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Dynamic Health Care Guide for Congress and the Media

The American College of Physicians (ACP) prepared this guide to serve as an ongoing resource for members of Congress and their staff, the news media, and other interested persons on the top health care issues affecting our members and their patients:

  • The guide is concise: distilling some of the most complex health care issues to be considered by the 114th Congress into two page summaries with additional resources for those interested in learning more.
  • The guide is dynamic: we will continue to update the content and the links for more information as circumstances change.
  • The guide is selective: we didn't include every health care issue that this Congress may address; only the ones that we believe will have the greatest impact on internal medicine physician specialists, and their patients, and of those, the ones where we believe that there is an imperative for Congress to act.
  • The guide strives to provide an accurate presentation of the issue and its impact on our members and their patients, yet framed in a way that reflects the College's views on each.

Although we are making the guide available in paper version, it will be most useful in digital form because it includes embedded URL links to other resources that will be frequently updated. If you're looking for a quick overview of the important issues, read our summary.

ACP's Six Most Important Health Care Issues

Medicare Sustainable Growth Rate/Physician Payment Reform

  • On April 16, 2015, President Obama signed into law the Medicare Access and CHIP Reauthorization Act of 2015, which permanently repealed the Medicare SGR formula used to calculate physician payments. The new law establishes stable, positive payment updates while transitioning Medicare toward a "value-based" payment system.

The Medicare Primary Care Incentive Program

  • Congress authorized mandatory funding for the Primary Care Incentive Program from 2011 through 2015. Funding for this program is set to expire at the end of this year unless Congress authorizes additional funding to continue it after 2015.

Medicaid Primary Care Pay Parity

  • The pay parity program expired on December 31, 2014. Because the program was not extended, primary care physicians experience an average cut of 42 cents on the dollar for providing primary care services such as office visits for the treatment of chronic diseases like high blood pressure and diabetes to Medicaid patients.

Graduate Medical Education

  • The number of available residency training positions funded by Medicare has been capped at 1996 levels since the passage of the Balanced Budget Act of 1997. With sharply increasing numbers of allopathic and osteopathic medical students and looming physician workforce shortfalls, especially in primary care, the current "choke-point" in the physician supply chain is residency training. Several bills were introduced in both the House and Senate last Congress that would increase the number of Medicare-supported training positions with preference for primary care and general surgery.

Funding for Vital Federal Health Care Programs

  • Access to primary care services is an essential part of everyone's health care. Studies have shown that seeing a primary care physician regularly and having access to preventive services leads to better health outcomes and savings to the system. Independent studies show that the U.S. is facing a shortage of tens of thousands of primary care physicians, and millions of patients in many parts of the country already have poor access to primary care.

The Affordable Care Act

  • Open enrollment for the 2015 plan year for most people ended on Feb. 15, and the special tax season enrollment period (for the marketplaces operated by the federal government) ends on April 30. In Jan., the House approved changes to the employer mandate work hour definition; the Senate has yet to take it up, and the administration has stated that it would veto the change. The U.S. Supreme Court will issue a ruling in 2015 on the King v. Burwell case, which will decide whether the IRS is permitted to provide premium and cost-sharing financial assistance to individuals in states with a health insurance marketplace operated by the federal government.

Mobile users: please note that links within the guide will not open in Safari on iOS 8; Chrome is the recommended browsing experience.

Updated August 2015