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From #ThisIsOurLane to fighting to preserve the health care law, ACP made a difference in the national discourse

Jan. 11, 2019 (ACP) – The �ܼ�����ˮ��̳ spent much of 2018 playing defense in an urgent bid to protect patients from threats on a variety of fronts. That advocacy made a difference. In fact, the College provided the spark for an extraordinary new movement that's uniting medical professionals across the nation against firearm violence.

“We're willing to take on issues that are controversial, and we'll speak out when we see policies that are harmful,” said Bob Doherty, ACP's senior vice president for governmental affairs and public policy. “We're guided by the lodestar of what's best for the public and patients.”

ACP's most high-profile advocacy moment in 2018 came when it helped to ignite the #ThisIsOurLane movement of physicians opposed to gun violence.

The movement began when the National Rifle Association responded to ACP's position paper on firearm violence by calling on physicians to “stay in your lane.” Hundreds of physicians responded on social media with stark “#ThisIsOurLane” messages about the violence and bloodshed they've seen on the job.

“ACP helped to change the conversation in our country,” Doherty said. “The backlash against the NRA created a massive organic response and emboldened physicians to speak out. I see a real breaking point where the narrative is changing and significant progress is possible.”

Here's a look at other ACP advocacy accomplishments and priorities from 2018:

Health coverage

Republicans in Congress and the White House continued to threaten the existence of the Affordable Care Act, and ACP joined with other medical organizations to rally to its defense.

Advocates for patients suffered defeats when the Trump administration succeeded in its push for short-term and association-based health coverage that fails to adequately protect patients. However, ACA enrollment for 2019 remained fairly steady, Doherty said, calling it a sign that Americans are still seeking and getting the coverage they need.

Currently, ACP is carefully monitoring a Texas federal lawsuit that threatens to dismantle the protections of the ACA if it is upheld by higher judges. ACP and its allies filed a court brief opposing the lawsuit, and are expected to follow up now that a federal judge has ruled in favor of the plaintiffs.

Meanwhile, ACP is encouraged that the Democratic leadership of the House of Representatives has signaled that it will do everything possible to preserve and stabilize the ACA. “With the new Congress,” Doherty said, “there are going to be more opportunities to potentially strengthen the ACA by propping up coverage and ensuring that it's available.”

Regulatory and payment issues

On several fronts, ACP successfully lobbied federal officials to reduce administrative burdens on physicians and adopt policies that put patients before paperwork.

For example, the Centers for Medicare and Medicaid Services eliminated a requirement that forced physicians to re-enter patient data that medical students had put into electronic health reports. Now, documentation is required only when patient information changes.

CMS also established a new office dedicated to eliminating unnecessary rules, and ACP, through participation in House subcommittee roundtables, helped convince Congress to advocate for a reduction in Medicare paperwork.

Other changes will improve the Medicare payment system, including a two-year delay of changes to payments for evaluation/management (E/M) services and continued higher payment for level 5 patient visits.

“We believe the doors are open to further improvements,” Doherty said. “That's going to be a major area of focus this year. There are a lot more things that CMS can do to simplify the Medicare payment program and make sure more meaningful measures can be used. We're going to push them on that, and we think we may get some helpful assistance from Congress.”

ACP also helped convince the Trump administration to eliminate extra fees that hospitals charge patients being seen at doctors' offices that hospitals own.

Immigration

ACP has been at the forefront of battles over immigration policy and the proper treatment of migrants and their families.

“We've stood up against the separation of children at the border, and we successfully led the charge to fix delays in visas for foreign medical students,” Doherty said.

“We are not experts on how best to control the border, but we do bring expertise about the health impacts of detaining kids at the border,” he said. “We will weigh in to make sure that they get proper medical care.”

Health funding

After intense lobbying from ACP and its allies, Congress agreed to fund essential health programs, including the National Institutes of Health and the Centers for Disease Control and Prevention.

ACP advocacy also helped push Congress to pass a new opioid law that increases funding for treatment and prevention while adopting other beneficial changes, including standardizing preauthorization requirements for prescription drugs.

Moving forward, ACP sees opportunities to continue to influence national debates over gun violence, climate change, and immigration.

Doherty said ACP is especially poised to make a difference in the fight against firearm violence, in light of its high profile in the new #ThisIsOurLane movement.

“There are some measures that could get through Congress, such as allocating money for gun violence research,” he said. “We're cautiously optimistic we can move that forward, and we believe multiple states will be willing to adopt new legislation. We'll be engaging our chapters to give them tools they can use to persuade their legislators and governors to take action.”

In the big picture, he said, “we see an opportunity to make a difference, and we will embrace it with all of the extraordinary energy and expertise that make ACP such a valuable part of the national discourse.”

More Information

An infographic, 2018 ACP Advocacy at Work, can be viewed on the College's website.

Details on ACP's position on current issues are available in the Where We Stand section of the ACP website.

Back to the January 11, 2019 issue of ACP Advocate