Editor’s note: This blog by Dr. Worthing originally appeared on the ACR’s Advocacy Listserv.
What a month! House Republicans introduced their bill to repeal and replace Obamacare. The ACR has analyzed the bill and believes the American Health Care Act (AHCA) does not go far enough to help Americans with rheumatic diseases.
Brief recap: The bill would repeal the mandate for people and employers to buy/provide insurance and allow people to use refundable tax credits instead of subsidies to buy insurance. It aligns with ACR policy to allow kids to stay on their parents’ plans to age 26, to avoid pre-existing condition exclusions, cap out-of-pocket costs and ban lifetime limits. It departs from ACR policy in that premiums may not be affordable using the refundable tax credit system and in allowing higher deductibles and copayments. Also, it does not repeal IPAB (the unelected group of officials that could cut Medicare reimbursement), but that is being addressed in separate legislation.
Conservative and moderate Republicans have criticized the bill, and multiple organizations (e.g., AMA, AHA, ACP, AARP) are opposing it, so the chances for passage are unclear. Your Government Affairs Committee is working hard to promote ACR policies as the bill moves through House committees via letters from ACR President Sharad Lakhanpal, MBBS, MD, a public statement on the AHCA as it is currently written and other messaging. Stay tuned!
ACR Health Policy
Speaking of ACR policy: The ACR has new 2017 health policy statements, which were approved by the ACR Board of Directors last month. The statements retain the College’s core principles to protect patient access to rheumatology care and treatments, and enhance funding for biomedical research and workforce/training.
With regard to MACRA, we caution CMS to make sure not to penalize rheumatologists for appropriate use of expensive drugs whose price we have little control over. The College is looking at solutions for the upcoming severe rheumatology workforce shortage. Finally, we are continuing to try to create a Congressionally-mandated research fund at the Department of Defense for rheumatology research. Go here to tell your member of Congress about it in just a few minutes!
The Immigration Order
Executive Order 2.0 on immigration, which many of you saw released earlier this month, reduced the number of restricted countries to six and allows for current visa holders to enter the U.S. The ACR previously signed onto a statement recognizing potential adverse effects of the first immigration order on scientific collaboration and medical care. The ACR wants to reaffirm the value of open interchange among clinicians, scientists and students to our international members and colleagues who are valued partners of the ACR/ARHP.
The ACR Government Affairs Committee and other leaders are strategizing how best to advocate on behalf of international members in order to minimize disruptions in patient care, education, research and, of course, travel to the ACR/ARHP Annual Meeting.
FDA/Drug Prices/Biosimilars
Amid some confusion about what is happening with FDA leadership and streamlining, the ACR has come out with a strategy to reduce specialty drug prices by supporting the FDA biosimilars unit. Your Government Affairs Committee is promoting support for the FDA through appropriations funding and the use of innovative hiring practices to make the biosimilars approval process more efficient and shepherd safe/effective products to market to compete and lower drug prices.
As for the political and logistical landscape here, it’s unclear if the administration’s hiring freeze affects the FDA.
Early in March, President Trump again addressed drug prices by announcing meetings with lawmakers and an upcoming new system to enhance market competition.
To-Do List
- Tell your member of Congress to create a rheumatology research fund at DOD. It will take you less than a minute!
- Join the AMA! We need about 200 more ACR members to join this year in order to keep our AMA delegates and leverage rheumatology initiatives with them. Call 800-621-8335 or sign up online. When you sign up to join or renew with the AMA, let us know you did by sending an email to [email protected].
- Invest in RheumPAC.
- Sign up for the ACR’s Advocacy Listserv.
All for now. On to March Madness—and I don’t just mean in Washington!
Angus B. Worthing, MD, FACP, FACR, is a practicing rheumatologist at Arthritis & Rheumatism Associates, PC, in Washington, D.C., and the chair of the ACR’s Government Affairs Committee.
