP’s views not only on the many policies they support, but changes they will be seeking in subsequent legislation.
  • ACP’s recent State of the Nation’s Health Care report[PDF], which makes a compelling case of why health reform is needed to avert an unprecedented affordability crisis in the United States. You may find the “without health reform” talking points to be of particular interest.

You can also view key ACP position papers that guided ACP advocacy activities, including:

  • The ACP’s seven year plan[PDF] to provide affordable coverage to all Americans, first released in 2002 and recently updated which is remarkably similar to the approach taken in the legislation passed by Congress.
  • ACP’s paper on solutions http://www.acponline.org/advocacy/where_we_stand/policy/solutions.pdf to the crisis facing primary care.
  • ACP’s paper on reforming physician payments http://www.acponline.org/advocacy/where_we_stand/policy/reforming_pp.pdf to achieve better value for internists and patients alike.
  • ACP’s paper on funding[PDF] of comparative effectiveness research.
  • Summary of ACP membership surveys data on internists’ views on health reform, from the ACP Advocate blog.
  • Interactive graphic from the Washington Post that shows how the legislation will benefit different categories of people and in different income brackets: insured married with children, small business owner, and Medicare beneficiary, and uninsured middle-age couple, uninsured single father of two, and a recent college graduate.
  • The Kaiser Family Foundation has an excellent summary[PDF] of the legislation, which can help answer questions about what is actually in the bill, rather than the allegations of what people think is in it. You can use that chart to search for key words, like primary care or medical homes.
  • Report by the Congressional Budget Office [PDF] on the impact of the legislation on the deficit and numbers of uninsured Americans. The CBO estimates that the legislation will reduce the deficit by more than $143 billion over the next ten years and likely by more than a trillion dollars over the next 20 years, and cover 32 million more Americans—95% of legal residents in the United States, who now lack access to health insurance coverage. The report also shows that the vast majority of Americans, 160 million, would continue to get their health insurance through private, employer-based coverage. The CBO does appropriately acknowledge the uncertainty of its forecasting, so critics can legitimately question whether the legislation will have the intended effect of reducing the deficit. Nonetheless, the CBO estimate is considered to be the definitive non-partisan evaluator of the impact of federal legislation on the deficit.
  • You can view www.politifact.com and www.factcheck.org, which provide accurate information to debunk the many falsehoods being spread by critics of the legislation, as well as unsubstantiated claims by supporters.
  • Kaiser Family Foundation has a March tracking poll[PDF], which shows a much more nuanced view of the public's opinions on health reform than the oft-repeated claim that the public rejects the legislation. Instead, it finds the public about evenly divided, but also shows that large segments of the public have some basic misunderstandings about the legislation. For instance, most did not know that the CBO says it will reduce the deficit. One interesting finding: support for health reform is highest in the southern states, which may seem counter-intuitive but this is because of a higher percentage of African-Americans, Hispanics, and younger persons. Opposition is greatest in the mid-west. You can download a chart pack[PDF] with the key findings from the poll. (A note of caution: polls of public opinion have limited utility in making decisions on complex bills).

Every ACP member who contacts ACP National to express concern about the legislation will get a written response from ACP, and in some cases, personal follow-up by phone or email, unless they specifically state they do not wish to be contacted by ACP. (They can’t promise to call every member who contacts them because of the volume involved. They also believe the most effective follow-up would be from trusted internist-colleagues within your own state, including your Governor). The ACP is tracking the responses to ensure they have an accurate assessment of what they have heard from members, including how many have specifically indicated they intend to resign. They are working on developing a system to report back to the Board of Governors on the responses they’ve received from members in all states.

The ACP believes this legislation will help patients by:

  • Providing affordable coverage for 95% of legal residents in the U.S. by closing gaps in the current employer-based system, in a way that is very consistent with ACP’s own plan (first released in 2002) to cover all Americans.
  • Eliminating insurance practices that exclude or over-charge people because they have pre-existing conditions.
  • Providing affordable coverage options and tax credits to small businesses, the self-employed, and working persons without access to employer-based coverage.
  • Expanding coverage for preventive services, at no out-of-pocket costs to patients.
  • Phasing-out the Medicare Part D doughnut hole.
  • Extend the solvency of the Medicare hospital trust by nine years by reducing unnecessary spending.
  • Helping to ensure access to primary care by training more primary care physicians and increasing Medicare and Medicaid payments to primary care internists.
  • Accelerating pilot-testing of innovative delivery and payment models, like the Patient-Centered Medical Home, which can result in better outcomes and more appropriate payment for internists’ services.
  • Help ensure better quality by funding research on the comparative effectiveness of different treatments.
  • Standardizing insurance practices that add administrative costs and hassles to the system.

These are changes that ACP has long-advocated, and take pride in getting them included in the final legislation. Please realize that health reform is a process, not a destination—that although this legislation is an important step towards advancing ACP priorities, they will continue to advocate for additional reforms and improvements in the legislation itself, but for the College to be effective, we need to continued support of ACP members.

Page updated: 04-14-10

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