An Update from the RheumPAC Chair on the 117th Congress

With the August recess over and only a couple months left in the legislative calendar for the 117th Congress, ACR staff and the Government Affairs Committee have continued to advocate and engage with members of Congress, while RheumPAC has been working to ensure that individual legislators understand what you, your practice, your patients and others in the rheumatology community face when it comes to delivering high quality care to those with rheumatic diseases.

Dr. Blumstein

As the only federal political action committee (PAC) dedicated solely to the interests of rheumatology, RheumPAC will continue to educate members of Congress and is always in need of additional resources to compete with those who have conflicting interests. Read on to learn about all the important work that has been done, and consider donating at www.rheumpac.org to help ACR advocacy efforts.

Congress has recently pivoted to considering a series of large packages consisting of multiple policies rather than its traditional bill-by-bill legislative process. The ACR and RheumPAC have taken part in those discussions to push for policy beneficial to rheumatology while pushing back on proposals that would hinder our ability to deliver care. Key provisions in some of the big bills you may have heard about in the news have:

• Placed a cap on patient Medicare Part D out-of-pocket costs at $2,000 annually;
• Expanded eligibility for low-income Medicare Part D subsidies;
• Provided no-cost vaccines under Medicare Part D;
• Limited Medicare Part D premium growth to <6%;
• Allowed Medicare to have the ability to negotiate prices with pharmaceutical companies,** and
• Put a cap on cost-sharing for qualified users of the Affordable Care Act.

**The ACR continues to work with Congress and will work with regulatory agencies to ensure physicians, practices and patients are not in the middle of negotiations between the government and drug manufacturers that will hurt access to Part B medications. The ACR is also proposing exempting Part B reimbursements from sequestration reductions.

In addition to those larger packages, we have been working fervently behind the scenes on other key provisions of the ACR’s policy priorities. These efforts have:

• Resulted in funding for the Pediatric Subspecialty Loan Repayment Program for the first time. Money has been appropriated to get this program launched, and the ACR continues to push for additional resources to help grow the pediatric workforce through loan forgiveness;
• Averted 10% cuts to Medicare reimbursement at the end of 2021. Although certain aspects of those cuts have been phased back in, the ACR has actively advocated against them and expects they will be addressed before the end of 2022; and
• Garnered nearly 400 Congressional co-sponsors on federal legislation to reform prior authorization, which has advanced out of committee in the House and is expected to go to the House floor, where ACR will push for its passage.

The ACR and RheumPAC have also been educating members of Congress and building bipartisan support for several other proposals, including:

• Growing the medical workforce by: 
  • Repealing the cap on Medicare-funded residency slots;
  • Transferring more than 30,000 Congressionally approved J1 visas to medical professionals; and
  • Deferring interest on medical student loans while in residency;
• Mitigating step therapy protocols;
• Banning copay accumulator policies;
• Expanding the use of telehealth by making many of the rules instituted during the pandemic permanent;
• Investigating pharmacy benefit manager practices to address their role in the rising cost of drugs; and
• Increasing NIH, NIAMS and CDC research funding for rheumatic diseases, as well as securing dedicated funding for arthritis through the Department of Defense.

As you can see, it has been a busy year in Congress and of advocating for policies that can positively address the issues that impact rheumatology care providers and their patients. We only expect that to heat up towards the end of the election cycle and in the “lame duck” session of Congress.

Let us work on your behalf and give us the resources to increase the ACR’s impact on decisions in Washington, D.C. Make your investment today at www.rheumpac.org.

Howard Blumstein, MD, is a rheumatologist at Rheumatology Associates of Long Island and chair of RheumPAC.