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ACA Round Up - February 3, 2017

By Shalini Pammal
 ACA Round Up - February 3, 2017
Get together locally to save healthcare. Will you host a 45-minute get together to plan for the upcoming Congressional recess? 
Email us at DFAHQ@drsforamerica.orgFor those of you who have already reached out, we are in the process of getting back to you asap.
Never done anything like this before? That's great! Here's what you do:
  1. Recruit one person to join you, and pick a day and time that works for you both, ideally before February 18.  Even two people getting together is more fun and productive than watching the news or your Facebook feed. While Doctors for America mainly organizes doctors and medical students, you are welcome to invite anyone you want.
  2. We'll send you resources including a sample agenda, actions to take during the meeting, a summary of what's happening in DC, and ways to reach out to Doctors for America members and like-minded organizations in your area.

Together, we can have a powerful impact on what happens in DC.


Following the Republican retreat held last Thursday, there is still little clarity into how an ACA replacement plan will take shape. While Senate Majority Leader Mitch McConnell is pushing for quick replacement, it seems some key Republican lawmakers are shifting their 'repeal and replace' goal to the more moderate goal of repairing the signature health law. It is unclear, however, the degree to which this is a shift in messaging versus policy. Senate Democrats have continued efforts to block the drive for repeal, honing in on women's issues, and even going so far as to boycott the confirmation vote for Tom Price, an avowed Obamacare opponent, for Secretary of Health and Human Services. However, attempts to boycott were not successful as the Senate Finance Committee changed the rules and voted to move Price's confirmation to the entire Senate.

Simultaneously, some states are working to preserve certain aspects of the ACA. Hawaiian lawmakers are working to merge popular ACA provisions (e.g., consumer protections) into state law, suggesting interest in a replacement plan that allows states to keep the ACA if they desire. Several Republican governors who expanded Medicaid under the federal health law, including Vice President Pence's home state of Indiana, are also seeking regulatory waivers to extend funding. Additionally, David J. Shulkin (nominee to lead the Department of Veterans Affairs) vowed to reform but not privatize veteran's health care – in contrast to Trump's campaign promise to allow veterans to choose private health care. These moves by states and leading department officials suggest continued uncertainty concerning a clear health reform plan moving forward.

Tuesday marked the final day of Open Enrollment for 2017 coverage through and the state-based marketplaces. Despite a last minute move by the Trump administration to pull millions of dollars worth of ads and confusion over coverage and the future of the health law, over 12 million people chose insurance plans.  

Stakeholders across the health care industry have continued to express concern regarding ramifications of ACA repeal. Hospitals nationwide could take a big financial hit, as a result of the reduction in Medicaid revenue and the increase in unpaid medical bills. Furthermore, it is likely that repeal will hamper innovations and progress made by hospitals that have significantly invested in accountable care organizations (ACOs) and value-based care programs. Leaders for the health insurance industry have warned that health plans will defect from the ACA marketplaces, unless there are more concrete assurances from Congress and the Trump administration. Aetna has already signaled that it will not expand involvement in the individual marketplace in 2018, citing GOP delay on replacement and "the unclear nature of where regulation's headed." 

President Trump hosted pharmaceutical executives at the White House this week, calling for lower drug prices and fewer regulations. This meeting followed an executive order also aimed at deregulation – requiring executive departments or agencies to remove at least two previously implemented regulations for every new one issued—the "one-in, two-out" rule. While some industry stakeholders are lauding this move, the call for fewer regulations in the pharmaceutical industry has drawn mixed reviews. Though PhRMA and other pharma industry leaders have voiced support for market-based reforms that lower drug prices and decrease regulation, plans for a "revolution at the FDA" did not resonate so well with biotech executives. Likewise, in response to the "one-in, two-out rule," some privacy & data security experts are questioning whether this will create a disincentive for important regulations, such as HIPAA-related measures.

Also noteworthy this week was the nomination of Judge Neil M. Gorsuch to the United States Supreme Court, and an executive order on immigration—both actions that will considerably influence the trajectory of health reform. Abortion rights groups immediately criticized the Gorsuch nomination, given his previous rulings. In two cases that involved the contraception mandate under the ACA, Gorsuch sided with businesses and non-profit groups that voiced religious objections to the requirement that they provide cost-free contraception to women. He has also expressed opposition to physician-assisted suicide, casting doubt on the future legality of "death with dignity" laws, which currently exist in four states, and are being considered by at least twenty more. The move to deny citizens and refugees from seven Muslim-majority countries entry into the United States sent shockwaves throughout the nation and was met with widespread protests, including objection from physicians and healthcare professionals who cite international exchange as fundamental to American medicine.  Many new stories have also come out about U.S. doctors from those seven countries who are being denied entry back into the country to continue patient care as well as patients who are no longer able to come for lifesaving treatments.
#DoNoHarm Medical Student Day of Action 

On Tuesday, medical students from around the country joined together for a #DoNoHarm Day of Action to stand in solidarity with the millions of Americans whose lives would be endangered by the repeal of the Affordable Care Act (ACA). Students conducted teach-ins, rallies, and public protests to highlight the catastrophic consequences of repealing the ACA. Read more.
Ohio Doctor Speaks Out to Save Health Care
Doctors for America's Ohio State Director Dr. Donald Nguyen offers his advice on fixing health care in this Dayton Daily News op-ed.
Doctors for America's Dr. Krishnan Narasimhan issued a strong statement condemning the Executive Order issued by the Trump administration which suspended the admission of all refugees to the United States for 120 days, indefinitely banned all Syrian refugees, and blocked citizens of seven Muslim-majority countries, refugees or otherwise, from entering the United States for 90 days. Read it here.
Doctors for America Chair Dr. Mona Mangat released a statement regarding the approval of Rep. Tom Price by Republicans on the Senate Finance Committee. We continue to believe Rep. Tom Price is the wrong choice to lead the Department of Health and Human Service. Our full statement is here.
G.O.P campaign to repeal Obamacare stalls on the details

Trump calls for lower drug prices, fewer regulations in meeting with pharmaceutical executives 

Price confirmed as Secretary of HHS – despite Senate Democrats attempted boycott to block committee votes
Health insurers warn of wider defections from ACA marketplaces for 2018
Trump's executive order likely to have major impact on medical training and health care
HSAs: ‘Tax-Break Trifecta’ Or Insurance Gimmick Benefiting The Wealthy

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