Topics this week:
1. Debate Recap: Health Care Policy
2. House Bill Proposed to Increase Residency Slots
3. Importance of Medicare in Swing States
4. Health Courts Increasing in Popularity
5. Health Policy 101: Free Preventative Health Services for Women
1. Debate Recap: Health Care Policy
2. House Bill Proposed to Increase Residency Slots
3. Importance of Medicare in Swing States
4. Health Courts Increasing in Popularity
5. Health Policy 101: Free Preventative Health Services for Women
1. Presidential Debate Recap: Health Care Policy
October 3rd marked the first Presidential Debate of 2012, and discussions of the Patient Protection & Affordable Care Act (PPACA), Medicare, and Medicaid received significant debate time. While both candidates misrepresented facts and inserted their personal opinions, the following summary is based on their main points, and is not an attempt to determine what aspects of these claims were truthful.
On the PPACA: Mitt Romney argued against the law, stating that it amounted to a government take-over. He called for a move of federal Medicare spending to the states. President Obama criticized Romney’s proposed alternative to the PPACA by stating that his plan would offer no guarantee of insurance coverage to those with pre-existing conditions who have had lapses in their insurance coverage.
On Medicare: Obama stated that Romney’s Medicare plan would place the healthiest elderly patients on private insurance and leave only the sickest in Medicare, which would eventually lead to rising costs and the collapse of Medicare. Romney argued that Obama’s $716 billion reduction in Medicare spending will slash services, and that the Independent Payment Advisory Board will determine which treatments someone can have. (See last week’s Health Policy 101 for a breakdown on IPAB!)
On Medicaid: Romney discussed a plan to cap growth of Medicaid and turn the funding entirely over to the states with full autonomy, rather than the current mechanism of shared funding between states and government, with the government setting the regulations. Obama criticized the Ryan (and now Romney) proposal to turn Medicaid into a block-grant program, by citing a study that estimated this plan would lead to 33% less federal spending, which would deplete the safety net for the poorest Americans.
Sources:
http://www.healthcareitnews.com/news/healthcare-kindle-presidential-debate
http://thecaucus.blogs.nytimes.com/2012/10/04/on-health-care-two-visions-with-their-own-set-of-facts/?hp
2. Resident Physician Shortage Reduction Act of 2012
Representative Joseph Crowly (D-NY) proposed House Bill (HR 6562) last month, which would increase the number of residency slots that are supported by Medicare by 15% (15,000 slots) over the next 5 years. This bill is a response to the anticipated physician shortage that is likely to occur in the United States over the next ten years. One of the primary obstacles to increasing residency sizes is the limited number of resources currently available to each program. This bill ensures that at least 1/3 of these added spots would go to residencies that are already training more residents than their current ‘cap’.
Many medical schools are already making changes to try and accommodate more students into their programs, with a goal of increasing medical school class sizes by 30% in 2016. This would increase the number of first year medical students to 21,434, up from 16.488 in 2002. This increase in medical students in training requires a compensatory increase in residency slots in order to address the impending shortage of physicians.
Sources:
https://www.aamc.org/advocacy/washhigh/highlights2012/305400/092812aamcsayshousebilltoincreaseresidencyslotsisagoodfirststep.html
https://www.aamc.org/download/82788/data/enrollmentreport.pdf
3. Medicare a top priority in swing states
A recent poll conducted by The Washington Post and the Kaiser Family Foundation found that among registered voters in the three key swing states of Ohio, Florida, and Virginia, Medicare is a top priority. The economy was listed as the top priority for voters, but 36% said that Medicare is ‘extremely’ important to their vote. Democrats were more likely to cite the importance of Medicare than Republicans. Although the Patient Protection & Affordable Care Act (PPACA) has received much attention in the media, it only ranked 4th on the voter importance scale.
The majority (55%) of Americans favor keeping the current Medicare system compared to 33% that support moving to a premium support model, similar to that proposed by Mitt Romney & Paul Ryan. Support for keeping the current Medicare system rises to 67% when limited to people over age 55, in spite of Governor Romney’s continued emphasis that his proposed change would not affect the coverage of those over 55. The poll also highlighted the lability of these opinions, with approximately 50% changing from one opinion to the other when presented with arguments against their original opinion. Overall more than 70% of those polled believe that there needs to be some change in Medicare to sustain it for future generations, but they were split on whether a change would require a big overhaul or more minor adjustments.
Source:
http://www.kff.org/kaiserpolls/8361.cfm
4. Support grows for Health Courts
Health Courts are a proposed solution to the inefficiency and increasing costs of the current medical malpractice and health care lawsuit system. Health courts would have a full-time judge (and no jury) that resolves health disputes and then writes decisions to set precedent and give guidance on standards of care. Plaintiffs would be allowed to appeal to a Medical Appellate Court. This system would be similar to those already in place in other areas of law such as worker’s compensation and tax disputes. This system would aim to decrease the inefficiencies and inconsistencies of the current legislative system as well as encourage doctors to move away from the current practice of ‘defensive medicine,’ which has contributed to increasing costs of medical care.
A recent nationwide poll found that 68% of Republicans, 67% of Democrats, and 61% of Independents are in support of these health courts. There was widespread recognition (75% of those polled) that legal fees and lawsuits contribute to the high cost of medical insurance. While President Obama and Governor Romney seem to disagree on most things regarding health reform, they have both publically endorsed health courts.
Source:
http://healthaffairs.org/blog/2012/10/02/the-growing-bipartisan-support-for-health-courts/
----------------------------------------------------------------------------------------------------------------------------------------------------------------------
5. Health Policy 101: Free Preventative Health Services for Women
What does it mean & what is covered?
Comprehensive preventative health care coverage is one of the most recent provisions of the Affordable Care Act to go into effect. After August 1st, women who enroll in new insurance plans will receive certain preventative services for free, with no copay requirement. This is in addition to other preventative measures that are covered by the ACA that went into effect in January 2011, such as cancer screening (colonoscopies, mammograms), cholesterol screening, annual wellness visits, and cardiovascular screening. It should be noted that follow up tests and further diagnostic evaluation that may result from these screening tests are not covered for free. The funding for this effort will largely come from the savings that will result from patients receiving these preventative measures.
The following 8 services are covered for women under this provision:
· Contraception & contraceptive counseling, which includes access to all contraceptive and sterilization methods included on the FDA’s recommended list, but does not include abortion drugs.
· Well-woman visits, or an annual physical with increased coverage of further appointments if deemed necessary
· Gestational diabetes screening for women 24-28 weeks pregnant or at high risk for gestational diabetes
· HPV DNA testing every 3 years for women over age 30, regardless of pap smear results
· STI counseling (annual), which aims to reduce risky behaviors in sexually active women
· HIV screening & counseling (annual)
· Breast feeding support, supplies, and counseling
· Domestic violence screening and counseling for adolescent and adult women, as 25% of women report some type of inter-partner violence in their lifetimes.
Who began receiving free preventative services on August 1?
Any person who started or renewed a private health insurance plan on or after August 1st will receive this benefit.
Why are some women still paying for these services?
Even though 64% of the population, or 57 million people currently have private insurance, their insurance companies are not yet required to offer these services without co-pay. The following are all reasons why a person may still not be receiving this benefit
· The type of birth control they are using is not FDA Approved
· If the plan was renewed or started prior to August 1st they are not obligated to provide the benefit until the next renewal after August 1st, 2012.
· If the insurance plan has not changed since March 2010 (when the ACA went into effect), then the plan can be grandfathered in, and will not be forced to offer these services free of co-pay.
· If a woman gets her insurance through a religiously-affiliated institution, she will still be required to pay the co-pay until August 2013, when insurance companies (not employers) will then be required to offer contraception free of co-pay (the other 7 services must be offered at no cost currently).
· If a woman is uninsured (19 million women) she must still pay for these services out of pocket
· If a woman is covered by Medicaid (17 million women), the decision is up to the state on whether these services will be provided free of charge.
While the current caveats are many, by August 2013, most women should be receiving preventative women’s health services at no cost.
Sources:
http://abcnews.go.com/Politics/OTUS/fact-checking-free-birth-control-day/story?id=16900144#.UG93AEKGW2R
http://healthland.time.com/2012/08/01/the-8-preventive-health-services-that-women-start-getting-free-today/
Your loyal Legislative Affairs team,
Brad Hunter – Northeast Region
Robert Sanchez – Central Region
Sean Vanlandingham – Southern Region
Claire Sadler – Western Region
William Teeter – National Delegate
--------------------------------------------------------------------------------
To access previous updates see our blog at:
https://www.aamc.org/members/osr/communications/legislative_affairs/
For more Health Care Policy news go to:
https://www.aamc.org/members/osr/communications/legislative_affairs/49198/legislative_affairs_resources.html
October 3rd marked the first Presidential Debate of 2012, and discussions of the Patient Protection & Affordable Care Act (PPACA), Medicare, and Medicaid received significant debate time. While both candidates misrepresented facts and inserted their personal opinions, the following summary is based on their main points, and is not an attempt to determine what aspects of these claims were truthful.
On the PPACA: Mitt Romney argued against the law, stating that it amounted to a government take-over. He called for a move of federal Medicare spending to the states. President Obama criticized Romney’s proposed alternative to the PPACA by stating that his plan would offer no guarantee of insurance coverage to those with pre-existing conditions who have had lapses in their insurance coverage.
On Medicare: Obama stated that Romney’s Medicare plan would place the healthiest elderly patients on private insurance and leave only the sickest in Medicare, which would eventually lead to rising costs and the collapse of Medicare. Romney argued that Obama’s $716 billion reduction in Medicare spending will slash services, and that the Independent Payment Advisory Board will determine which treatments someone can have. (See last week’s Health Policy 101 for a breakdown on IPAB!)
On Medicaid: Romney discussed a plan to cap growth of Medicaid and turn the funding entirely over to the states with full autonomy, rather than the current mechanism of shared funding between states and government, with the government setting the regulations. Obama criticized the Ryan (and now Romney) proposal to turn Medicaid into a block-grant program, by citing a study that estimated this plan would lead to 33% less federal spending, which would deplete the safety net for the poorest Americans.
Sources:
http://www.healthcareitnews.com/news/healthcare-kindle-presidential-debate
http://thecaucus.blogs.nytimes.com/2012/10/04/on-health-care-two-visions-with-their-own-set-of-facts/?hp
2. Resident Physician Shortage Reduction Act of 2012
Representative Joseph Crowly (D-NY) proposed House Bill (HR 6562) last month, which would increase the number of residency slots that are supported by Medicare by 15% (15,000 slots) over the next 5 years. This bill is a response to the anticipated physician shortage that is likely to occur in the United States over the next ten years. One of the primary obstacles to increasing residency sizes is the limited number of resources currently available to each program. This bill ensures that at least 1/3 of these added spots would go to residencies that are already training more residents than their current ‘cap’.
Many medical schools are already making changes to try and accommodate more students into their programs, with a goal of increasing medical school class sizes by 30% in 2016. This would increase the number of first year medical students to 21,434, up from 16.488 in 2002. This increase in medical students in training requires a compensatory increase in residency slots in order to address the impending shortage of physicians.
Sources:
https://www.aamc.org/advocacy/washhigh/highlights2012/305400/092812aamcsayshousebilltoincreaseresidencyslotsisagoodfirststep.html
https://www.aamc.org/download/82788/data/enrollmentreport.pdf
3. Medicare a top priority in swing states
A recent poll conducted by The Washington Post and the Kaiser Family Foundation found that among registered voters in the three key swing states of Ohio, Florida, and Virginia, Medicare is a top priority. The economy was listed as the top priority for voters, but 36% said that Medicare is ‘extremely’ important to their vote. Democrats were more likely to cite the importance of Medicare than Republicans. Although the Patient Protection & Affordable Care Act (PPACA) has received much attention in the media, it only ranked 4th on the voter importance scale.
The majority (55%) of Americans favor keeping the current Medicare system compared to 33% that support moving to a premium support model, similar to that proposed by Mitt Romney & Paul Ryan. Support for keeping the current Medicare system rises to 67% when limited to people over age 55, in spite of Governor Romney’s continued emphasis that his proposed change would not affect the coverage of those over 55. The poll also highlighted the lability of these opinions, with approximately 50% changing from one opinion to the other when presented with arguments against their original opinion. Overall more than 70% of those polled believe that there needs to be some change in Medicare to sustain it for future generations, but they were split on whether a change would require a big overhaul or more minor adjustments.
Source:
http://www.kff.org/kaiserpolls/8361.cfm
4. Support grows for Health Courts
Health Courts are a proposed solution to the inefficiency and increasing costs of the current medical malpractice and health care lawsuit system. Health courts would have a full-time judge (and no jury) that resolves health disputes and then writes decisions to set precedent and give guidance on standards of care. Plaintiffs would be allowed to appeal to a Medical Appellate Court. This system would be similar to those already in place in other areas of law such as worker’s compensation and tax disputes. This system would aim to decrease the inefficiencies and inconsistencies of the current legislative system as well as encourage doctors to move away from the current practice of ‘defensive medicine,’ which has contributed to increasing costs of medical care.
A recent nationwide poll found that 68% of Republicans, 67% of Democrats, and 61% of Independents are in support of these health courts. There was widespread recognition (75% of those polled) that legal fees and lawsuits contribute to the high cost of medical insurance. While President Obama and Governor Romney seem to disagree on most things regarding health reform, they have both publically endorsed health courts.
Source:
http://healthaffairs.org/blog/2012/10/02/the-growing-bipartisan-support-for-health-courts/
----------------------------------------------------------------------------------------------------------------------------------------------------------------------
5. Health Policy 101: Free Preventative Health Services for Women
What does it mean & what is covered?
Comprehensive preventative health care coverage is one of the most recent provisions of the Affordable Care Act to go into effect. After August 1st, women who enroll in new insurance plans will receive certain preventative services for free, with no copay requirement. This is in addition to other preventative measures that are covered by the ACA that went into effect in January 2011, such as cancer screening (colonoscopies, mammograms), cholesterol screening, annual wellness visits, and cardiovascular screening. It should be noted that follow up tests and further diagnostic evaluation that may result from these screening tests are not covered for free. The funding for this effort will largely come from the savings that will result from patients receiving these preventative measures.
The following 8 services are covered for women under this provision:
· Contraception & contraceptive counseling, which includes access to all contraceptive and sterilization methods included on the FDA’s recommended list, but does not include abortion drugs.
· Well-woman visits, or an annual physical with increased coverage of further appointments if deemed necessary
· Gestational diabetes screening for women 24-28 weeks pregnant or at high risk for gestational diabetes
· HPV DNA testing every 3 years for women over age 30, regardless of pap smear results
· STI counseling (annual), which aims to reduce risky behaviors in sexually active women
· HIV screening & counseling (annual)
· Breast feeding support, supplies, and counseling
· Domestic violence screening and counseling for adolescent and adult women, as 25% of women report some type of inter-partner violence in their lifetimes.
Who began receiving free preventative services on August 1?
Any person who started or renewed a private health insurance plan on or after August 1st will receive this benefit.
Why are some women still paying for these services?
Even though 64% of the population, or 57 million people currently have private insurance, their insurance companies are not yet required to offer these services without co-pay. The following are all reasons why a person may still not be receiving this benefit
· The type of birth control they are using is not FDA Approved
· If the plan was renewed or started prior to August 1st they are not obligated to provide the benefit until the next renewal after August 1st, 2012.
· If the insurance plan has not changed since March 2010 (when the ACA went into effect), then the plan can be grandfathered in, and will not be forced to offer these services free of co-pay.
· If a woman gets her insurance through a religiously-affiliated institution, she will still be required to pay the co-pay until August 2013, when insurance companies (not employers) will then be required to offer contraception free of co-pay (the other 7 services must be offered at no cost currently).
· If a woman is uninsured (19 million women) she must still pay for these services out of pocket
· If a woman is covered by Medicaid (17 million women), the decision is up to the state on whether these services will be provided free of charge.
While the current caveats are many, by August 2013, most women should be receiving preventative women’s health services at no cost.
Sources:
http://abcnews.go.com/Politics/OTUS/fact-checking-free-birth-control-day/story?id=16900144#.UG93AEKGW2R
http://healthland.time.com/2012/08/01/the-8-preventive-health-services-that-women-start-getting-free-today/
Your loyal Legislative Affairs team,
Brad Hunter – Northeast Region
Robert Sanchez – Central Region
Sean Vanlandingham – Southern Region
Claire Sadler – Western Region
William Teeter – National Delegate
--------------------------------------------------------------------------------
To access previous updates see our blog at:
https://www.aamc.org/members/osr/communications/legislative_affairs/
For more Health Care Policy news go to:
https://www.aamc.org/members/osr/communications/legislative_affairs/49198/legislative_affairs_resources.html