House Unveils Merged Health Reform Bill and Floor Schedule
This week House Speaker Nancy Pelosi unveiled HR 3962, the Affordable Health Care for America Act, on the steps of the US Capitol. Nearly 2,000 pages long, the legislation proposes to insure 36 million Americans and will cost under $900 billion over ten years. The Congressional Budget Office estimates that the bill would cut the federal deficit by approximately $30 billion over the ten years, if long term care insurance is not included. Separate legislation, HR 3961, was introduced by Representative John Dingell (D-MI) to reform Medicare’s physician payment system.
See the AAPA press statement on HR 3962.
Beginning in 2010, the legislation would implement immediate insurance market reforms, including: a ban on insurance rescissions; new limits on pre-existing conditions exclusions; a ban on lifetime limits; transparency in insurance rate increases; administrative simplifications; and a requirement that insurers spend a minimum 85% of insurance premiums on medical care.
Additionally, the reforms allow young adults through age 26 to remain on their parents’ policies; allow individuals to maintain COBRA coverage until the Insurance Exchange is up and running; prohibit insurers from arbitrarily reducing retirees’ health benefits; and provide an interim high-risk pool for those who are currently uninsured because of pre-existing conditions. See additional provisions with implementation dates.
House debate on HR 3962 is expected to begin next week.
PA Provisions in HR 3962
The new House bill removes current barriers to care provided by PAs by allowing PAs to order skilled nursing facility care and to provide hospice care for Medicare patients. The provisions were added to the bill despite a last minute challenge by the Centers for Medicare and Medicaid Services that allowing PAs to provide Part B hospice care would increase utilization. Additionally, the House bill reauthorizes the Title VII Health Professions Programs of the Public Health Service Act, the only federal source of funding for PA educational programs. The bill fully integrates PAs into new medical home and chronic care management models of care, including the following requirement for certification of community-based medical homes – “the organization provides medical home services under the supervision of and in close collaboration with the primary care physician, nurse practitioner, or physician assistant designated by the beneficiary as his or her community-based medical home provider.” The bill defines PAs, along with physicians and nurse practitioners as primary health care providers and makes it clear that PAs may lead the primary care team in the new chronic care management model.
Senate Timetable on Health Care Reform
The Senate continues its work to merge the health care reform bills reported by the Senate Finance and HELP Committees. Despite Senate Majority Leader Harry Reid’s statements earlier in the week regarding a public option, it does not appear that the votes exist to pass a health care reform bill in the Senate that includes the measure. A merged Senate bill is expected to be released soon and considered by the Senate in November.
The Senate Finance and HELP bills also contain strong PA provisions, including the PA Medicare provisions, a 15% carve-out for PA educational programs in Title VII reauthorization, and full integration of PAs in primary care and chronic care management.
Preparation for H1N1 in High Gear
With the rapid rise of illness caused by the H1N1 virus, the federal government has increased efforts to respond to the virus. On October 24, President Obama declared a national emergency with respect to the pandemic to allow US health care facilities to implement emergency operations.
The HHS Office of Women’s Health also released an alert on the need for pregnant women to receive seasonal and H1N1 vaccines.
Access AAPA clinical information on the H1N1 influenza outbreak.
Breaking News: Dr. Regina Benjamin Confirmed as U.S. Surgeon General
U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced today that the United States Senate unanimously confirmed Dr. Regina Benjamin as the nation’s Surgeon General. Benjamin, a family practice doctor, has spent most of her career serving patients at a rural health clinic in Bayou La Batre, Ala.
In addition to her work with the underserved in Ala., Benjamin has long demonstrated support and understanding of PA profession. Currently, she employs and works closely with a PA and AAPA member at the La Batre Rural Health Clinic. As surgeon general, she will bring a perspective to the delivery of health care that very closely allies with the policies and philosophies of the PA profession.
NIH Announces Stem Cell Breakthrough
Susan B. Shurin, M.D., acting director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development announced that researchers have discovered how to transform embryonic stem cells into germ cells, opening the door to learning more about infertility, birth defects, and chromosomal disorders. Learn more here.
PAs: Take Action!
As mentioned above, the House released its health care reform package Thursday, and it contains a number of very positive provisions for PAs on issues such as Medicare, primary care incentives, medical home and chronic care management. The Senate is still in the process of finalizing a package based on separate bills approved by the Finance and HELP Committees.
PAs must continue to make their voices heard. Congress needs to hear from the profession in support of these positive PA provisions contained in the bills. Please contact your Senators and Representatives today. Be sure to thank House members for PA provisions contained in the House bill. Urge both House and Senate members to support provisions in the final bills that would allow PAs to order skilled nursing facility care and provide hospice care for their Medicare patients, that integrate PAs into new models of are such as the medical home, and that provide critical support for PA education programs. Act now!
Save the Date – February 22-23, 2010 – Lobby with Your PA Colleagues on Capitol Hill
Join forces with your fellow PAs and PA students in Washington, D.C., for a day on Capitol Hill and the opportunity to deliver an important message to Congress. AAPA's new Capitol Connection (formerly Adventures in Lobbying) conference will be held February 22-23, 2010. Make plans now to attend! Online registration will begin November 2.
AAPA Federal Affairs staff is your resource on health care reform and other federal advocacy efforts. Do not hesitate to contact Sandy Harding, AAPA Federal Affairs Director, Kristin Butterfield, Assistant Director of Federal Affairs, or Kimberly Beer, Assistant Director of Federal Affairs, with your questions and suggestions.
