MMS Federal Advocacy Continues Support of ACA

By Sarah Ruth Bates, MBE, MMS Government Relations and Research Analyst

Predicting the next week of developments at the federal level, let alone the next year, is not easy — but we can safely assume that Republicans in Congress and the White House will continue their attempts to repeal and replace the Affordable Care Act (ACA). The MMS has been engaged in extensive and ongoing advocacy efforts to keep the ACA in place.

Protecting the ACA

The Society’s ACA efforts have proceeded on multiple fronts. These include our collaboration with the Massachusetts congressional delegation, grassroots advocacy and engagement with our membership, and our work with a statewide coalition of stakeholders. Nationally, as well as across the Commonwealth, we have partnered with colleagues including patient organizations, physician organizations, and business associations.

We will continue to do so in 2018, through the second session of the 115th United States Congress. We will also continue to work with state and national colleagues to seek reforms that build on the progress made under the ACA. The more that the Republican congressional caucus and the president have tried to repeal and replace the ACA, the more public opposition to those efforts we have seen. At present, however, congressional protection for the ACA rests on a very slim margin. Even a slight shift in congressional representation could jeopardize that margin. 

Senator Ed Markey

Senator Ed Markey, speaking on the Graham-Cassidy bill, referenced Dr. Henry Dorkin’s concerns; Senate floor, September 26, 2017.

Prescription Drug Costs and Telemedicine

So far, the president and congressional Republicans have maintained an unrelenting focus on the ACA. We hope to see in 2018 bipartisan interest in and legislative proposals addressing prescription drug costs. In particular, Congress will likely address the rising costs of naloxone, a drug used to reverse opioid overdose, as the opioid epidemic continues to worsen. Congress will likely take up the issue of increasing access to and utilization of telemedicine services as well, and broader discussions of health care cost and quality will also continue.

MACRA Reimbursement

On the regulatory side, the implementation of MACRA continues into its second year. Physicians can choose between two methods of reimbursement: the Merit-Based Incentive Payment System (MIPS), which is similar to fee-for-service, and the Alternative Payment Model (APM), an ACO-type option that offers both the potential for higher reimbursement and greater risk if physicians fail to meet the requirements put forward by their ACOs. Very few physician practices transitioned to APMs during the first year of MACRA; we expect to see more physician-led APMs and more virtual groups this year. These transitions will likely also result in a greater use of telemedicine. The MMS will continue to follow these and other regulatory developments this year.

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