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ACP's Advocacy Agenda for 2019: Stabilizing Insurance Markets, Fighting Firearms Violence and Controlling Drug Costs

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College holds hope for bipartisan support for issues that will protect patients and physicians alike

Feb. 8, 2019 (ACP) – The American College of Physicians is facing familiar challenges on the advocacy front as a new legislative season gets underway.

However, ACP's top advocacy executive says that 2019 could also bring good news on the pharmaceutical drug cost front and that the Affordable Care Act should hold up against challenges.

It's even possible that Congress will stabilize the insurance market and make it easier for the Centers for Disease Control and Prevention to conduct research into firearms violence.

“The opportunities for progress will be crucial this year,” said Bob Doherty, ACP's senior vice president for governmental affairs and public policy. “We're looking for those bipartisan sweet spots where we can move things forward with the support of both parties.”

Here's a look at advocacy areas that ACP expects to focus on in 2019:

Protecting patients from skyrocketing drug prices

“There's a lot of interest in the House, the Senate, and among President Trump and those in his administration, in advancing legislation to address the problem of rising drug prices,” Doherty said.

The unexpected rising cost of insulin, a long-standing drug that doesn't require research and development funding, is especially on the minds of legislators, he said. “Physicians are seeing people not being able to afford their insulin, and there are stories in the news media about this,” he said.

Doherty is “cautiously optimistic” about progress on the drug price front.

“We're also hoping to see legislation advance that would end abuses by which drug manufacturers keep competing drugs off the market in a variety of ways,” he said, “and there are a lot of things that could be done in terms of transparency and ensuring more competition.”

Resolving the budget impasse

Although funding for many medical programs wasn't affected, the partial government shutdown in January had both direct and indirect impacts on health in the United States, Doherty said.

“Indian health funding was at risk, the FDA delayed approval of new drugs and food safety inspections were suspended,” he said. “It was an inauspicious beginning to the year.”

While another shutdown is possible, ACP will continue to advocate for responsible budgeting that protects the health care system and those served by it.

Looking forward to the 2019-2020 budget, for the federal fiscal year that begins in October, ACP expects a debate over lifting budget limits that have restricted the ability of Congress to put more money into spending that's not related to national defense.

“If we get higher budget caps, we can work to get adequate funding for programs that are critical, like the Health Resources and Services Administration, the Centers for Disease Control, the Agency for Healthcare Research and Quality, the National Institutes of Health, and the Centers for Medicare and Medicaid Services,” Doherty said.

Protecting and reforming the Affordable Care Act

A federal judge has ruled against the Affordable Care Act, but ACP and other organizations are hoping higher courts will act to protect the ACA's vital health care reforms.

What's next as the legal process goes forward? ACP joined other groups to file legal papers supporting the ACA at the trial court level. However, ACP doesn't expect that there will be ruling in the case until next year.

In the meantime, ACP will be looking for bipartisan opportunities to improve coverage under the ACA. This could include measures to stabilize the markets by increasing federal premium subsidies, measures to encourage plans to enter and stay in the markets, or oversight related to the risks of short-term plans that are now allowed by the Trump administration. ACP will be monitoring hearings in Congress to address these issues.

“We've frequently testified before Congress, and we're eager to do so again if we're asked to participate,” Doherty said.

Passing legislation to address firearms violence

Last year, recommendations published by ACP helped spark a nationwide outcry when the National Rifle Association responded with a “stay in your lane” jibe. Using the #ThisIsOurLane hashtag, physicians used social media to describe their encounters on the job with the horrors of gun violence.

According to Doherty, however, the odds are “pretty slim” that significant federal firearm legislation will gain the approval that it needs, even as more states take action on their own.

“Polls show common-sense measures such as strengthening background checks have overwhelming support, but they won't make it through the Senate,” he said. “The Senate is more heavily weighted toward rural states that have high levels of gun ownership.”

Still, Doherty said, there's a chance that Congress could authorize the CDC to spend money to study firearms violence. “Congress recently clarified that CDC can still do research in this area but they haven't given them any money,” he said. “It's possible that change could come this year.”

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Back to the February 8, 2019 issue of ACP Advocate