We recently returned from the 30th Annual ACOG Congressional Leadership Conference (CLC) with a delegation representing the regional diversity of our District. Fellows, for whom attendance is an annual commitment, enjoyed presentations from political experts, ACOG leaders, and congressional representatives that outlined the political landscape for the future of healthcare in this election year. Junior Fellows and first time attendees had the option of attending "Lobbying 101" where they learned the basics of our federal legislative process. During state caucuses we learned from the experiences of other states as they encounter political battles we are now facing in New York, such as the implementation of nonpayment for Medicaid elective deliveries less than 39 weeks gestation. Texas adopted this legislation last year.
For all those in attendance, we found motivation in the long list of lobbying successes achieved throughout ACOG's history of holding the CLC. These wins for 2011 include the introduction of the IPAB repeal bill by ACOG Fellow and Congressman Phil Roe, MD, the introduction of HR 5 in support of comprehensive medical liability reform, ACOG leading the effort to fight Makena price increases, and the introduction of prematurity research expansion, among many other accomplishments.
On the third day of the conference we went to the Hill to lobby in support of ob-gyns nationally and advocate for our patients. This year’s lobbying agenda included three threats to the practice of medicine on which Congress will act this year. The first ask we had for Congress was to repeal IPAB (the Independent Payment Advisory Board). This Board of 15 is comprised of unelected officials with little congressional oversight and was formed as a result of the super committee's failure to find ways to sufficiently cut health care costs in order to pay for the Affordable Care Act. In the first five years, IPAB can only reduce costs by cutting payments to physicians and unless they meet Medicare cost savings goals, cannot recommend the needed payment increases to Medicare. During congressional visits we supported the repeal of IPAB by supporting the bipartisan House bill HR 452 and Senate bill S 668. Going hand in hand with IPAB, we argued that addressing the SGR Medicare cliff once and for all as extensions again expire 12/31/12 is essential.
Protecting government sponsorship of Graduate Medical Education (GME) was our second ask of Congress. Proposed budget cuts include significant reductions in both indirect and direct GME payments. Supporters have suggested that residents should pay tuition rather than receive government supported salaries. We explained our educational model clarifying the tremendous service provided by the residents of the 34 New York State programs. We emphasized the tremendous impact such cuts would have in New York where we train a disproportionate number of future physicians in comparison to other states with fewer programs. Given projected physician shortages and increasing numbers of medical student spots to address such shortages, we argued that the cuts were entirely illogical and lacked forward thinking.
The third item on this year’s agenda was support for Medicaid and avoiding cuts that have been proposed. We reviewed the impending expansion of patients into the system given the Affordable Care Act, as well as the fact that 40% of deliveries are Medicaid-covered deliveries. The impact in New York State with such cuts would be tremendous.
In total, there were over 300 in attendance representing 49 states who made over 250 congressional visits. Record numbers of direct meetings with members of Congress were made. ACOG is seeing an increase in direct access simultaneous with our expansion to a million dollar PAC and our 501C6 change. At this conference alone we raised $80,000 for our national PAC to continue to support legislators who will support Fellow practice and advocate for women's health. All in attendance were impressed by the extensive list of health care decisions currently being debated and decided upon by Congress as they look to change the future of the healthcare system. As practicing physicians caring for women and teaching the next generation of ob-gyns, it is clear that we are in a crucial time where we have an obligation to be informed about the details of these changes and advocate for the future of our specialty rather than passively viewing its evolution. I encourage you to join us in Albany on May 15th as we lobby our state's Capitol in support of practice and our patients.