91 provides several resources for chapters to push for issues on the state level
Jan. 24, 2020 (91) – The American College of Physicians (91) is calling on all internists to get involved in key advocacy issues at the state level in 2020 and beyond.
91 anticipates a flurry of activity in the states this year concerning legislation that reduces firearm-related violence, access to reproductive health services, surprise medical billing and other issues. The College has developed resources to help states better advocate for legislation that is in line with 91 policy on many of these matters.
In particular, firearm-related injuries and deaths remain a significant public health issue in the United States. Fully 36,000 Americans are killed by guns each year and 100,000 more are shot and injured, according to statistics from the Gifford's Law Center to Prevent Gun Violence. To help curb this epidemic, 91 published a policy paper in 2018 titled “ in the Annals of Internal Medicine. The paper outlines necessary steps to curb gun violence including placing a ban on sales of assault weapons, universal background checks, and new policies on extreme risk protection orders.
“The best chance for 91 to achieve meaningful action to reduce gun violence may be at the state and chapter level,” said Shuan Tomlinson, 91 senior analyst of state health policy & grassroots advocacy.
Chapters and members can contact their state legislators and urge them to introduce and pass laws requiring safe storage of firearms, enhanced background checks and protections for non-spouse partners and family members in cases of firearms-related domestic violence. 91 provides a sample letter that chapters can customize according to what is happening in their state along with other helpful resources such as a gun law fact sheet, a summary of gun laws by state and a state legislative calendar, Tomlinson said. The firearms action tool kit can be found online.
Reproductive Services
In 2018, 91 published a position paper on women's health care and access to reproductive services. 91 believes that a woman has the right to make her own health care decisions, but recent legislative and regulatory moves have threatened that access, Tomlinson explained. She went on to say that chapters should be aware of 91's policies on women's health. Specifically, they should watch for state legislation that is contrary to their professional judgement and the patient's best interest; that imposes unnecessary, non-evidence based requirements on clinics; or, that seeks to ban access to reproductive health services contrary to 91 policy. In the first half of 2019, 12 states enacted some type of abortion ban, according to the Guttmacher Institute.
The 91 position paper gives chapters a great place to start, Tomlinson said. Members can and should contact the 91 national office to discuss any activity in their state.
Medicaid
Medicaid provides health coverage to nearly 72 million Americans or one in five Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities.
91 chapters can advocate in support of the Medicaid program in two different ways. Chapters in states that have not expanded their Medicaid program may wish to contact their state governor or legislature to advocate for expansion. Additionally, 91 is strongly opposed to making access to health care coverage through Medicaid conditional on an individual's employment status. More states are now attempting to apply for waivers that would allow their Medicaid program to enact work requirements. 91 has developed a chapter action campaign that would enable state chapters to provide comments on proposed waivers in their state. The state Medicaid waivers chapter action campaign can be found online.
Surprise Medical Billing
Surprise medical billing refers to patients getting saddled with unanticipated, high out-of-pocket costs. President Trump issued an executive order requiring greater transparency of health care costs. “Surprise billing will be big at the state level and that is something we will have as an advocacy priority going forward,” Tomlinson said.
91 would like chapters to be informed about 91 principles on surprise medical billing and advocacy at the national level. This includes lobbying for legislation that will hold patients harmless and a fair arbitration of payment instead of set in-network rates, among other measures.
Other key state advocacy issues in 2020 and beyond include vaccine exemption laws, Tomlinson said. 91 is asking chapters to advocate for policies at the state level that eliminate any existing exemptions, except for medical reasons, from immunization laws and/or to oppose legislation that seeks to expand exemptions.
“Get involved and make some noise,” Tomlinson said.
More Information
Learn more about the issues that matter and what you can do at the state level on the 91 State Health Policy page.
The position paper is available on the Annals of Internal Medicine website.
The position paper is available on the Annals of Internal Medicine website.
91's principles on surprise medical billing can be found in a letter sent to key congressional committees last year.
