PAC pushes for fundamental changes for SGR
From the April ACP Observer, copyright © 2007 by the American College of Physicians.
By Jessica Berthold
| Sidebar: |
After a successful 2006, the ACP Services Political Action Committee is working in 2007 to create opportunities for ACP Services advocacy staff and volunteer leaders to press a newly elected Congress to avert Medicare pay cuts to internists and to expand health insurance coverage to uninsured Americans.
"The work that our very good staff in Washington does depends largely on being able to get our ideas into the hands of politicians who are trying to resolve difficulties in medicine," said ACP Services PAC Chair Richard Neubauer, FACP. "The PAC is one tool in the toolbox for doing that."
ACP Services' PAC was established in 2004 to promote the interests of internists and their patients in the political process by backing candidates for federal office who support internal medicine's legislative agenda. The PAC is an arm of ACP Services, Inc., an internal medicine membership organization that was created separately from the ACP but with a similar mission, to engage in advocacy activities that the ACP is unable to engage in as a non-profit charitable organization. ACP Services also employs full-time lobbyists to support internal medicine's advocacy agenda.
Consistent with ACP Services legislative agenda, one of the biggest issues for the ACP Services PAC this year will be supporting candidates who are committed to working for fundamental changes to the Sustainable Growth Rate (SGR), the statutory formula that's used to update Medicare physician payments. A 5.1% reduction was nixed by Congress at the eleventh hour last year, but the issue will rise again in 2007, Dr. Neubauer said.
"My understanding is that the projected cuts from last year will compound this year," Dr. Neubauer said. "An 8% to 10% cut would be devastating for internists and their patients, so this issue will, unfortunately, absorb a lot of time."
The PAC will also provide an opportunity for ACP Services leaders and staff to meet with congressional candidates at small fundraising events hosted or supported by the PAC. These events will give ACP Services representatives a chance to advocate for a longer-term solution that would result in the elimination of the SGR, provide positive and stable updates, and create incentives for improving quality. Such events will also allow for discussion of the need for medical liability reform and the creation of financial incentives to acquire health information technology.
Expand health insurance
Both ACP and ACP Services are advocating for legislation to expand health insurance coverage to ensure that patients have access to a core set of benefits that includes preventive and primary care services and other services associated with patient-centered care.
"State of the Nation's Health Care 2007," a report that was issued independently by the ACP, encourages proposals that dedicate federal funds to support state-based programs that will reduce the ranks of the uninsured; and provide waivers to states that want to redesign their Medicaid and S-CHIP programs to give enrollees access to services through a patient-centered medical home.
The report also urges members of Congress to provide health insurance coverage to all Americans by a specific date. Expanded health insurance coverage will be high on the list of criteria that ACP Services PAC uses in selecting candidates to support.
Other issues
Last year, in addition to its work on the SGR, ACP Services' volunteer leaders and advocacy staff helped to ensure that a three-year pilot of the patient-centered medical home model came to fruition. ACP Services PAC provided an opportunity for ACP Services members and advocacy staff to participate in fundraisers for legislators that had a record of support for patient-centered primary and principal care.
For instance, ACP Services PAC members and staff participated in fundraising events for Rep. Joe Barton, R-TX, the chair of the House Energy and Commerce Committee in the 109th Congress, based in large part to his commitment to patient-centered care. Rep. Barton was instrumental in including language on the medical home concept in H.R. 6111, the Tax Relief and Health Care Act of 2006. Internists who participate in the pilot will receive a fee for managing the care of patients with multiple chronic conditions.
"The ACP Services PAC allowed its members and the Services advocacy staff to engage in small, face-to-face discussions with key legislators on how a patient-centered medical home can improve quality and reduce costs," explained Ms. Allendorf. "It also created a means for internists to help elect or re-elect candidates who had a proven track record of support on issues, like the medical home and universal coverage, of importance to internists and their patients. In this regard, the PAC provided opportunities for ACP Services to advance internal medicine's agenda directly with members of Congress."
"Our agenda is patient-centered," Dr. Neubauer said. "It's not just based on getting doctors more income."
Facts and figures
In 2006, the PAC nearly doubled its membership to 741. Members contributed $162,332 in the 2005-2006 election cycle, of which $135,281 was given to 110 political candidates. PAC members and staff attended 117 political events.
Of the 80 incumbent lawmakers or open seat candidates the PAC supported in the mid-term election, 90% won. Many assumeed key positions on the committees with jurisdiction over health issues in the 110th Congress.
The PAC is governed by a 14-member Board of Directors that researches and analyzes the voting records and committee membership of Congressional candidates and members to gauge their support of issues important to internal medicine. PAC contributions go to candidates for federal office who are in a position to play a key role in the formulation and passage of health care legislation and whose voting records are consistent with the specialty's legislative priorities, as determined by the Board of Directors. The PAC doesn't participate in state campaigns, nor does it make contributions in support of or in opposition to state level ballot initiatives such as referenda and constitutional amendments.
Because of its tax status as a charitable organization, ACP cannot establish a PAC. ACP Services, Inc.—a separate and distinct organization from ACP that was established in 1998 to provide advocacy, practice management and other services for internist-members—has a different nonprofit tax status, which allows it to establish a PAC. ACP Members automatically become members of ACP Services, Inc.
Top 5 state contributors to ACP Services
Florida - $11,310
New York - $7,655
California - $6,845
Texas - $5,810
Pennsylvania - $3,660
Contact ACP Internist
Send comments to ACP Internist staff at acpinternist@acponline.org.