This Week – May 6, 2017

This Week in Washington, D.C.

  • House Passes ACA Repeal Bill- Long Slog Awaiting in Senate
  • At the State and Local Level: An Update from the ACG MOC Task Force
  • Congress Passes Budget with Increase to NIH Budget- Thank you ACG Governors

From ACG National Affairs Committee Chair, Whitfield L. Knapple, MD, FACG

House Passes ACA Repeal Bill- Long Slog Awaiting in Senate

The U.S. House of Representatives Thursday passed the American Health Care Act (AHCA), after months of negotiating with President Trump and fractions within the House Republican caucus.  The AHCA is designed to repeal and replace the Patient Protection and Affordable Care Act (“ACA”), which passed in 2010.  The House passed the bill on a 217-213 vote, with 20 Republicans and all Democrats voting “no.” Click here for the list of 20 Republicans who bucked party leadership and President Trump to vote “no.”

ACG updated its membership last week on the agreement brokered by two leaders in the conservative and moderate Republican caucuses, the House Freedom Caucus and the Tuesday Group, respectively.  The amendment, sponsored by Tom MacArthur (R-NJ), creates a waiver system for states that want to opt out of the ACA’s essential benefits and community rating requirements. If enrollees did not maintain continuous coverage over the past year, insurers under the AHCA are allowed to increase premiums based on the enrollee’s health status for one year. States are required to set up subsidized high risk pools or reinsurance programs that help these enrollees afford coverage.  However, after moderate Republicans argued that the changes would weaken protections for individuals with pre-existing conditions, Republican leadership secured another amendment, sponsored by Fred Upton (R-MI).  To help reassure moderates concerned about the amount of funding provided by AHCA for these pools, Upton worked on an amendment to add $8 billion over five years to assist those with pre-existing conditions in states choosing to opt out of ACA requirements.

The AHCA repeals the penalties associated with the individual and employer mandates retroactively to 2016. The bill also allows insurance companies to impose a 30% late-enrollment surcharge on individual or small group market beneficiaries who had a lapse in coverage for more than 63 days.  It also phases out the ACA’s Medicaid expansion, and transitions Medicaid to a “per capita cap model.”  Further, the bill eliminates a number of taxes in the ACA, including a delay of the “Cadillac Tax” on high cost health plans until 2026.  The full bill text was only unveiled hours before the vote. The Congressional Budget Office (CBO) didn’t have time to finish its study of the legislation.  Click here to read more about the CBO analysis and the next steps, as the bill moves toward the U.S. Senate.

From ACG MOC Task Force Chair, Daniel J. Pambianco, MD, FACG

At the State and Local Level: An Update from the ACG MOC Task Force

As ACG President Dr. Carol A. Burke wrote in March, ACG has heard the discontent and significant concerns of its members about ABIM’s new proposals for Maintenance of Certification (MOC) and their potential to generate a “broad-based, perpetual testing scenario.”  The College is committed to working actively on your behalf with ABIM to shift the focus of the high stakes MOC test into a process of lifelong learning that is more relevant to clinical practice.

ACG is also exploring alternatives at the state and national level, working collaboratively with state GI and medical societies, as well as other like-minded organizations.  I am honored to be spearheading this work group and coordinating efforts with the ACG Board of Governors.

The State of the States
I wanted to provide an update on this work with the ACG Governors, and steps you can take to help spread awareness in your state.

ACG has sent various action alerts to members throughout this year, urging you and colleagues to support state bills that prevent MOC as a condition to licensure, hospital privileges, employment, and/or reimbursement.  We continue to collaborate with state societies and we need to your support.

We need your help!
ACG has compiled an updated list of bills in statehouses across the U.S.  This list also provides ACG members a mechanism to express support with the state legislators sponsoring these bills. Embedded in the document are direct email links to send a message to elected representatives in your state.  Please review and express your support!

From ACG Board of Governors Chair, Costas Kefalas, MD, MMM, FACG

Congress Passes Budget with Increase to NIH Budget- Thank you ACG Governors!

This week, Congress struck a budget deal for the remaining fiscal year (FY) 2017, or until September 30th, 2017.  The agreement was cobbled together after Congress last week passed a week extension to keep the federal government open past April 28, 2017.   Included in the deal: lawmakers increased the budget for the National Institutes of Health (NIH) in the bipartisan deal.

Congress bolstered funding by $2 billion over the next five months, securing $34.1 billion for the NIH. It’s the biggest boost the NIH has received in more than a decade.

In March, President Trump had proposed cutting the NIH budget by $1.2 billion for the rest of the current fiscal year.  President Trump proposed cutting the NIH budget by $1.2 billion for the rest of 2017 to help pay for his proposed increases in defense spending.

ACG Governors were in Washington D.C. in early April, advocating Congress to oppose these changes by explaining the real-word and clinical impact that these cuts would have on GI patients and academic medical institutions.  Thank you ACG Governors and other ACG members advocating to prevent cuts to the NIH!
Congress passed the FY 2017 budget resolution and gave the NIH an extra $2 billion for the next 6 months, bumping its total 2017 budget to $34 billion.

Remember to contact your ACG Governor on important state and local issues impacting you and your practice.

The ACG Board of Governors is one of the most unique aspects of the American College of Gastroenterology. Governors are ACG Fellows that are elected from the membership of a particular state or region. There are currently 76 Governors across seven different regions in the U.S. and abroad. The Board of Governors acts as a two-way conduit between College leadership and the membership at-large. This helps the College make certain it is meeting the evolving needs of the membership.  Contact your ACG Governor today.