American College of Obstetricians and Gynecologists 2019 Legislative Priorities

Ensure Changes to Our Nation’s Health Care System Improve Women’s Health

Proposals must:

  • Maintain or increase the number of covered individuals. Maintain critical benefits, including:
    • Guaranteed maternity coverage
    • Full coverage and no cost-sharing for women’s preventive services, including contraception
    • Continued Medicaid state plan option to expand coverage of family planning
  • Preserve market protections, including:
    • Prohibition on pre-existing condition exclusions, gender rating, and annual and lifetime benefit caps
    • Direct access to ob-gyn care
    • Allowing individuals through age 26 to maintain coverage on their parents’ insurance and former foster care youth to access Medicaid through age 26
    • Access to premium subsidies for small employers and low-income individuals
  • Strengthen the health care safety net, including:
    • Continued Medicaid expansion to cover individuals up to 138% of the federal poverty level
    • Defend access to qualified providers within the Medicaid program
  • Ensure stabilization of the individual health insurance market
    • Enforce current law consumer protections
    • Ensure appropriate incentives to participate in the marketplace
    • Expand consumer choice
    • Enhance outreach and education efforts
    • Continue premium stabilization programs
  • Protect public health, including:
    • Continued required break time and location to express breastmilk
    • Preserving the Prevention and Public Health Fund
  • Include Medical Liability Reform
  • Reduce prescription drug costs while maintaining patient access to needed drug therapy
  • Protect and expand coverage of essential health benefits, including contraceptives, without cost-sharing by codifying into state laws:
    • No-copay coverage of essential health benefits, including contraception, covered under the ACA
    • No-copay coverage of contraceptive methods that are not guaranteed under the ACA, such as over-the-counter methods and male sterilization.

Support Our Physician Workforce

  • Support graduate medical education by exploring additional funding mechanisms and innovative approaches to medical education
  • Oppose cuts to Federal and State GME funding
  • Oppose funding GME through the appropriations process
  • Make medical student loan repayment more affordable
  • Oppose cuts in GME programs at Department of Defense
  • Address Women’s Health Workforce Shortages
    • Work to expand the women’s health care provider workforce
    • Address the rural hospital closures crisis
    • Support full scope of practice for Certified Nurse-Midwives/Certified Midwives

Oppose Political Interference

  • Protect the patient-physician relationship
  • Ensure federal and state health policy is science and evidence-based
  • Protect the self-regulation of physician Maintenance of Certification

Medicaid and Medicare – Advocate for Ob-Gyns and Our Patients

  • Ensure any changes to federal entitlements improve women’s health
    • Oppose proposals that shift costs to states, patients, or health care providers
    • Ensure participation of all qualified providers in the Medicaid program
    • Oppose work requirements, mandatory drug testing, mandatory participation in substance use disorder treatment programs and excessive out-of-pocket costs to receive Medicaid benefits
    • Oppose lockout periods and complicated administrative requirements.
  • Ensure MACRA Quality Payment Program implementation meets the needs of ob-gyns and women’s health
  •  Oppose efforts to privatize Medicare by transitioning to a premium support program
  • Protect ob-gyn ultrasound from any reimbursement or coverage cuts

Prevent Unintended Pregnancies and Increase Access to Contraceptive Care

  • Support access to reproductive health services
  • Ensure the use of medically-accurate information
  • Defend and expand access to contraception coverage without cost-sharing
  • Oppose efforts to deny access to qualified providers, including Planned Parenthood, in Medicaid, Title X, and state-run family planning programs
  • Oppose efforts to weaken or otherwise undermine family planning and teen pregnancy prevention programs
  • Reduce the need for abortion
  • Support insurance coverage of an extended supply of contraceptives
  • Improve insurer compliance with existing law through state executive action
  • Increase access to immediate postpartum long-acting reversible contraception

Support Physicians in Practice

  • Reduce administrative burdens
  • Achieve payment equity
  • Protect peer review activities from liability and retaliation, including both individual and institutional review programs and quality assessment and improvement programs

Enact Meaningful Medical Liability Reform

  • Support and protect caps on non-economic damages
  • Support and protect meaningful and innovative alternative reforms, including:
    • Safe harbors
    • Expanded application of the Federal Tort Claims Act to on-call ob-gyns
    •  “I’m Sorry” legislation

Reduce Rising Rates of Maternal Mortality and Severe Maternal Morbidity in the United States

  • Continue to educate policymakers on maternal mortality and severe maternal morbidity
  • Support the Alliance for Innovation in Maternal Health (AIM) program
  • Support state perinatal quality care collaboratives
  • Support efforts to ensure access to health coverage postpartum
  • Support the establishment and maintenance of state maternal mortality review committees
  • Support legislation to implement state review committee recommendations

Reduce Maternal Opioid Dependence

  • Promote public health efforts to reduce maternal opioid use disorder and neonatal abstinence syndrome (NAS)
  • Oppose punitive legislation against women with opioid use disorder
  • Support implementation of laws to ensure access to appropriate care for women with opioid use disorder and babies born with NAS
  • Protect against mandatory testing and reporting to law enforcement or child protective services; maintain protections for women undergoing medically assisted treatment (MAT)
  • Support continuous access to substance use disorder treatment and mental health services after delivery

Ensure Best Care for Patients - Scope of Practice/Midwifery

  • Oppose federal and state recognition of and reimbursement to midwives who do not meet the International Confederation of Midwives (ICM) educational standards
  • Ensure that the educational and professional standards of the American Midwifery Certification Board (AMCB) and the ICM are used to evaluate, certify and license all midwives

Protect Access to Care for Underserved Populations

  • Oppose cuts to discretionary programs, including the Indian Health Service, Special Supplemental Nutrition Program for Women and Children (WIC); CDC Breast and Cervical Cancer Screening Program; STDs; and programs to improve pre-pregnancy care, family planning, and breastfeeding.
  • Advocate for access to care for underserved populations, including adolescents, women of color, immigrant women, women in detention or incarcerated women, and American Indian/Alaska Native women, military servicemembers and dependents, women veterans, and LGBTQ+ persons. 
    • Support meaningful Veterans Administration (VA) reforms that ensure access to women’s health services for veterans
    • Protect access to ob-gyn care at Military Treatment Facilities (MTFs)
    • Ensure parity in women’s access to health care across DOD, VA, and private sector
    • End the practice of shackling pregnant and vulnerable women in correctional facilities, improve access to essential, evidence-based services including feminine hygiene products, and help ensure fair treatment of women and girls by correctional facilities and staff

Advance Research in Pregnant and Breastfeeding Women

  • Promote pregnant and breastfeeding women’s inclusion in clinical trials
  • Support ongoing work of the HHS Task Force on Research Specific to Pregnant Women and Lactating Women (PRGLAC)

Support Federal and State Funding for Women’s Health Programs

  • Biomedical research at NIH to address gynecologic health conditions, prematurity, obesity, maternal morbidity, and health disparities
  • Data collection and surveillance programs, including vital statistics systems, maternal mortality reviews, and the Pregnancy Risk Assessment Monitoring System (PRAMS)
  • Women’s health programs, including the Title V Maternal/Child Health Block Grant, Healthy Start, and Title X Family Planning
  • State programs to improve diagnosis and treatment options for maternal depression
  • Zika virus prevention and response

End Gun Violence, Ensure Women’s Health

  • Support an evidence-based, public health approach to gun violence that emphasizes education, prevention, safety, and research.

Continue Quality Improvement and Patient Safety Initiatives 

  • Support for ob-gyn performance measures developed by and in consultation with ACOG and dissemination through Medicare, Medicaid and CHIP
  • Work with HHS and other federal partners to promote the use of evidence-based practice guidelines, and identify innovative and best practices in care coordination

Support Healthy Pregnancy and Motherhood for Working Women

  • Ensure that pregnant workers are not improperly forced out of their jobs or denied reasonable job modifications that would allow them to continue working and have healthier pregnancies
  • Ensure breastfeeding workers have adequate allowance to express milk at work
  • Support families via paid parental leave

Protect Vulnerable Populations from Toxic Chemical Exposure

  • Ensure implementation of chemical safety reforms adequately protect the health of vulnerable populations including pregnant women, infants, and children

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American College of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188
Mailing Address: PO Box 96920, Washington, DC 20024-9998