APA’s Government, Policy, and Advocacy Update (October 2021)

APA joined five other leading physician groups in opposing a Texas state law that took effect last month banning abortions, medical counseling, and support related to abortion after six weeks of pregnancy.

APA CEO and Medical Director Saul Levin, M.D., M.P.A., noted that APA opposes legislative interference in the doctor-patient relationship and laws that threaten the health and well-being of women. “Restrictive abortion and contraception policies have been shown to be related to an increased risk for a variety of mental health problems and may have a negative impact on the overall health of women, including physical, emotional, and social well-being,” Levin said.

In a joint statement, APA and its five frontline partners wrote that the law, which bans all abortions after the first six weeks of pregnancy unless the mother’s health is seriously threatened, limits the evidence-based practice of medicine; threatens the patient-physician relationship; and inhibits the delivery of safe, timely, and necessary comprehensive care. “This new law will endanger patients and clinicians, putting physicians who provide necessary medical care, or even offer evidence-based information, at risk by allowing private citizens to interfere in women’s reproductive health decision making,” the coalition wrote.

The Department of Justice filed suit against the state of Texas in federal court asking a judge to declare the abortion ban unconstitutional and block its enforcement. A lawsuit is also pending against the law in the Fifth Circuit Court of Appeals. Meanwhile, two other abortion laws are both slated to take effect in 2021: Oklahoma’s six-week abortion ban and Montana’s law criminalizing the provision of abortion care.

House Speaker Nancy Pelosi (D-Calif.) vowed to pass legislation establishing a statutory right for health care professionals to provide and patients to receive abortion care, free from medically unnecessary restrictions. Such a bill would face an uphill battle in the narrowly divided Senate, with Republicans expected to filibuster.

APA’s continuous advocacy helped lead Illinois (HB 255) and Oregon (HB 3046) to sign into law new medical necessity criteria statutes.

The new laws are similar to a bill enacted in California last year that requires insurers to use generally accepted standards of care when determining medical necessity. The aim of the laws is to prevent insurers from creating their own internal guidelines for determining medical necessity. APA worked closely with its district branches to support passage of the legislation.

APA pledged its support for a group of House committee-passed mental health and substance use (MH/SU) disorder bills and urged House leaders to move them to the floor.

The 10 bills would address the following: social determinants of health; maternal mortality and morbidity, particularly among minority and ethnic populations; substance use disorders/drug policy; and Medicaid in the U.S. territories.

“Given the exacerbation of MH/SUD conditions during the COVID-19 pandemic, it is urgent that the House move these bills to the floor for passage expeditiously to ensure that Americans receive access to vital MH/SUD treatment,” Saul Levin, M.D., M.P.A., APA’s CEO and medical director, wrote in a letter to House leaders urging movement on the bills.

APA is pushing for more graduate medical education (GME) training positions supported by Medicare in the budget reconciliation package.

As a member of the GME Advocacy Coalition, APA urged congressional leaders to pass the APA-endorsed Resident Physician Shortage Reduction Act of 2021 (HR 2256/S 834) to promote a more robust and diverse physician workforce. The bill would provide 14,000 new Medicare-supported GME positions targeted for rural teaching hospitals, hospitals in health professional shortage areas, and other critical need areas. The legislation would also commission a study of ways to create a more diverse clinical workforce.

In a letter to House leaders, the coalition urged leaders to “build upon last year’s historic investment in the health care workforce.” In the FY 2021 spending bill, Congress provided 1,000 new Medicare-supported GME positions. The United States will face a shortage of 124,000 physicians by 2034, which will likely be exacerbated by early retirement due to the COVID-19 pandemic, according to the letter.

The Biden administration is investing more than $19 million in telehealth services for rural and underserved communities.

As part of the effort, $3.9 million will be directed to help health networks increase access to telehealth services in primary, acute, and behavioral health care and to assess their effectiveness; $4.3 million will be directed to building telementoring programs and providing training and support for primary care providers to treat complex conditions, including substance use disorder. ■