Thaddeus L. Anderson, MD, committee chair
The reelection of Barack Obama as US president ensures that provisions of the Affordable Care Act (ACA) will continue to be rolled out. US Department of Health and Human Services Secretary Kathleen Sebelius gave states more flexibility in defining their essential health benefits package under ACA. States could choose a level of benefits from one of the three largest small group plans in the state, one of three largest state employee health plans, one of three largest federal employee health plan options, or the largest HMO plan offered in the state’s commercial market. States could pick a benefits package for their health exchange in 2014 consistent with the typical benefits package available in their state.
The deadline for applying to establish a state-based exchange for health insurance was December 14, 2012. The deadline for applying to establish a partnership exchange with the federal government is February 15, 2013. The third option is to default to a federally facilitated exchange. Currently, 19 states, including Minnesota, and the District of Columbia plan to establish a state-based exchange. Seven states, including Illinois and Iowa, plan to establish a partnership exchange. Twenty-five states, including Nebraska, North Dakota, South Dakota, and Wisconsin, have declined the state-based exchange option and will default to a federally facilitated exchange.
The 27% Medicare physician payment cut scheduled for January 1, 2013, was delayed by Congress at the last minute. Medicare physician payments will remain at 2012 levels until December 31, 2013. The delay was part of the American Taxpayer Relief Act of 2012, which also delayed 8.2% across-the-board cuts to discretionary programs and a 2% cut to Medicare until March 31, 2013.
The cuts to discretionary spending will affect National Institutes of Health research, the Title V Maternal and Child Health Block Grant, the Title X Family Planning Program, the Centers for Disease Control and Prevention (CDC) Section 317 Immunization Grants Program (for childhood immunization), and the CDC National Breast and Cervical Cancer Early Detection Program. The Medicare cut will affect graduate medical education funding and physician reimbursement. ACOG is working to educate legislators about the effects these cuts will have on the health of women and children.
Legislative concerns and opportunities
Legislative areas of concern mentioned by District VI legislative chairs include attempts to license certified professional midwives, requirements for ultrasound prior to an abortion, funding restrictions on contraception and abortion services, and excessive requirements for facilities where abortions are performed.
ACOG’s federal political action committee, Ob-GynPAC, is now making monies available for use for Ob-GynPAC members in state elections. Members may request up to $50,000 to use in state elections, where allowed by state law. The OB-GynPAC Governing Committee will approve distributions on a first come-first served basis.
The Gellhaus Resident Advocacy Fellowship allows a senior ob-gyn resident to work in Washington, DC, for two to four weeks with the ACOG Government Relations and Outreach department. Expenses for travel, housing, and meals are covered by this fellowship. If you are interested or know someone who may be, you can contact firstname.lastname@example.org for information.
The ACOG Congressional Leadership Conference, The President’s Conference (CLC), is scheduled for March 3–5 in Washington, DC. District- and section-sponsored individuals have already been selected. Any ACOG member who wishes to fund their own attendance may register by contacting Stacie Monroe at email@example.com. If you are interested in being sponsored for the 2014 CLC, please contact your section chair.