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ACP advocates on behalf on internists and their patients on a number of timely issues. Learn about where ACP stands on the following areas:
© Copyright 2018 American College of Physicians. All Rights Reserved. 190 North Independence Mall West, Philadelphia, PA 19106-1572
Toll Free: (800) 523.1546 · Local: (215) 351.2400
June 30, 2014
David A. Fleming, MD, FACP
President of the American College of Physicians
(Washington) - The American College of Physicians (ACP) is
deeply concerned about the adverse impact on healthcare that may
result from today's Supreme Court ruling that allows "closely held"
for-profit employers to opt-out of evidence-based contraceptive
coverage requirements. We believe that this decision will make it
more difficult for women to access affordable contraceptives, and
potentially, open the door for for-profit employers to seek
additional exemptions from other evidence-based coverage
requirements established by the Affordable Care Act (ACA).
As a result of the ACA's mandated benefits, millions of
Americans may now access services such as flu shots, cancer
screenings, wellness visits, and tobacco use cessation care, at no
cost. According to the U.S. Department of Health and Human
Services, 71 million Americans received expanded evidence-based
preventive service coverage without cost sharing in 2011 and 2012
as a result of the ACA. Since implementation of the women's
preventive health benefit, women have saved millions of dollars in
out-of-pocket costs for contraception and may now access a wider
variety of high-quality care options.
ACP's concern about the potential impact of the Supreme Court
decision is grounded on our long-standing policy that all Americans
should have coverage for evidence-based medical care services,
including preventive services like contraception. We have no
position or expertise on the legal arguments and precedents
involved in the Hobby Lobby case (Burwell, Secretary of Health and
Human Services et. al. v. Hobby Lobby Stores Inc, et al); our
expertise is based on the potential impact of the decision on
public health, and specifically, the adverse health impacts on the
patients seen by the 137,000 internal medicine specialists and
medical students who are members of ACP. We are concerned that
allowing employers to carve-out exemptions to the ACA's
requirements that health insurance plans cover evidence-based
preventive services without cost-sharing, including but not
necessarily limited to contraception, will create substantial
barriers to patients receiving appropriate medical care as
recommended by their physicians.
We acknowledge that the Supreme Court has stated that, "This
decision concerns only the contraceptive mandate and should not be
understood to hold that all insurance-coverage mandates e.g., for
vaccinations or blood transfusions, must necessarily fall if they
conflict with an employer's religious beliefs." Allowing for-profit
employers to exclude coverage for contraception is itself deeply
concerning because of the demonstrated adverse impact it will have
on women's health. And, although we certainly hope that the Supreme
Court's decision does not result in for-profit employers obtaining
exemptions for vaccinations and other evidence-based benefits, the
ruling clearly does not preclude for-profit employers from
challenging such mandates, or the courts from granting further
coverage exemptions. Rather, it seems likely that the Supreme
Court's decision will open the door for more for-profit employers
to seek exemptions from the ACA's other insurance-coverage mandates
on the basis that they violate their owners' beliefs.
ACP reaffirms its support for requiring insurance plans and
products-whether purchased by an individual, through a
fully-insured group plan, or a self-insurance arrangement-to cover
evidence-based preventive services without cost sharing. We urge
the administration, Congress, and other policymakers to work
together to develop a remedy that ensures that women are not denied
access to no-cost contraception as a result of the Supreme Court's
ruling, and more broadly, to ensure that all Americans will have
access to coverage for evidence-based medical care as recommended
by their physicians.
The American College of Physicians is the
largest medical specialty organization and the second-largest
physician group in the United States. ACP members include 137,000
internal medicine physicians (internists), related subspecialists,
and medical students. Internal medicine physicians are specialists
who apply scientific knowledge and clinical expertise to the
diagnosis, treatment, and compassionate care of adults across the
spectrum from health to complex illness. Follow ACP on Twitter and Facebook.