Posts Tagged congress

Possible Government Shutdown with CHIP in the Balance?

Possible Government Shutdown with CHIP in the Balance?

Friday, Jan. 19: Government shutdowns are rare, with the last shutdown in 2013 that lasted 17 days. Even though the U.S. House passed legislation that would fund CHIP for six more years, the Senate may not approve the measure. In fact, Congress is facing the possibility of another government shutdown, which could leave health care for more than 9 million children caught in the middle of the fray.

Late Thursday evening the House passed legislation 230-197 to keep the government open for business through Feb. 16. The measure now faces a steep battle with Senate lawmakers as time ticks down to midnight to avoid a full shutdown. It’s been widely reported that conservatives in the House Freedom Caucus largely backed the measure even after being locked in debate with the White House and GOP leaders over concerns of military funding and immigration reform. The legislation also includes a measure to renew the Children’s Health Insurance Program for another six years.

Now with the legislation in the Senate it faces steep opposition by Democrats who appear intent on securing concessions that would, among other things, protect from deportation young immigrants brought to the country illegally as children, increase domestic spending, aid Puerto Rico and bolster the government’s response to the opioid epidemic. Senate Democrats have publicly decried the GOP does not have the votes necessary to pass the legislation.

According to the Georgetown University Center for Children and Families, there are now 11 states in danger of running out of CHIP money by the end of February…a number that will double by the end of March. Complicating matters even more, the Congressional Budget Office has stated that extending CHIP funding for 10 years would save the federal government $6 billion whereas initial estimates were that renewing CHIP funding would cost $8.2 billion.

The CBO adjustment stems from changes Congress has made to the Affordable Care Act making private health insurance more expensive and an increase in federal spending on subsidies for that coverage makes CHIP a better deal in comparison.

A government shutdown means more to medicine than health care for America’s children. It will affect the Centers for Disease Control and Prevention during one of the most dangerous flu seasons in recent history. The National Institutes of Health will be forced to stop enrolling patients in clinical trials. Drug approvals by the Food and Drug Administration will come to a complete stop.

The Medical Association is closely monitoring legislation pertaining to CHIP funding and will report any changes as they occur.

Posted in: Advocacy

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Three Simple Steps for Increasing Medicine’s Influence

Three Simple Steps for Increasing Medicine’s Influence

From the outside looking in, the political process likely seems as inviting as a shark tank, as navigable as a corn maze, as predictable as the Kentucky Derby. Intimidating, confusing and frustrating are often used by citizens to describe advocacy-related interactions with government and frankly, this isn’t surprising given most citizens’ level of understanding of the political process.

In his Gettysburg Address, President Abraham Lincoln famously opined our nation’s form of government — “of the people, by the people, for the people” — would long endure. Unlike the direct democracy of 5th century Athens, Americans live in a representative democracy, electing individuals from city councilmen to the President to make decisions for them.

Representative democracy eliminates the need for the citizenry to be involved in the minutiae of modern governance. The downside, however, can be a culture of complacency on the part of the electorate. Outcomes are typically directed by those choosing to engage government on issues important to them, and so government becomes “of the people, by the people, for the people [who choose to participate].” The citizenry is ultimately still responsible for holding government accountable, through either direct engagement with lawmakers or the electoral process (or both), though few understand how to do so.

By following the three simple steps below, physicians can increase their influence on issues important to them and the patients they serve.

Step 1: Join, join, join.

A significant portion of success is simply showing up, but most physicians don’t have the time to spend flying back and forth to Washington or driving to Montgomery for Congressional or legislative meetings, hearings and sessions. Laws and or regulations are constantly under consideration in either the nation’s or state’s capitol directly affecting medical care. A practicing physician can’t possibly make all the scheduled meetings and still see patients, much less attend to the necessary continual monitoring of legislative and regulatory bodies required of successful modern-day advocacy operations.

But when like-minded people pool their resources good things can happen. Advocacy organizations concerned with ensuring delivery of quality care and a positive practice and liability environment — from individual state and national specialty societies to the Medical Association of the State of Alabama — all deserve your support and membership.

They are all working for you and joining them gives these organizations the resources to hire qualified personnel to represent physicians and their patients before legislative and regulatory bodies.

Step 2: Get to know a few key people.

Physicians are responsible for a lot, and in today’s world especially, it’s easy to get into a routine and leave the job of representing the profession to someone else. After all, isn’t that what membership dues are for? Yes and no. While membership in organizations advocating for physicians helps fund advocacy operations, paying membership dues alone is not enough, not in the era of social media, 24-hour news and increased engagement by those on the other side of issues from organized medicine.

Perhaps surprisingly, getting to know a few key people is not difficult, even if only by phone or email. While those paid to represent physicians will know the members of the Legislature and Congress and try to convince them of medicine’s position, in lawmakers’ minds, there is no contact more important than one from a constituent.

Physicians should start locally, getting to know their State Representative and State Senator first, gradually working up to establishing relationships with their member of Congress and U.S. Senators. If they are doing their job well as an elected representative, these legislators and their staff will be glad to hear from a constituent and get his/her perspective. At the same time, don’t overlook the importance of encouraging fellow physicians to engage their local elected officials in meaningful dialogue as well so overall efforts will be amplified.

For more information on how to interact and communicate with lawmakers, check out the Medical Association’s ABCs of VIP.

Step 3: Put your money where your mouth is.

Medical and specialty society membership dollars cannot be legally used for elections purposes, and so separate political action committees or PACs must be established and funds raised each year to help elect candidates physicians can work with on important issues. Not surprisingly, numerous entities whose objectives are at odds with medical liability reform, meaningful health system reform and with ensuring the highest standards for medical care are eager to get their allies elected to office.

Just like their parent organizations, the PACs of specialty societies and the official political committee of the Medical Association of the State of Alabama (ALAPAC) are all worthy of your support. When it comes to PAC contributions, never underestimate the impact of even a small donation.

Choosing not to participate in the political process — when it’s known the decisions of lawmakers directly affect medicine — is akin to getting sued, consciously sitting out voir dire and letting the plaintiff’s lawyer pick the jury.


The future of medical care, in Alabama and the nation, rests not with elected lawmakers and appointed bureaucrats but with the men and women actually caring for patients every day. A representative democracy functions best when the electorate holds those elected to office accountable. Increasing medicine’s ability to successfully advocate for physicians and the patients they serve will require increased participation in the political process. It is incumbent upon physicians to join the organizations fighting for them, to get to know their elected officials and to contribute to PACs whose goals align with their own.

By Niko Corley
Director, Legislative Affairs
Deputy Director, Alabama Medical PAC (ALAPAC)

Posted in: Advocacy

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Coalition Pushes for CHIP Reauthorization

Coalition Pushes for CHIP Reauthorization




The Medical Association, the Alabama Chapter of the American Academy of Pediatrics, state lawmakers and a number of organizations advocating for children’s health care are petitioning the Alabama Congressional Delegation to support reauthorization of a bipartisan CHIP funding bill before the Sept. 30 deadline. In a letter to the Alabama Congressional Delegation outlining support for CHIP reauthorization, the coalition cited the great strides made possible through CHIP in ensuring children have access to the care they need. As well, any reductions in federal CHIP funding could cause problems for not only Alabama’s ALL Kids program but also children enrolled in Alabama Medicaid.

Below is the letter, and more signees are expected before the Sept. 30 deadline. Download a copy of the letter here.

We, the undersigned Alabama elected officials and organizations advocating for children and pregnant women in our state, write to urge your support of the Hatch-Wyden bill, Keeping Kids’ Insurance Dependable and Secure (KIDS) Act (S. 1827). This bipartisan legislation ensures stability for vulnerable children by extending funding for the Children’s Health Insurance Program (CHIP) for five years. The bill also provides additional protections for low-income children and increases flexibility for states.

As you know, federal funding for CHIP expires on September 30, 2017. Without certainty from Congress on CHIP funding, states will be forced to make drastic cuts to the program. This could mean slashing enrollment, reducing benefits, and imposing higher costs for families.

CHIP is a bipartisan success story. The program was created in 1997 and has been championed by lawmakers on both sides of the aisle since its very beginning. Together with Medicaid, CHIP has helped to reduce the numbers of uninsured children by a remarkable 68 percent. Now is the time for Congress to stabilize the CHIP funding stream and protect the gains in children’s health coverage that have resulted in more than 95 percent of all children in America being enrolled in some form of insurance coverage.

The program is designed around what children need. It offers benefits that are age-appropriate, including dental coverage and mental health and substance abuse services, which may not be covered by a family’s employer-sponsored insurance.

CHIP plans include networks of pediatricians, pediatric medical and surgical subspecialists, and children’s hospitals, which are especially critical for children with special health care needs.

Families deserve peace of mind knowing that they will be able to access the care and support services their children rely on to be healthy.

Currently in Alabama, 157,000 children are covered by CHIP, known as ALL Kids in our state. With state budgets already set for the coming year, states are counting on CHIP to continue in its current form. Changes to CHIP’s structure – including changes to the Maintenance of Effort or the enhanced CHIP matching rate – would cause significant disruption in children’s coverage and leave states with critical shortfalls in their budgets. Given CHIP’s track record of success, changes to CHIP that would cause harm to children must not be made. In Alabama, we would be forced to use funds originally appropriated for Alabama Medicaid to keep children covered on CHIP. So lack of continued funding at its current level would mean a double hit for Alabama!

Today, we stand united in urging you and your colleagues to work together to enact a five-year extension of CHIP funding.  Securing this critical source of coverage for children and pregnant women into the future is an important opportunity for meaningful, bipartisan action to honor CHIP’s 20 years of success.

Thank you for all you do for our state and the children of Alabama.



Representative Steve Clouse, Chair, House Ways and Means General Fund Committee

Representative Anthony Daniels, House Minority Leader

Representative Nathaniel Ledbetter, House Majority Leader

Representative Mac McCutcheon, Speaker of the House

Representative April Weaver, Chair, House Health Committee

Senator Del Marsh, Senate President Pro Tempore

Senator Jim McClendon, Chair, Senate Health & Human Services Committee

Senator Greg Reed, Senate Majority Leader

Alabama Academy of Family Physicians

Alabama Arise

Alabama Chapter-American Academy of Pediatrics

Alabama Children First

Alabama Hospital Association

Children’s of Alabama

Medical Association of the State of Alabama

UAB Health System

University of South Alabama Health System

VOICES for Alabama’s Children


Posted in: CHIP

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The Medical Association Supports Replacement of ACA with Workable Health Care System

The Medical Association Supports Replacement of ACA with Workable Health Care System

The Medical Association released its 2017 Legislative Agendas earlier this year, which were developed with guidance from the House of Delegates and great contribution from our physician members who participated in the 2017 Legislative Agenda Survey. The Medical Association has continued to express support for the repeal of the Affordable Care Act and its replacement with an adequate system to protect not only physicians but their patients as well.

The U.S. Senate is engaged in deliberations on legislation to repeal and replace the Affordable Care Act. So far these debates have one thing in common – they fail to meet the basic requirements of a solid health care plan, which does not further damage an already weakened Medicaid program or make it more difficult for low and moderate-income Americans to obtain affordable health insurance.

As from the beginning, Medical Association continues to support the repeal of the Affordable Care Act and replacement with a system that:

  • Includes meaningful tort reforms that maintain existing state protections
  • Preserves employer-based health insurance
  • Protects coverage for patients with pre-existing conditions
  • Protects coverage for dependents under age 26
  • With proper oversight, allows the sale of health insurance across state lines
  • Allows for deducting individual health insurance expenses on tax returns
  • Increases allowed contributions to health savings accounts
  • Ensures access for vulnerable populations
  • Ensures universal, catastrophic coverage
  • Does not increase uncompensated care
  • Does not require adherence with insurance requirements until insurance reimbursement begins
  • Reduces administrative and regulatory burdens

The disproportionate funding model dictated by the ACA has left most states, including Alabama, sorely underfunded. Medicaid is a critical component of our health care system, covering the young and elderly. Medicaid covers more than half of Alabama births and 47 percent of our children, as well as 60 percent of Alabama’s nursing home residents. Without full funding, the Medicaid program will collapse, leaving these individuals without coverage. While uncompensated care is delivered every day in all 67 counties of this state, without Medicaid, charity care needs could skyrocket, crippling the health care delivery system and potentially placing the burden on those with private health insurance through higher premiums and co-pays.

Now’s the time to fix our broken health care system to ensure access to care for our citizens and the ability for physicians to practice medicine without overwhelming federal burdens guiding the way. The Medical Association continues to work with our Congressional Delegation during these negotiations and urges them to work together toward the passage of a viable health care solution for our residents.

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