Since the 2016 election, health care reform has been at the top of Congress’ “to-do” list. But without the votes to pass legislation in the U.S. Senate, and Congress adjourned for August, the future of health care reform is uncertain. Meanwhile, a number of critical health care programs are set to expire Sept. 30.
The Wisconsin Medical Society represents more than 12,500 physicians and, like the rest of the country, we do not all have the same views when it comes to the Affordable Care Act (ACA). But what we do have in common is our commitment to patients and ensuring they have access to high-quality care. That’s why we are urging Wisconsin’s delegation — and the rest of Congress — to consider a new approach to health care reform legislation when they return to Washington, D.C., next month. Any next steps should be bipartisan, transparent and patient-centered. We are encouraged to see movement in this direction.
Earlier this year, the society developed a set of health care reform principles as the framework for any health care reform proposal. We ask lawmakers to preserve several patient protections contained in the ACA, including the ban on lifetime caps for coverage and allowing children to remain on their parent’s health care plan until age 26. We also strongly support guaranteed coverage for individuals with pre-existing conditions, including mental and behavioral health issues.
Data show that nearly 240,000 Wisconsinites obtained health insurance in 2015 via the Health Insurance Marketplace, with 84 percent being eligible for financial assistance. As of June, another 1.1 million receive some form of coverage through Wisconsin’s Medicaid programs. Any reform plan must include these protections and ensure individuals maintain access to quality and affordable coverage — without causing significant market disruption.
Reforms also should ensure that Medicaid is properly funded and that Wisconsin is treated fairly. We are hopeful that increased flexibility for states will provide opportunities to develop and implement new ideas and create more efficiencies for Wisconsin’s Medicaid programs. Adequate funding is essential for maintaining access to care while covering the costs incurred by providing services for Wisconsin’s most vulnerable and underserved patients.
It’s clear that agreeing on and implementing changes won’t be easy or quick, but there are some key priorities that require immediate attention:
• Funding for Cost Sharing Reduction (CSR) payments to insurers participating in the marketplace through 2019. This is a critical tool to assist patients’ ability to afford their coverage.
• Reauthorization and full funding for safety net programs such as the Children’s Health Insurance Program (CHIP) and federally qualified health centers. These programs support coverage and access for our most vulnerable patients and their families.
• Reauthorization of the Food and Drug Administration drug and medical device user fee legislation. This bill will help speed up the drug approval process for life-saving medicine for our patients. The U.S. House of Representatives recently approved this measure.
• Reauthorization of the “Medicare Extenders” established in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). There are multiple technical issues that need to be addressed to avoid disruption in Medicare payments to physicians.
Wisconsin physicians are committed to improving health insurance coverage and health care access so that patients receive timely high-quality care, preventive services, medications and other necessary treatments. We welcome the opportunity to work closely with our elected leaders to improve upon the framework implemented under the ACA to ensure that future reforms benefit and improve the health of the patients of Wisconsin.
Noel Deep, MD and fellow of the American College of Physicians is president of the Wisconsin Medical Society.
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