American College of Obstetricians and Gynecologists 2018 Legislative Priorities

Ensure Any Changes to the Affordable Care Act (ACA) Meet the Needs of Ob-Gyns and Our Patients

Any attempt to reform our Nation’s health care system must not compromise or reduce health insurance guarantees and protections achieved by the ACA.  Reform proposals must:

  • Ensure that any federal action or inaction does not result in fewer covered individuals
  • Maintain critical benefits, including:
    • Guaranteed maternity coverage
    • Full coverage and no cost-sharing for women’s preventive health 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
    • 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
  • Ensure stabilization of the individual health insurance market
  • Protect public health, including:
    • Continued required break time and location to express breastmilk
    • Preserving the Prevention and Public Health Fund
  • Repeal the Independent Payment Advisory Board (IPAB)
  • Include Medical Liability Reform
  • Reduce prescription drug costs
  • Codify or expand the ACA’s coverage guarantees in individual states

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 meet the needs of ob-gyns and our patients
    • Oppose Medicaid cuts and proposals that shift costs to states, patients, or health care providers including block grants and per capita caps
    • Ensure participation of all qualified providers in the Medicaid program
    • Oppose mandatory drug testing, mandatory participation in substance use disorder treatment programs, and work requirements to receive Medicaid benefits
    • Oppose burdensome lockout periods and complicated administrative requirements
  • Ensure MACRA implementation meets the needs of women’s health and ob-gyns
  • 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 Reduce the Need for Abortions

  • 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
  • Support insurance coverage of an extended supply of contraceptives
  • Support state funding if the US Congress or Administration exclude qualified providers from federal programs
  • Improve insurer compliance with existing law through state executive action
  • Increase access to immediate postpartum long-acting reversible contraception

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 gain designation of maternity care shortage areas by the National Health Service Corps
    • 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

Enact Meaningful Medical Liability Reform

  • Support and protect caps on non-economic damages
  • Support and protect meaningful and innovative alternative reforms, including but not limited to:
    • Safe harbors
    • Expanded application of the Federal Tort Claims Act to on-call ob-gyns
    • “I’m Sorry” legislation

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

  • Support federal grant program for state maternal mortality review committees
  • Support the Alliance for Innovation in Maternal Health (AIM) program
  • Support state perinatal quality care collaboratives
  • Continue to educate the US Congress on maternal mortality and severe maternal morbidity
  • Support the establishment and maintenance of state maternal mortality review committees

Support Appropriate Efforts to 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 and babies born with NAS
  • 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)

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) standards
  • Ensure that the educational and professional standards of the American Midwifery Certification Board (AMCB) and the International Confederation of Midwives are used to evaluate and certify all midwives.

Protect Access to Care for Underserved Populations

  • Oppose cuts to discretionary programs, including the Special Supplemental Nutrition Program for Women and Children (WIC); CDC Breast and Cervical Cancer Screening Program; programs to combat sudden infant death syndrome, 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/Alaskan Native women, military servicemembers and dependents, women veterans, and LGBT persons.
  • Support meaningful Veterans Administration (VA) reform that ensures 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 incarceration facilities.

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 Programs that Support Healthy Mothers and Healthy Babies, including:

  • Biomedical research at NIH to address 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)
  • Maternal 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

Continue Quality Improvement and Patient Safety Initiatives, including:

  • 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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