More recently, the ACR has written to the president and the director of Homeland Security to request that medical professionals be exempted from the suspension and any future modifications of the H-1B visa program to allow for international physicians to continue to enter the U.S. to take care of our underserved patients. Lastly, and perhaps most importantly, we have been communicating with our international colleagues to express our concerns with regard to travel restrictions, as well as our respect and regard for their expertise and friendship. The full impact of the Executive Order on travel restrictions may not be realized until we meet for the ACR/ARHP Annual Meeting in San Diego later this year.
ACA Repeal & the AHCA
The next shift in the wind carried with it the threat of the loss of access to healthcare for millions of Americans. In response to the proposed legislation to repeal and replace the Affordable Care Act (ACA), we wrote a letter to Speaker Ryan, Majority Leader McConnell, Minority Leader Pelosi and Minority Leader Schumer on behalf of our membership. The letter stated, in part, that “all Americans should be covered by sufficient, affordable and continuous health insurance that encourages high quality healthcare. Such high-quality healthcare would include treatment for arthritis and rheumatologic diseases with access to a rheumatologist and other rheumatology health professionals for both consultative and maintenance care.”
Since the passage of the American Health Care Act (AHCA) of 2017 by the House, the ACR has written to leaders of the U.S. Senate, stating that revisions to the AHCA should include:
- No preexisting illness exclusions;
- Affordable premiums, deductibles and cost sharing; high-deductible plans can reduce access to medically necessary rheumatologic treatments, such as biologics;
- Limitation of patient copayments, which reduce access to care and treatments;
- Caps on annual out-of-pocket patient costs and a ban on lifetime limits on healthcare benefits;
- Coverage allowing children to remain on their parent’s insurance plan until age 26;
- Coverage for services that are exceptionally valuable to arthritis patients (e.g., biological therapies, physical and occupational therapy);
- Coverage of health educational activities for chronic arthritis patients, realizing the importance of education in the management of chronic rheumatic diseases;
- Recognition of the difficulties of travel for rheumatic disease patients: laboratory, radiological services and infusion services should be conveniently available near the source of the patient’s medical care; and
- Continuation of the currently required essential health benefits, in order to ensure patients have access to a robust set of healthcare services.
Our objective over the last several months has been to be responsive in a timely and nonpartisan manner. This requires being agile, engaged, focused and politically neutral to best serve the needs of our members and their patients. The strategy seems to be working and once again getting the wind at our backs. Many of the editorials and other articles recently written by the College supporting the advance of rheumatology and the care of our patients have caught the attention of and been published in prominent and pertinent Washington, D.C., and other health policy publications.
RheumPAC
Angus B. Worthing, MD, FACP, FACR, chair of the Committee on Government Affairs, and the ACR staff have done a remarkable job of staying on top of political developments in D.C. and helping respond in a most expeditious manner. Going forward, advocacy will be more important than ever. We encourage you to kindly invest generously in RheumPAC and share your thoughts with its chair, Harry Gewanter, MD, FAAP, FACR. Please express your support and appreciation for our volunteers serving on the Committee on Government Affairs and RheumPAC. Their efforts will be instrumental in securing the relationships that will help us navigate the ever-shifting winds in these challenging times.