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Tuesday Sep 13, 2016

Crunch Time for Congress: Key Health Issues Unresolved

On Sept. 6, Congress returned to Washington, D.C., from a seven-week summer recess. With less than 60 days until Election Day, the opportunities to pass major legislation are fading.  

Given the limited number of legislative days remaining, Congress will focus its attention on a small set of priority or "must-pass" legislation prior to adjourning for the elections. At the top of that priority list is legislation to fund the federal government for the upcoming fiscal year and emergency spending to address the Zika outbreak.  

Congress must pass legislation prior to midnight Sept. 30, to fund the federal government from Oct. 1 through Sept. 30, 2017. Congress will once again use a short-term continuing resolution, or CR, to fund the government until mid-December. At that time, they will attempt to pass legislation to fund the government through September 2017.

The current continuing resolution has a handful of provisions that the AAFP is monitoring. Specifically, we are closely advocating for full funding for the National Health Service Corps, the Agency for Healthcare Research and Quality (AHRQ) and several education and grant programs funded through the Health Resource and Services Administration (HRSA). We also are concerned with provisions that would eliminate funding for certain provisions of the Patient Protection and Affordable Care Act and, more concerning, attempts to cut operational funds at CMS. The AAFP is keeping a close eye on the House and Senate negotiations and is communicating our priorities to members of Congress and congressional staff.

The second priority for September is providing resources to combat the Zika outbreak. Congress continues to seek a compromise on a public health funding request for Zika, even though these negotiations become more mired in politics by the day. Last week the Senate attempted to break a logjam and approve legislation that would provide more than $1 billion in funding to states facing the Zika outbreak.  

As of Aug. 31, the CDC had reported 2,687 laboratory-confirmed cases of Zika in the United States, including more than 500 in Florida.  

The CDC also reported more than 1,500 cases involving pregnant women in the United States and its territories. The known risk to pregnant women and children has been driving an outcry from the public health community and for good reason. Researchers at Yale University’s Center for Infectious Disease Modeling and Analysis estimate that the lifetime health care costs for children infected with Zika are $4.1 million. The CDC estimates the total costs between $1 million and $10 million per child.

FamMedPAC Emerges as Top Political Action Committee
As noted above, the 2016 elections are 56 days away. On Nov. 8, the country will elect a new president, 435 members of the House and 34 Senators. In addition, thousands of state and community officials will be elected. I am quick to admit that the presidential election may not be the most admirable process we as a nation have engaged in, but our open election process remains a beacon of democracy.

I have shared my views previously that to be an effective advocacy organization we must engage on four levels -- direct lobbying, grassroots advocacy, media relations and political advocacy. Each of these supports the other and each is less effective if one of the others is missing or under-represented. This is why it is important that family medicine has a robust and well-funded political action committee. FamMedPAC continues to experience record-breaking growth. Since 2006, FamMedPAC has received more than $4.7 million in donations from more than 8,000 AAFP members. That money has resulted in FamMedPAC making more than 1,300 contributions totaling more than $3.9 million to federal candidates.

In this election cycle (2015-2016), FamMedPAC is poised to raise more than $1 million and join a prestigious group of political action committees that have eclipsed the $1 million milestone in an election cycle. If you are a FamMedPAC supporter, thank you! If you have not supported FamMedPAC previously, I urge you to make a contribution. Your contribution is important to our efforts and, in the end, contributes to a better health care system for your patients and your practice. If you are attending the Family Medicine Experience (FMX) this month in Orlando, Fla., please look for the FamMedPAC booth in the AAFP Marketplace.

Wonk Hard
The percentage of the U.S. population that is uninsured has fallen to historic lows. The CDC stated in a new report that the uninsured rate was 8.6 percent for the first quarter of 2016. The agency report also noted that the uninsured rate, since the enactment of the Affordable Care Act, has fallen from 14.4 percent in 2013. The previous low was 9.1 percent last year.

Also of note, is a recent study published in JAMA Internal Medicine that shows the positive impact of health insurance on health outcomes. Researchers at the Harvard School of Public Health compared the health outcomes for low-income adults in Arkansas and Kentucky (Medicaid expansion states) to Texas (non-Medicaid expansion state). Two quick findings stand out. Low-income adults in Arkansas and Kentucky were more likely to be insured than their counterparts in Texas, and they were more likely to receive basic preventive care and care for chronic conditions. These findings continue to advance the importance of health coverage as an indicator of health and well-being.

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About the Author



Shawn Martin, AAFP Senior Vice President of Advocacy, Practice Advancement and Policy.

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The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.