Advocacy and policy news for internists
With Election in the Rearview Mirror, ACP Looks Toward Challenges Ahead
Decisions loom on insurance exchanges, Medicaid expansion and more
The first reaction of Dr. David Bronson, president of the American College of Physicians, to the Nov. 6 election results was one of relief -- but perhaps not for the reason you might think.
Bronson works as president for Cleveland Clinic Regional Hospitals, in the heart of the 2012 key battleground state of Ohio.
"Most of us, we were just happy it's over," Bronson said a few days after the election. "We were inundated with robo-calls and emails. You couldn't watch television any more for the political ads."
But as far as his professional reaction to the election, Bronson said the re-election of President Barack Obama means that health care reform will continue to roll out in the United States. The concern had been that Republican candidate Mitt Romney would, if elected, either move to repeal health care reform or act to block its implementation.
"The Affordable Care Act is the law of the land, and now we need to move quickly forward with its provisions to get Americans insured," Bronson said.
With Obama's election, however, Bronson expects the real struggle over health care reform to devolve down from the federal level. "The action is at the level of the states now," he said. "Each state has to make its own decision as to what it's going to do."
Governors must declare by Dec. 14 whether they plan to implement the Affordable Care Act by creating a state-run health insurance exchange. The deadline was to have been Nov. 16, but at the last minute the Department of Health and Human Services announced the extension. Those states without an exchange will have one imposed on them by the federal government.
A number of Republican governors -- Rick Perry of Texas, Rick Scott of Florida and Robert Bentley of Alabama among them -- have gone on record saying they will not help set up the exchanges in their states.
Also, as a result of the Supreme Court's ruling this past summer on the Affordable Care Act, states must decide whether they will take part in the expansion of Medicaid that is part of the health care law. The ruling gives states the latitude to opt out of the expansion, which could leave millions uninsured.
"We're concerned that the provisions for Medicaid are implemented," Bronson said. "We think it's the right thing to do." He added that ACP argues in favor of Medicaid expansion on medical, financial and moral grounds:
- Medically: Studies have shown that expanding Medicaid reduces mortality and saves lives.
- Financially: States will be able to add people to their Medicaid rolls with the federal government footing much of the bill for the first years of implementation.
- Morally: People should be able to receive the medical care they need without stress or worry.
Bronson said he hopes that, if nothing else prevails, the financial argument will win the day.
"I'm hopeful in the end they'll realize this is a good deal," he said of recalcitrant states. "It doesn't cost them anything for quite a while, and in the long run picking up these people will extend their budgets. We believe it's a deal too good to turn down."
November 15, 2012
Copyright © 2012 HealthDay. All rights reserved.
|»||Heading to ACP's Internal Medicine 2017 Meeting? Check out Health Policy courses |
On Fri. Mar. 31, Examining the Rise in Prescription Drug Pricing and Costs (9:30am-10:30, Rm 1).
On Sat. Apr. 1, 60 Minutes: Special Report on Hot Issues in Health Policy (9:30am-10:30, Rm 8), Climate Change: The Health Perspective (4:00pm-5:00, Rm 2).
|»||Heading to ACP's Internal Medicine 2017 Meeting? Check out Medical Practice Management courses |
On Thur. Mar. 30: Patients before Paperwork: What Can Be Done to Ease Administrative Burdens on Physicians and Their Patients? (8:15am-9:15, Rm 2), ACP's Dragon's Lair: Breathing Fire into Health Care Transformation (11:15am-12:45, Rm 14), Implementing Revenue-Positive and Time-Saving Adult Immunization in Your Practice (11:15 am-12:45, Rm 1), Hospital Inpatient Coding: Thinking inside the Box (2:15 pm-3:45, Rm 7), Opportunities for Subspecialists: Navigating Alternative Payment Models under MACRA (4:30pm-5:30, Rm 8),
On Fri. Mar. 31: There Is No Place like Home: Why Patient-Centered Medical Homes and PCMH Specialty Practices Are Here to Stay (7:00am-8:00, Rm 7), Promise and Peril of Value-Based Payment: What Will You Be Measured On—and Will You Measure Up? (11:15am-12:45, Rm 8), More News You Can Use: Current Best Practice Advice (11:15 am-12:45, Rm 20A), MIPS Reporting: Managing the Health IT Challenges (11:15am-12:45, Rm 7), New Physician/Provider Boot Camp (11:15am-12:45, Rm 2), Outpatient Coding: Do It Right and Get Paid for What You Do (2:15pm-3:45, Rm 1), iPatient/Electronic Health Records (2:15pm-3:45, Rm 7), What May Change Your Practice Tomorrow: Hot Topics in Medical Informatics (4:30pm-5:30, Rm 2),
On Sat. Apr. 1: C. Wesley Eisele Lecture: The Good, the Bad, and the Ugly: Physicians in the Digital Age (8:15am-9:15, Rm 7), Team-Based Care: Interprofessional Practice Innovations in Primary Care (11:15am-12:45, Rm 1), Billing and Coding: What You Didn’t Learn in Residency, and Why It Matters (11:15am-12:45, Rm 8), MIPS or APM: Making the Most of Medicare Payment (11:15am-12:45, Rm 7).
|»||Heading to ACP's Internal Medicine 2017 Meeting? Check out Health Information Technology courses |
On Thur. Mar. 30: Looking Towards 2020: New Care Delivery Models Enabled by Existing and Near Future Technology (11:15am-12:45, Rm 7),
On Fri. Mar. 31: Beyond the Hype and into the Real World: Making Mobile Health (mHealth) Matter for Your Practice (8:15am-9:15, Rm. 7), MIPS Reporting: Managing the Health IT Challenges (11:15am-12:45, Rm 7), iPatient/Electronic Health Records (2:15pm-3:45, Rm 7), What May Change Your Practice Tomorrow: Hot Topics in Medical Informatics (4:30pm-5:30, Rm 2),
On Sat. Apr. 1: C. Wesley Eisele Lecture: The Good, the Bad, and the Ugly: Physicians in the Digital Age (8:15am-9:15, Rm 7), Blogging and Social Media in Health Care (8:15am-9:15, Rm 2), Telemedicine Use in Providing Quality Care (9:30am-10:30, Rm 7), What Physicians Really Need from EHRs to Be Successful in a Value-Based World (2:15pm-3:45, Rm 7), Wearables, Smartphones, Trackers—Oh My: The New Age of Patient Technologies (4:00pm-5:00, Rm 8).
|»||ACP Applauds Court Decision Overturning Ban on Physicians Counseling Patients on Gun Safety |
On February 16, following legal efforts taken by ACP members in Florida, the United States Circuit Court of Appeals for the 11th Circuit overturned Florida state law preventing physicians from counseling patients on firearm safety and violence. ACP has long recommended that physicians ask about gun ownership as a normal part of screening patients. Read more about the case and ACP's involvement in the March 10 issue of The Advocate.