End-of-Year Federal Legislation Increases Funding to Crucial Health Programs

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However, ACP urges Congress to do more to address high prescription drug costs and ‘surprise’ medical billing

Jan. 10, 2020 (ACP) – For once, physicians and patients don't have to worry about budget brinkmanship in the nation's capital and the effects on federal health programs. Thanks to a deal struck in the last days of 2019, funding for many of these programs is stable, and there's no risk for a government shutdown for at least another nine months.

There's even more good news. Congress and the president agreed to boost funding for crucial health programs, and federal agencies will now be able to extensively study gun violence and safety. The legal age to buy tobacco products will rise, and patients will have more access to cheaper generic medications.

However, the American College of Physicians is pushing lawmakers to do more. “While ACP is glad to see that legislators have recognized many of the public health priorities where we have urged them to take action, it is important that Congress act promptly to address several remaining priorities that are not included, or only partially addressed, in the appropriations measures,” Dr. Robert McLean, ACP's president, said in a statement.

Positive developments in the budget bills passed by Congress and signed into law by the president include increased funding for the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), and Health Resources and Services Administration in fiscal year 2020, which ends on Sept. 30, 2020. Funding is also now available to allow the CDC and NIH to study gun violence and safety. Both agencies can receive up to $12.5 million each.

“The key to solving any public health crisis is knowledge, and our efforts to prevent firearms-related injuries and deaths have been hampered by inadequate research,” said Jared Frost, an ACP senior associate for legislative affairs. “This funding is a promising first step. The research will help us to better understand the causes and consequences of firearm-related injury and death, and to identify, test, and implement strategies to reduce these events is important.”

In addition, the bills will also make it easier for patients to access generic versions of prescription medicines via provisions of the CREATES Act. The bills also raise the minimum age to buy tobacco products to 21. “This will help reduce smoking and addiction to nicotine, since the overwhelming majority of adult smokers started as teenagers,” Frost said.

Another positive development: The Patient-Centered Outcomes Research Institute will be funded for 10 years. According to Frost, “its research is key to getting the right treatment to the right patients for the right problem.”

However, ACP is still concerned that the budget bills don't go far enough on several fronts such as the cost of health care.

“While the legislative package begins to address high prescription drug costs, more needs to be done to solve this problem, such as more accountability for the big drug companies, including greater price transparency, increased competition, and allowing the federal government to negotiate prices with manufacturers,” Frost said.

ACP is calling for Congress to enact many of the public health priorities included in the Lower Health Care Costs Act, including a national campaign to raise awareness of vaccine safety and effectiveness, funding for programs that aim to reduce maternal mortality, and funding for programs that reduce and prevent health care discrimination. However, ACP does have concerns with the provisions included in the Lower Health Care Costs Act on “surprise” medical bills that can sock patients with high unexpected expenses. ACP believes the provisions included in this bill could create barriers to access and affordability. “Legislation should hold patients harmless without tilting the playing field to insurers at the expense of patients and their physicians,” Frost said.

ACP also urges Congress to ensure funding by passing the long-term reauthorization of several programs now set to expire in May 2020. These programs include Community Health Centers, the National Health Service Corps, and the Teaching Health Center Graduate Medical Education program. “These programs should be funded for several fiscal years at a time, not just for a period of months,” Frost said.

Finally, ACP is disappointed that the new budget bills didn't include a House of Representatives provision that would have prevented the administration's restrictions on the Title X program from moving forward. “Those restrictions greatly limit the ability of women to access reproductive and other health care services and inappropriately restrict physicians from discussing treatment options with their patients,” Frost said.

Moving forward, Frost said, “ACP will continue its vigorous advocacy on all fronts in 2020, including addressing high prescription drug costs, stopping surprise medical billing for patients and imposing a comprehensive ban on flavorings in all tobacco products. And we will push for increased funding for ACP priorities in fiscal year 2021, which begins in October.”

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