Do Your Part: ACP Calls for Increased State Advocacy on Key Issues in 2020

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ACP provides several resources for chapters to push for issues on the state level

Jan. 24, 2020 (ACP) – The American College of Physicians (ACP) is calling on all internists to get involved in key advocacy issues at the state level in 2020 and beyond.

ACP anticipates a flurry of activity in the states this year concerning legislation that reduces firearm-related violence, access to reproductive health services, surprise medical billing and other issues. The College has developed resources to help states better advocate for legislation that is in line with ACP policy on many of these matters.

In particular, firearm-related injuries and deaths remain a significant public health issue in the United States. Fully 36,000 Americans are killed by guns each year and 100,000 more are shot and injured, according to statistics from the Gifford's Law Center to Prevent Gun Violence. To help curb this epidemic, ACP published a policy paper in 2018 titled “Reducing Firearm Injuries and Deaths in the United States in the Annals of Internal Medicine. The paper outlines necessary steps to curb gun violence including placing a ban on sales of assault weapons, universal background checks, and new policies on extreme risk protection orders.

“The best chance for ACP to achieve meaningful action to reduce gun violence may be at the state and chapter level,” said Shuan Tomlinson, ACP senior analyst of state health policy & grassroots advocacy.

Chapters and members can contact their state legislators and urge them to introduce and pass laws requiring safe storage of firearms, enhanced background checks and protections for non-spouse partners and family members in cases of firearms-related domestic violence. ACP provides a sample letter that chapters can customize according to what is happening in their state along with other helpful resources such as a gun law fact sheet, a summary of gun laws by state and a state legislative calendar, Tomlinson said. The firearms action tool kit can be found online.

Reproductive Services

In 2018, ACP published a position paper on women's health care and access to reproductive services. ACP believes that a woman has the right to make her own health care decisions, but recent legislative and regulatory moves have threatened that access, Tomlinson explained. She went on to say that chapters should be aware of ACP's policies on women's health. Specifically, they should watch for state legislation that is contrary to their professional judgement and the patient's best interest; that imposes unnecessary, non-evidence based requirements on clinics; or, that seeks to ban access to reproductive health services contrary to ACP policy. In the first half of 2019, 12 states enacted some type of abortion ban, according to the Guttmacher Institute.

The ACP position paper gives chapters a great place to start, Tomlinson said. Members can and should contact the ACP national office to discuss any activity in their state.


Medicaid provides health coverage to nearly 72 million Americans or one in five Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities.

ACP chapters can advocate in support of the Medicaid program in two different ways. Chapters in states that have not expanded their Medicaid program may wish to contact their state governor or legislature to advocate for expansion. Additionally, ACP is strongly opposed to making access to health care coverage through Medicaid conditional on an individual's employment status. More states are now attempting to apply for waivers that would allow their Medicaid program to enact work requirements. ACP has developed a chapter action campaign that would enable state chapters to provide comments on proposed waivers in their state. The state Medicaid waivers chapter action campaign can be found online.

Surprise Medical Billing

Surprise medical billing refers to patients getting saddled with unanticipated, high out-of-pocket costs. President Trump issued an executive order requiring greater transparency of health care costs. “Surprise billing will be big at the state level and that is something we will have as an advocacy priority going forward,” Tomlinson said.

ACP would like chapters to be informed about ACP principles on surprise medical billing and advocacy at the national level. This includes lobbying for legislation that will hold patients harmless and a fair arbitration of payment instead of set in-network rates, among other measures.

Other key state advocacy issues in 2020 and beyond include vaccine exemption laws, Tomlinson said. ACP is asking chapters to advocate for policies at the state level that eliminate any existing exemptions, except for medical reasons, from immunization laws and/or to oppose legislation that seeks to expand exemptions.

“Get involved and make some noise,” Tomlinson said.

More Information

Learn more about the issues that matter and what you can do at the state level on the ACP State Health Policy page.

The position paper “Reducing Firearm Injuries and Deaths in the United States” is available on the Annals of Internal Medicine website.

The position paper “Women's Health Policy in the United States” is available on the Annals of Internal Medicine website.

ACP's principles on surprise medical billing can be found in a letter sent to key congressional committees last year.

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