The Buzz Around Washington Healthcare Reform! UPDATES!

Dr. Angus WorthingAngus B. Worthing, MD, FACP, FACR

 

Greetings from Washington, DC.! As you probably know, this town is highly focused on health care this week — but more on that later. First off, a little good news…

 

A Victory For Regulatory Reform
As I wrote earlier this spring, the Trump Administration stopped allowing professionals to rapidly process their H1-B visa applications; these are commonly used by immigrant physicians to transition from training to jobs in underserved areas. The American College of Rheumatology (ACR), facing dour workforce shortage projections, immediately began lobbying the Dept of Homeland Security to exempt physicians from this suspension of premium processing for visas. When these efforts were unsuccessful, the ACR brought the case to the American Medical Association, which adopted our request as a resolution. Shortly after that, in late June, the Department of Homeland Security announced the exact exemption for doctors that ACR requested — just in time for newly minted physicians to enter the workforce, and provide care for patients where it is needed most.

 

PBMs and Drug Prices
More and more data shows that the pharmacy benefits management system is bad for patients and drug prices. For example, a recent JAMA article suggested that rebates for drugs covered by the Medicare Part D program may raise costs for patients and Medicare while increasing the profits of Part D plan sponsors and pharmaceutical manufacturers. 3 state rheumatology societies — Florida, NY, and California — have joined ATAP, the coalition to make the PBM’s role in drug pricing more transparent, along with several national organizations ACR, CSRO, AWIR, NORM, the Rheumatology Nurses Society, and GHLF (Creaky Joints). I encourage you to check out ATAP. The coalition went to Capitol Hill in early July and had productive meetings educating Congress about the issue of transparency and the perverse incentives of the PBM system that raise drug prices.

 

Medical Research Funding
More good news: Congress is pushing back against the Trump Administration’s proposal to cut biomedical research funding through NIH. Instead of cuts, the House health appropriations subcommittee proposed boosting funding, in a bipartisan move. Meanwhile the ACR’s advocacy team is watching what the Senate does. We have had multiple meetings with Congress about supporting research this year and will continue to keep up the pressure when we return to the Hill during Advocates for Arthritis. Speaking of #Act4Arthritis: patients are invited to apply to join us on the Hill to lobby Congress in September by applying here. We’ll be asking for lower out of pocket costs for patients, and discussing other timely issues.

 

Senate Debate
Today, the Senate began a floor debate on the topic of repealing and replacing Obamacare. In order to get the required 51 votes to open debate, Senator McCain apparently postponed his brain cancer treatment to travel to DC and vote with 49 other Republicans, and then Vice President Pence cast the 51st vote. The Senate will now spend 20 hours voting on various amendments ranging from a “skinny repeal” (I’m not making this up) revoking the device tax and mandates to buy insurance; to a version of the House BCRA bill with Cruz’s amendment to allow scaled-down insurance. As I’m writing this email, I am finding out that the latter amendment has been voted down. So, I’m updating myself in my own email.
It appears that we are all now up to date on health care from Washington, D.C.!

 

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