APA’s Government, Policy, and Advocacy Update (September 2023)

The 2018 SUPPORT Act (Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities) was a bipartisan package aimed at addressing the opioid crisis. This year, legislation has been introduced to reauthorize the SUPPORT Act (HR 4531). In a letter to leaders of the House Committee on Energy and Commerce, APA CEO and Medical Director Saul Levin, M.D., M.P.A., urged the committee to support additional legislation to further aid patients and communities impacted by the substance use disorder (SUD) crisis.

The APA-supported bills that would build upon the SUPPORT Act include the following:

“Earlier this year, the Centers for Disease Control and Prevention reported a staggering 107,477 drug overdoses during the previous 12-month period ending in August of 2022,” Levin wrote in the letter, which was addressed to the committee’s chair, Rep. Cathy McMorris Rodgers (R-Wash.), and ranking member Rep. Frank Pallone (D-N.J.). “Fortunately, Congress has the ability to address this crisis by championing and enacting policies that would ensure millions receive the care that they so desperately need.”

The Children’s Hospital Graduate Medical Education Program (CHGME) has historically enjoyed bipartisan, bicameral support. This year, however, the CHGME reauthorization under consideration in Congress (HR 3887) would prohibit CHGME funding to hospitals that have provided gender-affirming care services to minors at any time during the past fiscal year.

The reauthorization bill “threatens the sanctity of the physician-patient relationship and subjects vulnerable children to political, rather than medical, decision-making,” Levin wrote to the House Committee on Energy and Commerce leaders. “A family’s decisions about whether such care is clinically appropriate should be made by them in consultation with their physician, not subject to government intrusion.”

APA expressed its support for a clean, five-year reauthorization of the CHGME program with no gender-affirming care exclusions. Such a bill would ensure the availability of predictable, state funding for children’s hospitals, the letter states.

Further, in another letter sent along with 62 organizations, APA called on Congress to reject efforts to ban access to gender-affirming care for transgender patients.

“Currently, twenty states have enacted legislation banning care for adolescents; five of these bans enact felony penalties against health care professionals for following their professional oath to provide ethical, evidence-based care,” the letter states. “These efforts have now made their way to Congress.

“We strongly oppose these discriminatory state and federal efforts to ban best-practice, evidence-based care for transgender people,” the letter states.

Earlier this year, the Federal Trade Commission (FTC) proposed a rule to expand requirements for entities that are not covered by the Health Insurance Portability and Accountability Act (HIPAA) to notify individuals, the FTC, and, in some cases, the media if they experience a breach of personally identifiable health data. In a letter expressing support for the rule, APA called it a “critical starting point to establishing accountability and transparency for [the] protection of health-related data by non-HIPAA-covered entities.”

The rule would expand the FTC’s definition of entities that provide health care services or supplies to include any online service “that provides health-related services or tools,” such as mobile apps that host wellness, sleep, fitness, or diet information. These companies would be required to follow the FTC’s rules about notifying customers about data breaches.

Mobile health applications are an important tool in supporting access to and quality of health care services, reads APA’s letter, which was signed by Levin. “Confidentiality is critical to ensuring that patients access needed mental health care services. If these technologies are not private or secure, users that are the most vulnerable—including those without in-person care options, those with lower digital literacy, and those with significant mental health needs—are at the greatest risk of harm to their privacy and well-being.”

Further, APA urged the FTC to take additional steps to protect users’ data, such as by undertaking a public awareness campaign; requiring companies to make the language they use in privacy policies accessible to users, ideally at no more than a sixth-grade reading level; and presenting key privacy information in large print with fewer words. ■