March 18, 2019
Area(s) of Interest: Advocacy Physician Leadership
The California Medical Association (CMA) physician leaders were recently in Washington, D.C., for the American Medical Association (AMA) National Legislative Advocacy week. CMA physicians met with key congressional leaders to discuss strategies to make health care more affordable, including addressing the rising cost of prescription drugs, improving the Affordable Care Act (ACA) and protecting patients from unanticipated medical bills by mandating stronger network adequacy requirements.
CMA urged Congress to focus on improving the ACA by increasing Medicaid rates and reinstating the individual mandate, cost-sharing assistance and reinsurance funding to keep premiums more affordable.
CMA also discussed the access-to-care challenges of implementing a Medicare-for-all program, not only because the overall cost could be more than $32 trillion because also because stagnant Medicare physician reimbursement rates are more than 20 percent below what it costs to operate a medical practice. CMA strongly supports universal coverage and universal access to care, but expanding Medicare does not fulfill the promise of universal access to physicians.
To make health care more affordable, CMA urged Congress to reduce the costs of prescription drugs by authorizing Medicare to negotiate prices with drug-makers. Medicare drug spending has doubled over the last decade. For instance, the cost of insulin, which has been available for nearly a century, has skyrocketed by 500 percent over the last few years. Physicians told lawmakers that many patients delay or forego prescriptions entirely because of the cost.
CMA also asked Congress to go further in equalizing Medicare payments regardless of whether a physician service is provided in a physician’s office or a hospital-owned clinic.
CMA leaders also met with officials from the Centers for Medicare and Medicaid Services (CMS) to urge them to delay the requirement for physician-led accountable care organizations to accept downside financial risk and to authorize more physician-led alternative payment models. CMA also urged final adoption of the CMA-authored California Medicaid Payment Demonstration Project.
Other issues the CMA physicians discussed with lawmakers include:
- Reauthorization of the Conrad 30/ J-1 VISA program which allows foreign physicians to remain in the U.S. after residency training if they practice in an underserved area for three years. CMA is asking Congress to reauthorize and improve the program by expanding the number of available positions. Through a bipartisan formula that was developed several years ago but not enacted, the California numbers could increase from 30 to 60.
- HR 8, “The Bipartisan (Firearm) Background Checks Act of 2019,” which would expand the existing background check system to cover all firearm sales. The CMA-supported bill has passed the U.S. House of Representatives, and now moves to the U.S. Senate where it faces greater hurdles. (See “Major gun legislation passes U.S. House”)
- CMA also asked for balanced legislation to address the problems of patients facing unanticipated medical bills for services that their insurance would not cover. CMA called on Congress to address the problem by incentivizing insurers to maintain meaningful physician networks and accurate provider directories while assuring patient access to in-network physicians. (See, “CMA urges Congress to adopt New York surprise coverage law”)
For more information, see the packet of CMA Talking Points on these issues.