What’s in Store for Rheumatology in the 113th Congress?

Library of Congress.

When the new 113th Congress convenes this month, it will not look much different from the 112th Congress. The status-quo outcome of the 2012 election means Republicans remain in control of the U.S. House of Representatives despite losing eight seats. In the Senate, Democrats were able to gain two seats and retain control, but they are still seven votes shy of a filibuster-proof majority.

While the election result means control of both chambers is unchanged, the implications of the November elections will be felt. The reelection of President Obama means full repeal of the Affordable Care Act is now off the table and both parties could be more willing to consider modifications to the law. Without an election looming, compromise may also be more possible in other policy areas. Should Congress choose to make revisions to the healthcare reform law, the ACR will continue to work with lawmakers to ensure rheumatology professionals’ interests are represented.

In addition to working with the new Congress on potential improvements to the Affordable Care Act, the ACR will promote these other major legislative priorities in 2013:

Physician Payment Reform

Thanks to sustained outreach from ACR members and the broader physician community, Congress again acted during the lame-duck session at the end of 2012 to postpone the SGR-mandated payment cut to physicians. The ACR has been working with Congressional leaders on the permanent repeal of the SGR that will be necessary to stabilize Medicare and ensure fair physician reimbursement and patient access to quality care. The ACR will continue to advocate for solutions that would repeal the flawed SGR formula and replace it with a payment system that recognizes the value of the specialized care rheumatologists provide.

Patient Access to Treatment

During the 112th Congress, Representatives David McKinley (R-WV) and Lois Capps (D-CA) introduced the Patients’ Access to Treatment Act (H.R. 4209). Thanks to the work of ACR advocates and our partners, we secured 40 bipartisan sponsors for the legislation. The bill would promote greater access to treatments by eliminating excessive Tier IV cost sharing for specialty drugs, placing them within the confines of Tier III nonpreferred drugs. Without such legislation, the practices of some insurance companies will continue to place necessary treatments out of reach of insured Americans who have chronic diseases, contributing to disability and rising healthcare costs. With its partners, the ACR is working with Reps. McKinley and Capps to reintroduce and generate support for this critical bill in the 113th Congress.