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Looking Ahead at What's 'Hot' in Advocacy
ACP takes aim at issues that confront physicians and patients
May 3, 2019 (ACP) – With Congress and many state legislatures in session, and the 2020 election getting closer, pushing for policies that support patients and physicians remains a top priority for the American College of Physicians.
At the College's recent annual meeting – more than 7,000 attendees gathered April 11-13 in Philadelphia – briefings were held on issues of particular concern, such as firearms violence, the rising cost of prescription drugs, and the administrative burdens physicians now face.
As Richard Trachtman, ACP's director of legislative affairs, told members during an advocacy presentation at the meeting, ACP's voice is deeply respected from Capitol Hill to statehouses across the nation. “You have that credibility, and you should use that credibility,” he said, encouraging members to take part in ACP's advocacy efforts.
Goals for the “hot topics” in ACP's advocacy portfolio moving forward this year include:
Ensuring access to quality health care
“We are advocating for policies to stabilize the insurance markets, make more premium subsidies available and expand Medicaid,” said Bob Doherty, ACP's senior vice president for governmental affairs and public policy. “We're supporting legislation in Congress that is consistent with these recommendations, and we'll be asking our members to express their support.”
Supporting patients and physicians via the courts
Beyond speaking up to elected policymakers, ACP also is working through the legal system to support the preservation and improvement of the Affordable Care Act.
For instance, ACP submitted a legal brief in opposition to the Trump administration's bid to kill health care reform via a Texas federal court case. Now, ACP is closely monitoring the case as it moves forward after a federal judge's ruling that, if upheld, would overturn the health care law. “We are emphasizing the devastating impact if all of the protections are declared unconstitutional,” Doherty said.
On another front, ACP is working to reverse a Trump administration regulation that would interfere with the patient-physician relationship by effectively prohibiting physicians at clinics that receive federal dollars under the Title X program from any discussion of or making referrals for abortion. Federal law already prohibits funding of abortion out of taxpayer dollars; and this rule would cut off Title X funding that is used for a number of preventive and medical services offered at these clinics should they decide not to abide by these changes. “This disrupts the doctor-patient relationship,” Doherty said. “It would also create access problems to preventive and family planning services for millions of patients, mainly women, if clinics are forced to close because of the administration's rule.”
ACP joined in an amicus brief with the American Medical Association and other health advocacy groups in a federal lawsuit challenging the Title X final rule. Two federal judges have issued nationwide injunctions temporarily halting implementation of the regulation.
ACP is also raising the alarm about regulations in Arkansas and Kentucky that set work-related requirements for Medicaid recipients.
Reducing administrative burdens on physicians
ACP continues its work to reduce burdens on physicians as outlined in its “Patients Before Paperwork” initiative.
“We have the ear of the Trump administration, and they are moving on many fronts to reduce administrative tasks, like electronic health record documentation requirements,” Doherty said. “We'll be asking Congress to make some tweaks to the legislation that created Medicare's Quality Payment Program so physicians can get stable updates, and we're going to explore opportunities to work with them on related issues.”
Lowering drug costs and increasing transparency
ACP is calling for Medicare to directly negotiate Part D drug prices with manufacturers. And on the transparency front, “we would like to see them disclose material and production costs, and the research and development costs for their drugs, to regulators and the public,” Doherty said at the ACP annual meeting.
Reducing firearms violence
“With the start of the new Congress this January, there has been more activity in Washington to put into place policies that would help to prevent firearms injuries and deaths,” Dr. Ana María López, ACP's immediate-past president, said in a presentation at the annual meeting.
ACP, which considers firearms violence to be a public health emergency, supports a variety of common-sense policies to reduce the violence, including the closure of loopholes in the background check process and the allocation of federal funding for studies.
“We've got to have data,” López said. “We need research so we can move forward with what are the best practices, and what works.”
ACP has several other advocacy priorities moving forward, Doherty said. They include ensuring proper funding for medical programs for the 2019-2020 federal fiscal year, supporting equity for women in medicine and ensuring protections for LGBTQ patients.
“We have much to do,” he said, “and we look forward to making a difference.”
ACP's new position paper, “Improving the Patient Protection and Affordable Care Act's Insurance Coverage Provisions,” is available on the Annals of Internal Medicine website.
ACP's comments on the changes to the Title X regulations are available on the ACP website.