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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!


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
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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
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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


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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
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 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
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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
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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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Victory for patients

By Dr. Alice Chen
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"We're going to be living with Obamacare for the foreseeable future" -- Speaker Ryan

We did it.

I'm working at the hospital with my patient charts open listening to House Speaker Paul Ryan say, "Obamacare is the law of the land for the foreseeable future." I can't even begin to describe what a mixture of relief, elation, and disbelief I am feeling as I type these words. All day, I have been rounding on patients, wondering how many of them would be facing a darker future without the ACA, a future with more worry, uncertainty, and impossible choices. As of right now, the future is brighter.
 
And why? Because of you. Because despite the questions in our minds of whether our actions mattered, each of you decided to take action. Action big and small. Actions that were new and uncomfortable and nerve-wracking like writing an op-ed for all your friends and neighbors to see. Like standing up in front of a crowd in a white coat. Like calling and meeting with members of Congress and worrying that they would make us feel small, or that we were wasting our time. Like asking other doctors and medical students to believe in their power even when you were uncertain of yours.
 
Progress is built not on inevitability but on people choosing hope over cynicism, action over complacency, and a love for our patients over fear of failure. Today and over the past eight years, we have proven that if we hang onto one another and even a small wisp of hope that we can still bend the arc of the moral universe toward justice. Justice for the mother with diabetes who just wants to be well and guide her children into adulthood. Justice for the writer with cancer who wants to focus on finishing his book before it's too late instead of calling insurance companies begging them not to cut him off. Justice for the child who survived a heart transplant and wants to know whether he can pursue his dreams when he grows up knowing he will be covered no matter what career path he chooses. Justice for 24 million people who came this close to becoming uninsured.
 
The work we each do did not begin with the fight to pass the ACA, nor does it end today. Those who sought to take away our patients' care are not finished, and neither are we.
 
Tomorrow, we must continue to make health care better and more affordable for our most vulnerable patients. We must continue to be vigilant about ways our ability to care for our patients is threatened. We must continue to take action and stand in strength so our patients know that someone is willing to speak up for them when they feel lost and alone. We must be there each time a policymaker or any other powerful party tries to do wrong by our patients. We must remain standing to ensure that everyone in America has access to equitable, affordable, high-quality health care. We must keep speaking up to make the system better and to make our society better, to make sure our patients have nutritious food and communities safe from gun violence, that they have clean air to breathe and affordable medications, that we will care for them regardless of their faith, the color of their skin, or whom they choose to love. We must keep pushing our nation to put patients over politics and ensure that everyone in America can get up in the morning knowing that they matter.
 
The power of our collective voices has never been more clear. That is why I know we must be even stronger, more ready, and more resourced to take up the mantle of whatever challenges and opportunities lie ahead. That is why I close this note of celebration and reflection with one more request:
 

Alice Chen, MD
Executive Director

 

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This is it

By Dr R Scott Poppen
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Tomorrow, on the seventh anniversary of the Affordable Care Act, the House of Representatives will vote on an ACA repeal bill that would take away healthcare from 24 millions patients, make disastrous cuts to Medicaid and strip away consumer protections.

Now is the time to urge your member of Congress to oppose this bill, which hurts patients. Members of the House are divided about the bill and that gives us an opening. We must make certain Congress hears from doctors and medical students right now about our opposition to this bad bill.

Action AlertCall your member of Congress at 202-224-3121
Urge them to 
VOTE NO on the ACA repeal bill.

This is the time to stand up and speak out for the progress we have made together over the last seven years in getting America covered. We must not go backward. 

In solidarity,

Scott Poppen, MD MPA
Vice Chair
Doctors for America

 

 

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ACA Round Up - 3/17

By Shalini Pammal
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 TAKE ACTION

  • Register for the 2017 National Leadership Conference and book your hotel room before the April 6th cut-off date to recieve the room block rate.

  • The Congressional Budget Office (CBO) says 24 million patients will become uninsured if the GOP repeal bill passes. That's unacceptable. The House plans to vote on the repeal bill on THURSDAY March 23rd -- the 7th anniversary of the signing of the ACA. Let's make our voices heard at this critical moment!

    • Call your member of Congress at 202-224-3121 and tell them doctors and medical students urge them to vote no.

    • Then make your voice heard on social media. Sample Twitter and Facebook posts are below.

      • Sample Tweets:

        All major hospitals are united against Congress' new health care bill because it fails patients across the US. #ThisIsntCare


        Those who know our health care system the best are united against Congress’ proposed replacement bill. #ProtectOurCare

        The new health care bill will worsen opioid crisis. Fewer people will have access to addiction treatment and mental health care. #ThisIsntCare

      • Sample Facebook Post:

        The people who know our health care system the best are united against Congress’ proposed health care bill because they know it will fail millions of patients. Call Congress now: 202-224-3121.

        Mental health and addiction services are absolutely critical for those battling addiction. By defunding Medicaid, Congress’ new health care bill all but ensures that America’s opioid crisis will worsen. Call Congress now: 202-224-3121.

 WEEK-AT-A-GLANCE

The Congressional Budget Office scoring of the American Health Care Act (AHCA) drew largely negative responses from the left and also from the right, who have long struggled to unite around a single replacement plan for the Affordable Care Act (ACA). The CBO is a non-partisan government agency, led by a director who was appointment by GOP leaders in 2015. Some key highlights from the CBO report include 14 million fewer Medicaid enrollees by 2026, 24 million more people without insurance over a decade, $337 billion reduction in deficit over the next decade, a 15% - 20% increase in 2018 premiums, and a $880 billion drop in federal Medicaid spending over the decade. Even prior to the CBO report, there have been numerous studies examining the impact of the ACHA on coverage levels, affordability and state costs, including an issue brief from the Kaiser Family Foundation examining how health insurance tax credits are reduced under AHCA in comparison to the ACA, and a Commonwealth Fund report on high-risk pools which are a central feature of the Republican replacement plan.

AHCA has advanced through the House Ways and Means and Energy Committees, and just yesterday was narrowly approved by the House Budget Committee to repeal and partially replace Obamacare. The vote reinforced GOP divisions over the legislation with three GOP defections from members of the House Freedom Caucus. House Speaker Paul Ryan has conceded that changes will have to be made to the House bill, in light of these lingering GOP divisions as well as the CBO analysis. Among potential changes are considerations to drop a provision requiring insurers to charge a 30 percent penalty for people who do not have continuous coverage, as well as changes in age-based tax credits and the freeze date for enrollment in Medicaid expansion states.

President Donald Trump and Vice President Mike Pence have been meeting with lawmakers and holding rallies across the country to address concerns and encourage support for the replacement plan. Department of Health and Human Services Secretary Tom Price has been communicating the same message, most recently in a town hall this past Wednesdayduring which he fiercely defended the American Health Care Act. However, challenges to the proposed bill pervade the broader stakeholder landscape, as numerous industry and hospital associations have spoken out against various provisions. Critics include the American Medical AssociationAmerican Hospital AssociationAARP and the American Academy of Family Physicians. Opponents also include conservative groups, right-wing media and Republican lawmakers. Health insurer Anthem, Inc. had also sought changes to the Republican replacement plan for the ACA, stating interest in maintaining cost-sharing subsidies.

And just as the Republican health care bill is expected to make sweeping changes to the Centers for Medicare and Medicaid, the Senate confirmed Seema Verma as the new Centers for Medicare and Medicaid Administrator in a 55-43. On her first day in office, she issued a joint letter with Secretary Price to governors, affirming the partnership between HHS, CMS and States to improve the Medicaid program. The letter outlines intent to increase employment among Medicaid beneficiaries and to have states lead a number of reforms to align Medicaid and private insurance policies for non-disabled adults.

WHAT THE CBO SAID

The bill would lower federal deficits by $337B over 10 years, largely as a result of cuts to Medicaid.

Read the CBO projections on the impact of the Republican American Health Care Act here.

The CBO projects that the AHCA would result in 24M Americans losing their health insurance, and rising premiums for those covered on the individual market.

  • The cost of the bill is estimated at $900B (55% less than the ACA).

  • Medicaid expansion enacted by the ACA would be rolled back by 2020; overall Medicaid spending cut by $880B; by 2026, federal Medicaid spending would be 25% lower under the house bill than is projected under the current law, and the number of Medicaid beneficiaries would be 17% lower (14M fewer people on Medicaid).

  • Average premiums in the individual market would rise by as much as 20% in 2018 and 2019 before falling in 2020 (for an overall drop of 10% on average).

  • The total number of uninsured would grow by 24M over the next decade, resulting in a total of 52M uninsured Americans in 2026; if the bill is implemented soon, it is estimated that approximately 14M will be uninsured, largely due to the repeal of the individual mandate.

  • The plan would allow insurers to sell health plans covering a smaller share of medical costs and cost-sharing subsidies would be repealed for low-income individuals starting in 202; out-of-pocket costs would be higher.

  • The repeal bill primarily deals with individual and Medicaid segments; however, estimates that employer coverage would drop by 7M over the next decade.

 MEMBERS IN ACTION

Over 100 doctors and medical students have submitted letters to the editor opposing the House Republican ACA Repeal Bill because it would hurt patients. Make sure to send us a link to your published LTE. EmailDFAHQ@drsforamerica.org.

DFA Statement on the CBO Score of the American Health Care Act. Read full statement here.

"In medicine, we triage. That means we strive to make sure that those who need help the most get it first. The American Health Care Act does the opposite. Far too many of the 24 million people who will become uninsured are the sick, the poor, and seniors."

California

Dr. Joyce Adams, a retired Clinical Professor of Pediatrics in Sacramento, CA, penned a letter to the editor in the Sacramento Bee. It read, in part:

"Doctors are caring for millions of patients with chronic diseases who cannot afford to have their care disrupted. We want our patients and communities to be able to get the health care they need. Our children must have access to health care that is equitable, affordable and high quality. The House plan falls far short of this goal and puts the coverage of millions of patients at risk. I urge people to tell Congress to oppose this bill."

CA State Coordinator Jose Tapia and others met with the Republican members of the California congressional delegation to express concerns about how much money California would lose if the House bill passed. Most of the staff understood the concern.


Indiana

Dr. Theresa Rohr-Kirchgraber’s letter to the editor was published in the Indy Star. 

“We need to give Hoosier patients the care they deserve and this plan will threaten care women receive for preventive services and increase rates on seniors, allows insurance companies to charge people -- including people with pre-existing conditions -- 30 percent more if they have a gap in coverage. This breaks Trump's promise of healthcare for everybody.”

New Jersey


Dr. Jennifer Chuang
, also a candidate for the NJ State Assembly, wrote an op-ed in the Courier Post titled, A doctor’s take on why GOP health plan is bad medicine.

“Medical societies are voicing concerns about this healthcare bill because to not do so would do harm to our patients. It is now time for physicians to take our advocacy for our patients out of the office and bring it to the public.”


Washington

Dr. Lisa Plymate
 held a meeting with a coalition in Seattle, WA where they discussed their plans for the upcoming March 26th Consult Day and efforts to fight ACA repeal. She also shares that a member of the coalition, Dr. Rupin Thakkar, had a LTE published in the Seattle Times.

Washington, DC

Dr. Alice Chen emceed the finale of the Save My Care Bus Tour at a press conference featuring House Minority Leader Nancy Pelosi, Senate Minority Leader Chuck Schumer, New Hampshire Senator Maggie Hassan, Buddy Henlock (a songwriter from Tennessee whose ACA insurance helped him get treated for Hep C), Paula Cheveney (a woman with stage 4 breast cancer who is on an ACA plan), and Steve Gomez (the father of an 18-month old who had a heart transplant and will need a great deal of health care for life). 

Dr. Sanjeev Sriram moderated a Facebook Live session with Steve, Buddy, and Paula. The bus traveled 15,000 miles to 50 cities in 22 states with Doctors for America members participating in multiple states to highlight what ACA repeal would mean in real places across the country.

Wisconsin

Dr. Cindy Haq shares that she met with Senator Tammy Baldwin at a town hall meeting in Milwaukee, WI. And, that Sen. Baldwin remains a strong advocate for universal health care coverage. She has also been meeting convening a group called  ‘Healthcare for All-Southeast Wisconsin’ and is outreaching to the media media. Read this mention on her in the Journal Sentinel.

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

KEY ARTICLES

Kaiser Family Foundation: Restructuring Medicaid in the American Health Care Act: Five Key Considerations

Kaiser Family Foundation: Obamacare Pushed Nonprofits to Do Good Beyond Their Walls. Now What?

Vox: Trump's budget on health: 3 losers, 2 winners

Washington Examiner: Conservatives prep amendment to GOP's Obamacare repeal bill

Morning Consult: Wyden Introduces Bill to Increase Transparency of PBMs


 


 

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