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Progress Notes features doctors and medical students across the country on the frontlines of our health care system. Our views and experiences are diverse, but we share common goals and values. We speak up to move toward a future where everyone can have access to affordable, high-quality health care. Please share our posts, and follow us on Facebook and Twitter!


Thank you for eight extraordinary years

By Dr. Alice Chen
.

Today is my final day as Executive Director of Doctors for America. I awoke this morning with a sense of pride and gratitude for all we have done together and a sense of possibility and excitement for all that Doctors for America will do moving forward.

I came to Doctors for America over eight years ago as a newly trained internal medicine hospitalist wondering how I could stop the heartbreak of so many of my patients who were struggling to get care in a system that felt stacked against them.

My first act was simple: I signed a petition. It was the first time I signed anything as a doctor in the public sphere, but I saw that I was among thousands of colleagues who went first, so I followed. Then I got a phone call asking me to get more involved. I was touched that a stranger thought I could contribute even though I knew little about politics or advocacy. But I knew I had to do something, so I buzzed around as a happy worker bee, eager to help in whatever small ways I could.

I found myself increasingly captivated by the power I could see in the doctors and medical students who were coming out of the woodwork, peering out from our clinics and hospitals and realizing that our experiences from the trenches of patient care might help make things better. What we lacked in experience, we made up in bounds with heart and determination.

In the years since those early days, I have had the incredible honor and privilege of leading our movement of passionate, thoughtful, brave, and generous doctors and medical students across all 50 states who put their names, voices, and reputations on the line to speak up again and again on the issues that impact our patients’ lives. While I have had plenty of fears, frustrations, and self-doubt as a leader, it is this community that has always been there to buoy my spirits and keep me going.  

We have accomplished so much together. Today, over 20 million people have health care who didn’t before. Gun violence prevention is no longer a taboo subject and is seen by many as an issue of public health. Doctors for America members have become leaders in communities and nationally. Medical students just entering the profession now know that advocacy is part of our responsibility and our role as physicians. And millions of people see doctors standing up for them and feel like they matter.

Yet there is still so much to do. Even as I write, a group of Senators are working hard to find ways to repeal major provisions of the Affordable Care Act and cut Medicaid funding, throwing the care of millions into jeopardy. Women’s health is coming under attack. Congress is considering proposals that would make it easier for gun violence to happen. Immigrants and people of color - doctors and patients alike - are facing discrimination and violence. The Administration is looking to re-energize the war on drugs instead of recognizing substance use disorders as a chronic disease to be treated with compassion and evidence-based care.  Vulnerable communities worry about how they can afford healthy food and how they will care for their families if they lose their jobs or get sick.

America needs us to stand firm for the kind of country our patients deserve. America needs us to lead the way, to remind us of what matters, to demand that our leaders put patients over politics every time. I hand over the reins of Doctors for America today to our board, national and state leaders, and to all of you knowing that America needs your ideas, creativity, energy, and determination in the fights at hand and the fights ahead.

I believe even more today than ever before in the power of Doctors for America. I believe in our power to shape the world around us, especially in difficult times. How we use that power depends on you. I ask you in moments of darkness to choose light. Speak up for your patients. Reach out to support one another and recruit people to our movement. Step up as often and in as many ways as you can, and together we will build a better world.

In closing, I want to say thank you to my husband Vivek for his love and leadership and for dreaming up the idea of Doctors for America in the first place that has so enriched my life and the lives of so many others. Thank you to Milan de Vries and Nikhil Wagle for their audacity in co-founding our movement. Thank you to Doctors for America leaders and staff past and present especially our outgoing board chair Mona Mangat, our incoming board chair Scott Poppen, and our communications director Brannon Lazo. Thank you to our funders and donors, to our partner organizations, to elected officials and public servants who have stood with us, and to my family and friends who have supported and encouraged me on this journey.  

Most of all, I want to thank you for your faith in me as a leader, for all you have taught me, and for every action you take to stand up for what is right. I may be signing off as Executive Director today, but I look forward to marching alongside you in the days and years ahead to safeguard the health and wellbeing of everyone in the country we love.

Yours always,

Alice

 

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House passes ACA repeal bill

By Dr. Mona Mangat
.

As we gather today for our National Leadership Conference, House Republicans have voted on a bill to repeal the Affordable Care Act. 

The bill would cause an estimated 24 million to lose coverage. It would end protections for those with pre-existing conditions, strip away essential health benefits, ration care under Medicaid and raise premiums by 20 percent. The bill would make everyone pay more -- children, young people, seniors and families. 

Simply put, House Republicans have failed our patients. But, we will not. 

The repeal bill now moves to the Senate which we have always known would be the battleground. We have a chance to stop this bad bill in the Senate if we put our shoulders to the wheel. 

Those who seek to repeal the ACA are betting you are too tired, too worn out from the previous fights to make your voices heard. We know they are wrong.

Together, we stood shoulder-to-shoulder with President Obama in the Rose Garden to urge the passage of the ACA. We spoke out across the country to connect millions with lifesaving coverage, many for the first time. We locked arms to defend the ACA against repeated attacks over the years. And, we won’t give up now.

Stand with the 24 million patients who are at risk of losing coverage by donating $24 a month to efforts to save their care.

With your generous contribution we will arm physicians with the resources they need to advocate against the repeal of the ACA.

 

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Weekly Round Up 4-28-17

By Shalini Pammal
.
DFA Weekly Round Up - April 28, 2017
 
TAKE ACTION
  • Call your Representative via the Capitol switchboard at (202) 224-3121, and urge that they oppose the American Health Care Act, and any proposal that that strips healthcare from millions of Americans, guts protections for people with pre-existing conditions and ends Medicaid expansion.
  • Refer to this toolkit from our partners at the Center for American Progress Action Fund to make calls and send tweets to a targeted list of representatives who are currently undecided or have yet to publicly oppose the bill.
 
WEEK-AT-A-GLANCE
 
As the government works to avoid a federal shutdown, Republicans introduced a new amendment to their Obamacare replacement bill, breathing life into the American Health Care Act (AHCA) that was previously pulled from the House floor, and suggesting that another vote may be scheduled soon. An amendment drafted by New Jersey congressman Tom MacArthur keeps much of the AHCA in place, but allows states to eliminate major insurance regulations established by Obamacare— a provision that won endorsement from the conservative House Freedom Caucus. Along with waivers for the ban on insurers charging premiums based on consumer health, and the requirement that insurers' cover essential health benefits, the GOP amendment exempts members of Congress and their staffs to ensure that they will still be protected by such provisions.
 
Though the MacArthur amendment language has helped garner support from some conservatives, many moderate Republicans and leading healthcare and advocacy groups remain opposed to the bill, including the American Hospital Association (AHA), the American Medical Association (AMA) and the American Association of Retired Persons (AARP). The Kaiser Family Foundation also published poll findings that a majority of the public believes Trump and Republicans should work together to make the ACA work while its legislative future remains uncertain.
 
The White House also affirmed this past week that it will continue cost-sharing subsidies which are critical to the success of the Affordable Care Act marketplaces. However, it is unclear how long the White House plans to fund the cost-sharing reduction payments, leaving many insurers without the assurance necessary for their continued participation in the marketplace. Blue Cross Blue Shield insurer Anthem, among other insurers like Molina and Centene, had been pressing Congress to guarantee this crucial subsidy to help with out-of-pocket costs for low-income customers on the federal exchanges. Given the ongoing uncertainty, states are also making moves to bolster their own insurance markets, in an effort to curb big rate increases and pullbacks by insurers. Idaho, Oklahoma and Minnesota have all passed bills that allow insurers to unload some of the expense for costly consumers onto state program, using a version of reinsurance.
 
KEY ARTICLES
 
Health Affairs Blog: The MacArthur Amendment Language, Race in the Federal Exchange, and Risk Adjustment Coefficients
 
Reuters: Study says that government costs could rise $2.3 billion without Obamacare payments

Center on Budget and Policy Priorities: Amendment to House ACA repeal bill guts protections for people with pre-existing conditions
 
Vox: What the huge AHCA concession to the Freedom Caucus would actually do

 

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2 minutes to urge AHCA opposition TODAY


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Yesterday, the conservative House Freedom Caucus announced their support for the MacArthur amendment to the American Health Care Act, reviving the Republican effort to repeal health care for millions of Americans, and raising the stakes for our efforts immensely. The MacArthur amendment would allow states to opt out of essential health benefits and bring back pre-existing conditions.

Your voice is critical in the next 48 hours. Take 2 minutes today to call your House Representative, 202-224-3121, and urge that they oppose the American Health Care Act and any proposal that strips health care from 24 million Americans, guts protections for people with preexisting conditions, and ends Medicaid expansion. 

Please refer to this updated Toolkit from our coalition partners to call and tweet at targeted Members of Congress.

For details of the amendment, which builds upon the existing harmful AHCA, here is a blog from Families USA.

Thank you for all that you do everyday, to fight for your patients and the health of our nation.

 

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Doctors for America Leadership Updates

By Dr. Alice Chen
.

We are writing to announce a series of leadership updates in Doctors for America as we charge ahead on the important work of protecting the health and well-being of our patients in the face of challenges that are cropping up from every direction.

On May 12, Alice Chen will be stepping down after six years as Executive Director and over eight years as a founding leader of our movement. Additionally, at the end of June, Mona Mangat will be wrapping up her three-year term as board chair and six years as a board member.

Both Alice and Mona came to our movement as full-time practicing physicians who wanted to do more to help our patients but were new to advocacy and community organizing. Through eight years of Doctors for America’s campaigns, bus tours, rallies, marches, meetings, conference calls, and the input and action of our extraordinary members, they have discovered their voices and the power that each of us have individually and collectively. They have worked through the years not only to build a better future for patients but also to lead, advise, and mentor hundreds of individual physicians and medical students across the country. Alice and Mona will remain active in fostering new leaders and strategies as Advisors to the Board.

This is part of a long-planned leadership transition towards building a sustainable organization that will long outlast our founders and individual leaders thanks to an active membership that has stood up to lead.

Building Doctors for America into a sustained movement is more important in 2017 than we expected. The Administration and leaders in Congress are determined to repeal the Affordable Care Act, though they have so far been stalled by opposition from all of us who know how much pain that would cause millions of people.

Beyond the ACA, members of Congress are using tax reform efforts and federal budget negotiations to push cuts to Medicaid. Vocal lobbies are pushing to remove protections against gun violence and eliminate healthy standards in school cafeterias. They are pushing to loosen environmental regulations even as the children of Flint experience the after effects of lead poisoning that shocked the nation.

We have work to do. The public trusts us – professionals who spend each day caring for them and assuaging their fears in their darkest hours – far more than they trust elected officials. Our 18,000-member movement of doctors and medical students across all 50 states has an extraordinary amount of power collectively to shape the future of our country.

That is why we are so excited to present your Doctors for America leadership moving forward. We have posted contactsfor our leaders on our website to make it easier for you to connect with them:

On July 1, Scott Poppen will begin his three-year term as Board Chair. He will be joined by our Board of Directors of previously elected members (Patrick Cannon, Meghana Desale, Lori Heim, Don Mathis, Kyle Ragins, Ethan Rome) and those who were elected recently (Shree Govindarjan, Joe Kanter, Krishnan Narasimhan, Shalini Pammal, Evan Saulino). Congratulations to our new board members!

The board will be working closely with our dozens of volunteer national and state leaders in forging our collective path ahead in the important work before us. In addition to our board, we have developed a slate of National Campaign and Issue Leaders focusing on specific arenas in addition to protecting the ACA, Medicaid, and access to health coverage. Those teams include: Gun Violence Prevention; Drug Value, Pricing, and Affordability; Food as Health / Food Insecurity; Substance Use and Addiction; Mental Health; Racism in Medicine; and Physician Wellness. These leaders are pioneering our way forward in diversifying the issues Doctors for America can track and play a role in shaping. If you want to help the leaders in any of these areas or see a gap that you can fill in other areas, please contact us!

We know that much of the work ahead will happen locally and in states. We are lucky to have State Directors and Leaders in most states continuing to serve as our point people for both state issues and for mobilizing around particular elected officials who need to hear from us.

We are also all fortunate to have Brannon Lazo continuing on as our Communications Director who does so much more than communications to support our work every day.

Many people think Doctors for America must have a dozen paid staff for all the work and impact that we have had these past eight years. The truth is that Doctors for America's power has always come from our diverse members and volunteer leaders -- doctors and medical students who find time after clinic, between classes, and on evenings and weekends to speak up for their patients and help others do the same.

We have laid out our current leadership here, but more than ever before, we need you. A member-driven movement thrives on our commitment not only to our shared cause by also to one another. Please reach out to your state director, the leaders of the issues that are important to you, and our board to share your ideas, perspectives, and most of all your willingness to help with your time and energy. If you don’t see a state director listed or don’t see a working group on an important issue that you want to work on, please let us know.

Connect with our Doctors for America Leaders!

Together, with your help, we will continue to bring the voices of physicians to the places where we are most needed to protect and improve the health and lives of millions of people in America.

In service,

Alice Chen, MD - Executive Director
Mona Mangat, MD - Board Chair
R. Scott Poppen, MD MPA - Incoming Board Chair

 

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DFA Round Up - April 21, 2017

By Shalini Pammal
.
TAKE ACTION

  • Republicans in Congress are still working to repeal the ACA. They have a new proposal that makes a bad healthcare bill even worse. Make your voice heard.
     
  • Last chance! Register for the 2017 National Leadership Conference and earn up to 19 hrs of CME.
WEEK-AT-A-GLANCE

As the two-week congressional recess period concludes, efforts to revive the American Health Care Act are underway again and some say that a vote is expected early next week. The MacArthur-Meadows amendment would allow states to opt out of Essential Health Benefits, allow increased premiums for pre-existing conditions, and create an "invisible risk pool" that, unlike regular reinsurance, would be administratively complex and likely result in higher premiums. Given that the first 100 days of the administration are nearing, the White House is pressuring Congress for another attempt to repeal-and-replace Obamacare, against the backdrop of an impending government shutdown.

in the balance, as states debate whether to proceed with expansion or address budget shortfalls by ending the efforts. Democratic lawmakers in Oregon have suggested cutting Medicaid expansion to curb the $1.6B budget deficit. Thus far, 350,000 people have gained coverage through Medicaid in Oregon. And in Kansas, hospital closures have renewed calls to expand Medicaid, though lawmakers recently failed to overcome Governor Sam Brownback's opposition to expansion. The Center on Budget and Policy Priorities recently published this report detailing the long-term health and economic benefit that Medicaid provides children, particularly students with disabilities. 

Meanwhile, uncertainty regarding ACA marketplaces continues to put both healthcare advocates and insurers on edge. Healthcare advocates have warned that rural areas would be hit particularly hard if Congress and the administration do not express a clear commitment to stabilizing the marketplaces in 2018. Insurers are still struggling to make decisions about their 2018 exchange offerings given mixed signals from the Trump administration and congressional Republicans about the future of the ACA. Some companies like Anthem, Cigna and Aetna have made preliminary filings to offer plans in the marketplace, while others have seen soaring profits as a result of scaled-back participation in ACA exchanges. This past week health insurers once again pressed the administration to continue funding subsidies for low-income individuals buying on the marketplace; but, were left with little assurance. 


MEMBERS IN ACTION


Tell us about what you are up to! Email your updates and photos to DFAHQ@drsforamerica.org.

DFA Leads on Drug Pricing

Doctors for America, led by Dr. Bruce RectorJustin Lowenthal, MD/PhD student and members of the Drug Pricing, Value, and Affordability Campaign, is supporting the Improving Access to Affordable Prescription Drug Act, which includes a wide-ranging approach to make prescription drugs more affordable. DFA support was noted in Senator Al Franken’s press release announcing the milestone effort to bring down prescription drug prices. 

New York

Dr. Katherine Scheirman shares that she and Mark Hannay, Director of Metro New York Health Care for All, met with Elie Peltz, Representative Jerrold Nadler’s Community Affairs liaison. They discussed Doctors for America - NY and the #NYDocs collaboration, and described what they have been doing in 2017 to protect patient care, particularly in NY-11.

North Carolina

Dr. Seanta Clark attended a health care rally at Carolinas Healthcare Center in Charlotte, North Carolina earlier this month.

Ohio

Dr. Arthur Lavin shares that doctors turned out on Public Square, the center of the community of Cleveland, with the Congresswoman Marcia Fudge. They had about 30 practicing physicians from all 3 major medical centers in Cleveland and medical students stand with the Congresswoman.

Five doctors spoke on the Square:
Dr. Lollie McDavid on the medical-social infrastructure
Dr. Eric Schreiber on Climate Change
Dr. Peggy Stager on Women's Health
Dr. Michael Sideman on cuts to Section 8 and Homelessness
Dr. Arthur Lavin on the EPA 

KEY ARTICLES

Kaiser Health News: Conservatives' Goal to Relax Mandatory Health Benefits Unlikely to Tame Premiums

CBPP: Interactive Map: Cost-Sharing Subsidies at Risk Under House GOP Health Bill

Vox: The looming government shutdown deadline, explained

Modern Healthcare: Community ratings, essential benefits at center of new GOP push to replace ACA

 

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Earn CME at the DFA National Conference


.

We are excited to announce the approval of CME credit for our national conference in Tampa, FL on May 5-7th.

This Live activity, Doctors for America National Leadership Conference 2017, with a beginning date of 05/05/2017, has been reviewed and is acceptable for up to 19.00 Prescribed credit(s) by the American Academy of Family Physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Below is the official invitation and a link to the preliminary agenda. It’s going to be a great event with exciting speakers like Wendell Potter, Harold Pollack and Congressman Raul Ruiz, MD.

Will you be joining us?

Sincerely,

R. Scott Poppen, MD MPA
Vice Chair

 

Please join us at the Doctors for America National Leadership Conference on May 5-7, 2017 for a chance to connect with colleagues across the country who share your values and ideals. Join us to be inspired by wonderful speakers, and to learn new ways of reaching out to build healthier communities and to address the pressing issues now facing our patients. As an added bonus this year, a training for those looking to take their leadership to the next level will be led on Friday, May 5th, for no additional cost. 

 

Congressman Raul Ruiz, MD (CA-36)

Wendell Potter, Author of Deadly Spin

Harold Pollack, DFA Senior Advisor and University of Chicago Professor 

Will Craig, Senior Executive Coach with The Handel Group

We just won a major victory in stopping efforts to repeal the Affordable Care Act, but we know that the work to protect the health care of patients is far from over. Be there at the national conference as we discuss the important work ahead and learn the skills necessary to protect patients.

Register today and book your hotel! You can view the preliminary agenda here

 

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DFA Round Up - April 7, 2017

By Shalini Pammal
.
 TAKE ACTION
  • During the congressional recess week, take action to make your voice heard at local town halls and from home. 
     
  • Register for the 2017 National Leadership Conference and book your hotel room before the extended April 9th cut-off date to recieve the room block rate. 
WEEK-AT-A-GLANCE

Though discussions between the White House, the House Freedom Caucus and centrist Republicans continued this past week in an attempt to revive support for the American Health Care Act, the GOP health bill is still in shambles as the House commences a two-week spring recess. Following the cancelled vote, momentum for the AHCA stalled given discordance between different factions within the Republican party. Yesterday, House Republicans introduced an amendment that creates a federal "invisible risk-sharing program," to reduce premiums in the individual insurance market. The $15B amendment is a form of re-insurance, designed to help states reduce premiums by reimbursing insurers for individuals with high-cost medical conditions. The proposal passed the House Committee on a party line vote; however, it leaves out specific details regarding enrollee eligibility and state funding qualifications. The White House is reportedly working on additional amendments to the billthat would allow states to request waivers to opt out of certain Obamacare insurance regulations, like essential health benefits— a move that the Freedom Caucus has viewed favorably. Discussions are expected to continue during the two-week break, in order to rally enough support for the bill to pass the House thereafter.
 
Efforts in two states to expand Medicaid were also stalled this week. The Kansas state legislature were unable to override the governor's veto of Medicaid expansion. And in Virginia, the Republican-controlled House rejected a budget amendment to expand Medicaid, despite significant effort from Democratic governor Terry McAuliffe. Maine, North Carolina and Georgia are among those GOP-led states that are reconsidering their decision to not expand Medicaid. In other state-related news, new Centers for Medicare & Medicaid Services administrator Seema Verma has stated that she will recluse herself from the decision to grant Kentucky a waiver request that would allow the state to remake its Medicaid program, which is modeled closely to the plan Verma designed for Indiana. The decision could make Kentucky the first state in the country to require Medicaid recipients to work in order to qualify for health coverage.
 
As the deadline for insurers to submit exchange participation applications approaches, AHIP and other insurance industry groups remain concerned about the future of the Obamacare cost-sharing subsidies. This funding issued to insurers to subsidize exchange customers' out-of-pocket costs are not guaranteed next year, as the administration decides how to handle the House Republican's court case challenging the legality of cost-sharing subsidies. House Speaker Paul Ryan has stated that he expects the funding to continue; however, some advisers believe that funding should cease. Meanwhile, insurers are still wavering on their participating in the individual market. Aetna has announced that it will exit from the Iowa individual exchange marketplace. This decision came soon after Wellmark Blue Cross and Blue Shield, Iowa's dominant insurer, also retreated from the individual marketplace, leaving many Iowa counties with only one insurance option.
 
Lastly in the pharmaceutical sector, companies learned of a new effort by the Medicare Payment Advisory Commission to change the way in which drugs are paid for under Medicare Part B. The Commission voted 15-0 to recommend that Congress enact new drug reimbursement lawsthrough several proposals that would decrease Medicare spending by as much as $750M in the first year of implementation, and $5B over five years. Pharmceutical companies and providers have previously succeeded in lobbying against a similar attempt to change reimbursement laws under the Obama administration.
 

MEMBERS IN ACTION

Tell us about what you are up to! Email your updates and photos to DFAHQ@drsforamerica.org.

March for Health

New York

Dr. Bruce Rector, New York State Director and Co-chair of the DFA Drug Pricing, Value, and Affordability Campaign, shares that on Saturday, April 1st, DFA-NY members marched with other physicians from our New York physician advocacy coalition, nurses, patients and union members to deliver a strong, unified message on the need for equitable and affordable access to high-quality healthcare for all. Speakers shared powerful stories on how the ACA benefited them as women, people with disabilities, people with mental health problems, LBGTQ members, freelance employees, veterans and more. Local politicians joined them on stage to speak about the need for equitable health care for all and DFA-NY member, Kamini Doobay, passionately spoke about the need to dismantle racism in healthcare.



Washington

Dr. Lisa Playmate, Washington State Director, 
also spoke at a March for Health rally in Washington. During her remarks she said, "When we moved to Seattle 10 years ago, I decided to follow my passion and go where I was most needed.  I first went to eastern WA, to work with migrant workers in a federally funded community clinic; we did not ask for citizenship papers, and most of patients were in subsidized programs.  I then worked for a special clinic in Rainier Valley, where our patients were frail, elderly, complex and poor - eligible for both Medicare and Medicaid.  I cannot imagine how any of the patients I saw in either of those places could have been seen under the repeal plan."

KEY ARTICLES

New York Times
: Neil Gorsuch confirmed to the United States Supreme Court

Kaiser Family Foundation: State Medicaid Expansion Approaches fact

NEJM: Comparison of FDA regulatory review process to that of the European Medicines Agency (EMA)

STAT: Senate HELP Committee confirmation hearings begin Wednesday for FDA Commissioner nominee Scott Gottlieb

Kaiser Family Foundation: Webcast on how the decision regarding ACA cost-sharing subsidies could disrupt Obamacare marketplaces

CBPP blog: Tweak to House GOP health bill much ado about nothing

CBPP report: To help stabilize the individual health insurance market, take ACA repeal off the table

 

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Exciting new speakers for 2017 conference

By Brannon Lazo
.

We are pleased to announce exciting new speakers for the upcoming Doctors for America National Leadership Conference on May 6-7, 2017. As an added bonus this year, training for those looking to take their leadership to the next level will be led by Handel Group Senior Executive Coach, Will Craig, on Friday, May 5th, for no additional cost.

 

Congressman Raul Ruiz, MD (CA-36)

Wendell Potter, Author of Deadly Spin

Harold Pollack, DFA Senior Advisor and University of Chicago Professor 

Will Craig, Senior Executive Coach with The Handel Group

We just won a major victory in stopping efforts to repeal the Affordable Care Act, but we know that the work to protect the health care of patients is far from over. Be there at the national conference as we discuss the important work ahead and learn the skills necessary to protect patients.

Register today! And, book your hotel room before the Friday deadline.

I hope to see you in Tampa!

 

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ACA Round Up - March 31, 2017

By Shalini Pammal
.
 
TAKE ACTION
  • Register for the 2017 National Leadership Conference and book your hotel room before the April 6th cut-off date to receive the room block rate. 
 
WEEK-AT-A-GLANCE
 

Following the House failure to garner enough support for a vote on the American Health Care Act last Friday, it seemed that political leadership would move forward with other administrative priorities, conceding that Obamacare would remain in place after the massive effort to repeal-and-replace the Affordable Care Act. However, some Republican leaders are now suggesting that a new vote will take place next week, though there are few details on a definitive timeline to revisit the GOP healthcare overhaul. Furthermore, this legislative undertaking exposed deep divisions within the Republican party, particularly between the centrist Tuesday Group and the more conservative House Freedom Caucus, with some reports that growing intraparty tensions are threatening progress on healthcare. Some GOP lawmakers have since expressed interest in working with Democrats to reform the law, rather than finding votes from hard-line conservatives, including a recent affirmation to fund cost-sharing reductions which reimburse insurers for providing discounted deductibles for low-income Obamacare enrollees. This move toward bipartisan reform comes alongside a renewed left-wing enthusiasm for single-payer healthcare. Despite the percolating push toward bipartisanship, House Speaker Paul Ryan has reiterated that he does not want to work with Democrats on healthcare. 

Meanwhile, GOP legislatures are facing increasing pressure to expand Medicaid. Lawmakers in Kansas have voted to approve Medicaid expansion, suggesting that the nineteen other states that have yet to expand might also reconsider. Governor Sam Brownback vetoed the bill yesterday; however, supporters in the Kansas House and Senate are still hoping to raise public support to gather the additional votes necessary to override the veto. Lawmakers also voted yesterday to keep Arkansas' hybrid Medicaid expansion for another year, which supports more than 300,000 people in the state. Though the Republican push to repeal the Affordable Care Act failed, certain aspects of the law remain vulnerable, including the Cadillac tax and other Obamacare taxes that could be tackled in the upcoming Republican tax reform drive.

Department of Health and Human Services Secretary Tom Price has also defended proposed cuts to the National Institutes of Health, citing that its budget is rife with unnecessary expenses. The administration has proposed an additional $1.2B cut to the NIH for its current fiscal year, on top of a suggested $5.8B cut for 2018. This has spurred fierce nonpartisan opposition, including from Ann Romney, wife of former Republican presidential candidate Mitt Romney, who affirmed that NIH funding is critical to medical innovation and scientific progress. 

And in the midst of pervasive health law uncertainty, insurers are still struggling to chart their path forward in the individual markets next year, seeking more clarity from the Trump administration as the deadline for submitting 2018 plans and rate requests looms. Anthem has signaled that they are likely to exit Obamacare's individual insurance markets, leaving consumers in parts of Colorado, Kentucky, Missouri and Ohio at risk of having no Obamacare insurers for next year. The Justice Department has also joined a whistleblower lawsuit against UnitedHealth Group, claiming that the company committed fraud in its popular Medicare Advantage plans, and has also stated that it will investigate risk-score payments to other Medicare Advantage insurers. 

MEMBERS IN ACTION

Tell us about what you are up to! Email your updates and photos to DFAHQ@drsforamerica.org.
 
CONNECTICUT 
 
Eamon Duffy, Connecticut State Director and MD-MBA candidate, recently testified in favor of several laws under consideration in Connecticut to curb predatory drug pricing. He worked with Drug Pricing, Value, and Affordability Campaign leaders Bruce Rector and Justin Lowenthal on his materials and testimony, which aimed to provide a medical student perspective to the issue of drug pricing.
 
 
PENNSYLVANIA
 
Dr. Chris Hughes, Pennsylvania State Director, convened health care providers for a house meeting on Sunday, March 26th.
 

KEY ARTICLES

JAMA Infographic: US Public Opinion on Health Care Reform, 2017

TIME: Some Democrats Say They'll Vote to Confirm Neil Gorsuch to the Supreme Court

Christopher Jacobs: "To Overcome the Obamacare Repeal's Failure, Let's Understand its Causes"

Bloomberg: House GOP Weighing Another Try on Obamacare Next Week

Wall Street Journal: After GOP Bill's Failure, Health-Law Lawsuit Takes Center Stage


 

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