Archive for Advocacy

April Weaver Wins the Special General Election for Senate District 14

Congratulations Sen. April Weaver!

Sen. April Weaver with Dr. John Meigs

Republican Candidate, April Weaver, won the special general election against Democratic candidate, Virginia Applebaum, for Senate District 14 seat on Tuesday, July 13, 2021. The seat was previously held by Cam Ward (R) and covers Bibb, Chilton and Shelby counties.

According the certified election results published by the Secretary of State, April Weaver received 6,234 of the 7,768 votes, 80.3%.

Sen. Weaver Being Sworn In

As the political action committee representing physicians across the state, Alabama Medical PAC (ALAPAC) was proud to support April Weaver in this special election. At a time when healthcare policy is so polarized, electing candidates who understand these issues and value physician input is a top priority. April Weaver, having previously served as the Chair of Alabama House Health Committee and a Regional Director with HHS, is that type of candidate.

“Supporting April Weaver for Senate District 14 was an easy decision,” said ALAPAC Board Chairman David Herrick, M.D. “From her previous roles in both the Alabama House and HHS, Weaver has consistently been a leader in healthcare industry and an advocate of policies that move medicine forward. The overwhelming outreach and support from physicians in her area, as well as statewide, is a testament to the positive impact Weaver has made both personally and professionally.”

Thank you to everyone that voted!

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Discussions with Decisionmakers: Sen. Jack Williams

Discussions with Decisionmakers

Background

Senator Williams was born in Mobile County and is a passionate farmer. Senator Williams was elected to the Alabama Senate in 2018 after serving one term in the Alabama House of Representatives. He is a member of the Senate Healthcare Committee. Senator Williams represents Alabama’s 34th District covering Mobile County.

Please tell us a little bit about yourself – Primary occupation? Interests? Hobbies?

I’m a farmer by trade, and I went into the nursery business. My son also works in the nursery business.

What first prompted you to consider running office?

Mostly because of the way things were being run in our state, plus people asked me. I thought, hey, why not?

How does your background help serve you on the Health Committee and also the Legislature?

Building a business from the ground up and taking on numerous tasks. My unique perspective of living in a rural area allows me to relate to more.

What are some health-related issues important to your district and your constituents?

Getting more doctors out into rural areas. We are also against scope creep.

What can be done to alleviate the unnecessary and growing administrative and regulatory burdens and laws being placed on the medical community by insurers and government payers like Medicare and Medicaid?

We have to see significant money come into our rural hospitals. We are losing rural hospitals at an alarming rate and that needs to change quickly.

What do you think people understand the least about our health care system?

They don’t always understand quite how much the medical community has given up. People are sacrificing quite a bit to keep our state alive and healthy. They deserve our thanks.

If you could change anything about our state’s health care system, what would it be?

I want to help doctors who have to travel far to reach patients to be able to get to those patients.

Do you have a position on the expansion of Medicaid?

I’m all for it.

How can the Medical Association – and physicians statewide – help you address Alabama’s health challenges?

Please come talk to me. With their help, I can help fight issues they care about.

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Not a “Rock Throwing” Committee; Pandemic Response Task Force Holds First Meeting

On Thursday, July 1, the first meeting of a legislatively-created task force to examine the state’s response to the COVID-19 pandemic was held in Montgomery.  During the 2021 Legislative Session, amidst a flurry of bills being introduced related to the pandemic (like Sen. McClendon’s bill to abolish the position of State Health Officer and abolish the State Committee of Public Health), the Medical Association asked state lawmakers to “press pause” on any such bills until an out-of-session, full and complete analysis of pandemic response could be completed.  That request was largely honored, and a task force was created to do just that. 

At the task force’s inaugural meeting, Gov. Kay Ivey, Senate President Pro Tem Greg Reed and House Speaker Mac McCutcheon addressed members of the task force.  All three agreed the past year created unprecedented challenges for Alabamians and that while there may have been and in some instances may continue to be disagreement among some regarding how the state handled certain things, the desire of the Governor, Sen. Reed and Speaker McCutcheon was for the task force to identify positive steps the state can take for the future.  Sen. Reed reminded the group there wasn’t a “manual” for how to manage a global pandemic within Alabama but that he wanted their help in moving the state forward.  

“We aren’t interested in rock throwing here,” Sen. Reed said.  “We want this group to identify how Alabama can be better prepared for the next pandemic.”

Speaker McCutheon echoed his words, adding COVID-19 had continued to change so rapidly that it made responding effectively difficult at times. He thanked State Health Officer Dr. Scott Harris and the Governor for their work and leadership during the pandemic.  Speaker McCutcheon said he wanted to be sure the task force had “facts to promote our [recommended] actions.”

In her remarks, Gov. Ivey encouraged Alabamians who haven’t been vaccinated to do so and outlined the “team effort” between her administration, Dr. Harris and the Health Department, Director Brian Hastings and the state Emergency Management Department and others.  She also acknowledged that business closures, the many lives lost and setbacks in education as some of the most difficult effects of the pandemic.  

“The response to the pandemic wasn’t perfect,” Gov. Ivey said, “and we regret some of the decisions made but [ultimately] we prevailed.” 

Task force co-chair Sen. Tim Melson, M.D., said his intention was for the task force to be a “fact-finding and not a fault-finding committee.”  Rep. Paul Lee, House Health Chairman and co-chair of the task force, said COVID-19 had been “a moving target” and that “hindsight is 20/20”.  Both Sen. Melson and Rep. Lee welcomed ideas from committee members and the public as to how to improve Alabama’s pandemic response moving forward.  The task force plans to meet again before the end of the summer.  

Posted in: Advocacy, Coronavirus

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SD14 Special General Election

SD14 Special General Election is Tuesday, July 13, 2021. The seat was previously held by Cam Ward (R) and covers Bibb, Chilton and Shelby counties.

As the political action committee representing physicians across the state, Alabama Medical PAC (ALAPAC) is proud to support April Weaver in this special election. At a time when healthcare policy is so polarized, electing candidates who understand these issues and value physician input is a top priority. April Weaver, having previously served as the Chair of Alabama House Health Committee and a Regional Director with HHS, is that type of candidate, and we encourage all physicians in Senate District 14 to support her campaign.

“Supporting April Weaver for Senate District 14 was an easy decision,” said ALAPAC Board Chairman David Herrick, M.D. “From her previous roles in both the Alabama House and HHS, Weaver has consistently been a leader in healthcare industry and an advocate of policies that move medicine forward. The overwhelming outreach and support from physicians in her area, as well as statewide, is a testament to the positive impact Weaver has made both personally and professionally.”

For those physicians who live in Senate District 14 (Bibb, Chilton, and Shelby), we hope you’ll go to polls on Tuesday, July 13, and cast your vote for April Weaver.

Unsure about voting in-person? Can’t remember what polling location you vote? Please click here to find out.

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Discussions with Decisionmakers: Senator Tom Butler

Discussions with Decisionmakers

Background

Senator Butler has been a member of both the Senate and House of Representatives and has served in the Legislature for over 30 years. He is on the Senate Healthcare Committee. Senator Butler is also a registered and certified pharmacist and recently passed a bill that allows pharmacies to find more affordable alternative drugs for patients.

What first prompted you to consider running office?

John Kennedy challenged youth in this country to run for office. When I left college, I joined the Huntsville JC. I like serving people.

How does your background help serve you on the Health Committee and also the Legislature?

Having a background in medical technology and pharmacy.

What are some of your legislative priorities this term?

The Pharmacy Benefit Manager bill which prevents practices of pharmacy benefit managers relating to patient steering to use mail-order pharmacies and prevents price discrimination. It requires the PBM to act as a fiduciary to clients and prevents them from stopping pharmacists from disclosing prices.

We need to give patients freedom.

What can be done to alleviate the unnecessary and growing administrative and regulatory burdens and laws being placed on the medical community by insurers and government payers like Medicare and Medicaid?

We are spending about a billion dollars a year on Medicaid, but we need to monitor how it is administered and what it costs taxpayers.

What do you think people understand the least about our healthcare system?

People don’t understand how long it takes to fill a prescription. Overall, people want healthcare as fast as possible. People also sometimes don’t understand the financial side of healthcare, and just how expensive it really is.

If you could change anything about our state’s health care system, what would it be?

Prevent medical shortages in rural communities. We don’t have enough physicians in rural communities. It is hard to see current physicians fleeing rural areas due to a lack of incentives. We need more incentives.

Do you have a position on the expansion of Medicaid?

I can’t support it right now for one reason: it would cost us $300 million in new funding, and I don’t see how we can take that on right now. I would like to see greater access to quality healthcare, but I don’t believe this costly choice is the state’s best option

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What if No One was On Call?

2021 Legislative Recap

After the 2020 Session was cut short by the COVID-19 pandemic, it was widely expected that health care would be a hot topic for the 2021 Session. Those forecasts proved to be true, with roughly 20 percent of bills and resolutions filed during the 2021 Session relating to health care!

Had the Medical Association not been “on call” during the 2021 Session, problematic bills for physicians and bills dangerous to patients could have become law.  

*Click the button below to download a pdf version*

Moving Medicine Forward in 2021

While preventing dangerous and problematic proposals from becoming law consumes much of the Association’s advocacy efforts, at the same time the Association is trying to move medicine forward each session. The 2021 Session saw continued success for the Association in two top-priority funding requests (MMRC and BMSA) as well as the enactment of legislation to further access to physician-led, team-based care for patients in Alabama. 

If no one was on call . . . physicians, their staff, and their practices would have no protection from COVID-19 frivolous lawsuits. The Association worked with both Sen. Arthur Orr (R-Decatur) and a coalition of other organizations on legislation providing liability protection to businesses but also to physicians for care whose provision to patients was affected or impacted by COVID-19 and/or the state’s response to the pandemic. This bill was one of the first to become law in 2021.

If no one was on call . . . the Maternal Mortality Review Committee (MMRC) could not have received vital funding for the second year in a row. In 2019, the Association spearheaded a coalition of stakeholders – which included March of Dimes, the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, and Johnson & Johnson – to bring awareness to the issue of increasing maternal mortality rates in Alabama and spotlight the impact this committee could have to reverse that trend if properly staffed and resourced. As she did in 2020, Gov. Ivey again supported funding for the MMRC in her initial 2022 budget request and legislators maintained that funding in the final budget.

If no one was on call . . . the MMRC’s inaugural report outlining its findings and initial recommendations would not have been recognized. To raise awareness of this important work, the Association worked with Sen. Linda Coleman-Madison on a legislative resolution (SJR106) and joined several legislators at a press conference event in April. 

If no one was on call . . . the Board of Medical Scholarship Awards could not have maintained its significant funding increase in the coming fiscal year. As she did in 2020, Gov. Ivey recommended maintaining the additional $500,000 increase for the BMSA. The legislature agreed, and the total amount for physician-student-loans for 2022 remains at $1.9 million, allowing roughly 10 medical school tuition loans to be granted annually to physicians willing to set up practice in medically underserved areas of Alabama. This program remains one of the best mechanisms for expanding access to quality care.

If no one was on call . . . necessary physician-supported updates to Alabama’s athletic trainer statute as it relates to supervision and care continuity wouldnot have become lawThe Association worked closely with the Athletic Trainers Association and several medical specialty societies in drafting legislation to better define the practice of athletic training, ensure appropriate physician supervision, and allow joint-promulgation of athletic trainer rules between the professions’ respective licensure boards.

If no one was on call … the creation of a new physician-led program to utilize paramedics to reach at-risk patients in communities across the state would not have become law. The Association worked closely with the Alabama Chapter of the American College of Emergency Physicians on the legislation.

If no one was on call … the medical community’s voice and needs of physicians as it relates to expanding broadband in Alabama would not have been heard. The legislation that passed creates a digital expansion authority to expand access to the internet in all 67 counties and will undoubtedly help patients connect with their physicians via telehealth.

If no one was on call … awareness of the need to expand Medicaid would not have grown as much as it did. The Association, as part of Cover Alabama – a coalition of more than 100 organizations supporting Medicaid expansion – continues to advocate for those caught in the coverage gap. 

Fighting “Scope Creep”

(the Replacing of Education with Legislation)

Many people would like to be a physician, but few are willing to endure medical school, residency, and all the other various education and training requirements to become an M.D. or D.O. Instead of pursuing higher education, some non-physician organizations pursue legislative changes as an end-around-means to practice medicine, endangering quality care for patients.

If no one was on call . . . the physician referral requirement for physical therapy could have been abolished. As introduced, the legislation (sponsored by Sen. Jim McClendon) would have abolished the need for a medical diagnosis before a physical therapist could begin providing therapy to a patient. 

If no one was on call . . . podiatrists could have been granted the ability to perform surgery on the ankle and lower leg. The legislation (co-sponsored by Sen. Jim McClendon) would have allowed podiatrists who have completed as few as 2-years of podiatry residency (significantly less than either a general orthopaedist or an orthopaedic surgeon specializing in the ankle) to perform ankle surgery.

If no one was on call . . . optometrists could have begun performing eye surgeries using scalpels and lasers as well as eye injections. The legislation (pushed by Sen. Jim McClendon) would have allowed optometrists, who do not undergo any surgical residencies anywhere in the U.S., to perform surgeries and injections on the eye and would also have given the Alabama Board of Optometry the sole power to define and regulate what is considered to be the practice of optometry, taking all authority away from the Legislature to define it. 

If no one was on call . . . a newly-created state board could have unilaterally set the scope of practice for imaging technologists and significantly increased costs to medical practices utilizing medical imaging. Working with the Alabama Academy of Radiology, the Alabama Academy of Family Physicians and other medical specialty societies, the Association was able to reach a consensus with the technologists on their legislation.

If no one was on call . . . the State Board of Nursing could have gained jurisdiction over, along with the ability to charge licensure fees to, medical assistants working in physician offices. Working with a coalition of partners, the problems with the legislation were resolved. 

If no one was on call … various “interstate compacts” for non-physicians could have enabled “scope creep” far beyond what Alabama law allows.   

Beating Back the Lawsuit Industry

Plaintiff lawyers are constantly seeking new opportunities to sue physicians. Alabama’s medical liability laws have long been recognized for ensuring a stable legal climate and fostering fairness in the courtroom. But those laws come in jeopardy every session and the Association must defend against allowing more frivolous lawsuits to be filed against physicians.

If no one was on call … new vaccine-related lawsuits against physician-employers and medical practices could have become law.

If no one was on call … physicians accepting Medicaid could have been subject to whistleblower lawsuits for honest billing mistakes, costing $5,500-$11,000 per billing mistake plus triple damages under a Medicaid fraud bill (sponsored by Sen. Jim McClendon). The Association, along with a coalition of health care associations, offered a substitute bill the sponsor rejected. 

If no one was on call … physicians treating prisoners who are pregnant could have been exposed to new liability for others’ actions. The Association worked with the bill sponsor to remove the problematic language.  

If no one was on call … physicians treating survivors of sexual assaults could have been exposed to new liability and requirements for new statutory standards of care. The Association worked with the bill sponsor to remove the problematic language.  

If no one was on call . . . physicians could have been held liable for emergency medical treatment decisions of individuals believed to be a threat to themselves or others. The Association worked with the bill sponsor to remove the problematic language.  

If no one was on call . . . physicians could have been held liable for school system employees’ deviations from DNR orders made portable for minors in schools. The Association worked with the bill sponsor and bill proponents to remove the problematic language.  

If no one was on call . . . physicians could have been held liable for the actions of school system employees if the physician helped create a “seizure action plan” for his or her minor child patient with a seizure disorder. The Association worked with the bill sponsor to remove the problematic language.  

If no one was on call … legislation to criminalize female genital mutilation could have unintentionally created new liability issues for physicians. The Association worked with the bill sponsor and the Alabama Section of the American College of Obstetricians and Gynecologists to ensure the bill adhered to ACOG guidelines and that no new physician liability was created.   

Other Health-Related Legislation of Interest

If no one was on call . . . the Board of Medical Examiners and Medical Licensure Commission would have been abolished. The legislation (sponsored by Sen. Jim McClendon) would have banned physicians who were members of county, state or national medical and specialty societies from participating in regulating their profession. The proposed structure in the legislation would also have ensured little diversity amongst the physicians serving on the reconstituted BME and would likely have prevented rural physicians from being represented as well. 

If no one was on call … the State Health Officer and the State Committee of Public Health would have been abolished. The legislation (sponsored by Sen. Jim McClendon) would have allowed for a non-physician to head the Health Department and would have replaced most of the physicians on the committee with an optometrist and other non-physicians.Instead of making drastic changes to ADPH midstream, the legislature and the governor agreed to a full-spectrum study of the state’s COVID-19 response efforts between now and the beginning of the 2022 Session to identify areas for improvement moving forward.

Legislation was enacted to enable cannabis for medicinal use ifapproved by a physician certified by the state to recommend it to patients. The bill provides for the regulation by the state, from “seed to sale”, of cannabis for medicinal use and creates a new commission to oversee all aspects (other than physician regulation) of cannabis.  The new law allows physicians to become “certifying physicians” and allows patients who are approved by a certifying physician to access medical cannabis at a state approved dispensary. In 2019, the Medical Association did an in-depth survey of its members to gauge Alabama physicians’ opinions on the topic. While opinions amongst individual physicians on cannabis for medicinal use differed then and still do, there was broad support amongst physicians for – IF cannabis for medicinal use were legalized in Alabama – that the state would regulate and inspect the products. As well, there was also broad support for keeping all regulation of physicians who choose to recommend cannabis to patients under the Board of Medical Examiners and not moved under the purview of the new Cannabis Commission or the Agriculture Department. Those areas and others of strong support identified via the 2019 survey, as well as several others, became the basis for the Association’s advocacy efforts on the legislation. As a result, those areas of broad agreement were included in the final bill that passed.

Legislation was enacted that would prevent practices of pharmacy benefit managers relating to patient steering to use mail-order pharmacies and would prevent price discrimination. It would also require the PBM to act as a fiduciary to clients and would prevent them from stopping pharmacists from disclosing prices.

A resolution was enacted to establish the chronic weight management and type 2 diabetes task force. The task force will study the health implications of chronic weight management and type 2 diabetes, the costs associated with the diseases, and the various health treatments available to reduce the epidemic in this state caused by those diseases. The task force is also tasked with making recommendations for improving the health of Alabamians. The Association has an appointment to the task force.

Legislation was filed to require all vaccine providers to check the state vaccine registry (ImmPrint) before administering a vaccine and also to input vaccine-recipient information into the database. The legislation was amended to exclude flu shots for those 19 and older from falling under the legislation. The bill did not pass.

Legislation was filed to ban transgender therapy. It would have criminalized counseling, prescribing and performing surgery if the intent of any of the preceding was to assist and/or affirm in transitioning a patient to a gender different than the one listed on the patient’s birth certificate. The legislation was amended to remove “counseling” from the list of banned therapies for treating transgender patients. The bill did not pass.

Legislation was filed to change the way county health officers issued countywide public health orders. Various bills were filed related to county health orders. Some would have established an advisory panel to weigh in on countywide health orders before implementation while others would have prohibited a county health officer from issuing an order that relates to pandemic or outbreak unless it was approved by the State Health Officer. These bills did not pass.

Legislation was filed to change how statewide public health orders are issued and also to curtail the emergency declaration powers of the governor. These bills did not pass.

Multiple pieces of legislation were filed related to abortion. The topics ranged in focus from requiring information be provided to patients about possible reversal of chemical abortion medications, to banning chemical abortions altogether, to banning the public funding of abortions, to requiring that babies born alive after an abortion in a reproductive health center be provided the same life-sustaining treatment than if the baby were born elsewhere. Of these, the “born alive” bill passed in the final legislative day.

Multiple pieces of legislation were filed related to banning vaccine passports.  The bill that passed on the final legislative day leaves in place existing immunization requirements for students (and also allows exceptions for religious or medical reasons) but bans the issuance of vaccine passports in Alabama by the state or any other governmental body. It also prevents businesses from being able to require proof of vaccination for entry into a business or as a condition for provision of a good or service to a customer. 

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Medical Association Supports Continued Funding for Maternal Death Investigations

Medical Association Supports Continued Funding for Maternal Death Investigations

‘Shocking’ Nearly 70% of Deaths Are Preventable, Experts Say      

MONTGOMERY – The Medical Association of the State of Alabama today joined Alabama legislators in calling for continued state funding to investigate why Alabama mothers die from childbirth and pregnancy complications at more than double the rate of women nationally.

The funding for this research, which was first appropriated by Governor Kay Ivey and the Alabama Legislature just last year, enables the Alabama Maternal Mortality Review Committee (AL-MMRC) to pay for additional autopsies and costs associated with compiling case files and reviewing medical records of Alabama mothers who died up to a year after giving birth. While the AL-MMRC was launched in 2018, it relied solely on the work of volunteers to undertake such reviews until last year.

Appearing at a press conference in Montgomery today, Aruna Arora, MD, MPH, President of the Medical Association, applauded Senator Linda Coleman-Madison for sponsoring a resolution spotlighting the findings of the first AL-MMRC report and acknowledging continued funding of the program is critical to saving Alabama mothers.

“The recent report of the Maternal Mortality Review Committee was both shocking and informative,” said Dr. Arora. “That nearly 70 percent of the deaths could have possibly been prevented highlights the inequities of our current health system and underscores the need for the continued annual review to determine why these high numbers of deaths are occurring. Funding the review committee provides invaluable insight into the deaths of Alabama mothers and will enable the experts to develop specific strategies to save lives in the future.”

For its initial report, the AL-MMRC undertook a review of all maternal deaths in the state from 2016. Highlights from that report include:

  • 36 mothers lost their lives within one year of the end of pregnancy and 36 percent of those deaths were directly related to the pregnancy.
  • Nearly 70 percent of deaths were determined to be preventable.
  • Mental health and substance use disorders were identified as key contributors in almost 50 percent of deaths.
  • 67 percent of deaths occurred 43 to 365 days after the end of pregnancy.

Additionally, the AL-MMRC also made more than 100 recommendations to improve maternal health. Chief among those recommendations is for the state to expand Medicaid. 

“Right now, amid a global pandemic, affordable and accessible health care is more important than ever,” continued Dr. Arora. “Just last week, new research found the risk of maternal mortality to be 22 times higher in women who tested positive for COVID-19 during pregnancy. Thus, with other research showing reduced maternal mortality rates and positive maternal health outcomes in states that expanded Medicaid, the decision to expand here in Alabama is abundantly clear.”

The Medical Association appreciates Governor Ivey’s recommendation for initial funding for the review committee for 2020-21 as well as the continued efforts from legislative leaders like Senator Coleman-Madison, Rep. Laura Hall, and others.                                                                                 

The Medical Association also launched an online social media effort aimed at increasing awareness of maternal health needs with #SaveAlMoms and a website:  www.alabamamedicine.org/SaveAlMoms/.


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American Rescue Plan Offers $940 Million for Medicaid Expansion and Other Benefits for Healthcare

American Rescue Plan Offers $940 Million for Medicaid Expansion and Other Benefits for Healthcare

The American Rescue Plan Act of 2021, signed by President Biden on Thursday, includes a number of key provisions that strengthen both public and private health insurance coverage. Among its Medicaid and the Children’s Health Insurance Program (CHIP) provisions, the American Rescue Plan encourages states to finally take up the Medicaid expansion by offering even more favorable financial incentives than those already in place and allows states to provide longer postpartum health coverage for new mothers.

Right now, some 300,000 Alabamians living in the health coverage gap. They earn too much to qualify for Medicaid under the state’s stringent income limit but too little to qualify for subsidized ACA marketplace plans. If Alabama were to expand Medicaid and provide much-needed healthcare coverage for these individuals, the state would receive an estimated $940 million over two-years for doing so. 

A complete analysis of the Act and its potential impact is below. 

HEALTHCARE PROVISIONS

Additional Federal Funding to States that Newly Adopt the Medicaid Expansion

  • Newly expanding states would receive a 5-percentage-point increase in their FMAP for all non-expansion enrollees, who account for most of a state’s Medicaid enrollees and costs. The increase would begin the first day of the quarter that expansion begins and last for two years. Not only that, this increase is on top of the 6.2-percentage-point FMAP increase that all states will receive for the duration of the public health emergency under last year’s Families First Act, which will provide $86 billion in additional federal Medicaid dollars in 2020 and 2021. 
  • According to the Center for Budget and Policy Priorities (CBPP), Alabama would receive an estimated $940 million in federal funds for expanding. 

New Medicaid and CHIP Option for States to Extend Postpartum Coverage for 12 Months

  • The American Rescue Plan offers states a new “state plan” option to provide pregnancy-related Medicaid and CHIP coverage for one year after the end of pregnancy, extending coverage well beyond the current cutoff of 60 days. States can take up this option starting in the first calendar year quarter one year after enactment, which is April 1, 2022. The option, however, is temporary and will be available to states for five years unless Congress acts to extend it at a later time.
  • The Congressional Budget Office (CBO), for example, estimates that about 45 percent of women covered by Medicaid on the basis of pregnancy now become uninsured after the end of the 60-day postpartum coverage period. Alabama is no different, and this new option would directly help address our current maternal mortality statistics. 

Expansion of the State Medicaid Option for Coverage of COVID-19 Testing for the Uninsured to Include Coverage for COVID-19 Vaccines and Treatment

  • The Families First legislation included a Medicaid option for states to cover COVID-19 testing for the uninsured through the duration of the public health emergency. The federal government picks up 100 percent of the cost. The American Rescue Plan expands this fully federally-funded option to cover COVID-19 vaccines and their administration, and treatment, including prescription drugs, and treatment for conditions that complicate COVID-19 treatment.

Policies to Improve the Affordability and Access of Private Insurance Coverage

  • COBRA Coverage: Premiums for COBRA coverage for individuals who are laid off or leave their jobs because of the pandemic will be subsidized at 100% through September 30, 2021. The employer or health plan could claim a refundable tax credit against its Medicare payroll tax liability for the cost of the premiums.
  • Affordable Care Act (ACA) Marketplace Subsidies: Refundable credits for households with income between 100% to 400% of the federal poverty level (FPL). For 2021 and 2022, premiums for individuals with income at 150% of the FPL will be eliminated, while premiums for all other households will be capped at 8.5% of their income.
  • Health Insurance Marketplace: $20 million in grants to states to modernize and update health insurance marketplace systems, programs, or technology.

Public Health Provisions

  • $7.66 billion to expand the public health workforce, including grants to state, local, and territorial health departments that increase the number of contact tracers, social support specialists, community health workers, public health nurses, epidemiologists, lab personnel, disease intervention specialists and communications personnel.
  • $7.6 billion for testing and vaccinations at community health centers (CHCs).
  • $3 billion for block grant programs under the Substance Abuse and Mental Health Services Administration (SAMHSA) to provide community mental health services and prevention and treatment of substance abuse.
  • $800 million for the National Health Service Corps, as well as $100 million reserved for state student loan repayment programs, $200 million for the Nurse Corps Loan Repayment program, and $330 million for teaching health centers that operate graduate medical education.
  • $250 million for states to establish “strike teams” that could be deployed at skilled nursing facilities (SNFs) with high rates of COVID-19.

Posted in: Advocacy, Health, Insurance, Medicaid, Medicare

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Stutts, Melson Defend “Physician-Led” ADPH in Committee Hearing

Stutts, Melson Defend “Physician-Led” ADPH in Committee Hearing

A bill (SB 240) by optometrist and Senate Health Committee Chairman Jim McClendon (R-Springville) to abolish the position of state health officer and overhaul the entire Alabama Department of Public Health and all county health departments in the state passed committee on an 8-3 vote this week.  The opposing votes came from Sens. Larry Stutts (R-Tuscumbia) and Tim Melson (R-Florence), both physicians, and also from Sen. Dan Roberts (R-Mountain Brook). 

Sen. McClendon told the audience that the State Committee of Public Health, which appoints the state health officer, was just “a private club” of doctors, and that he aimed to change that.  While current law provides that the State Committee of Public Health (12 physicians and four other members) appoints the state health officer, SB 240 would instead have the governor appoint a “secretary of health” who would not be required to be a physician in the proposed legislation.

Senators Larry Stutts, M.D. and Tim Melson, M.D, both took issue with McClendon’s explanation of the bill and with the bill itself.  Stutts said he believes the timing of the bill is wrong.

“The tail end of a pandemic is not the time to do this.  I respect Dr. Harris and his objectivity and expertise.  I haven’t always agreed with all the decisions made, but I don’t want the state health officer to be political appointment,” Stutts said. 

Melson agreed.

“I want the state health officer accountable to other doctors,” Melson said.  “I don’t want to make [it] a political position…I think the system may need a tune-up but not an overhaul, not what’s in this bill.”

Sen. Billy Beasley (D-Clayton), a pharmacist, said he thinks State Health Officer Dr. Scott Harris should be “commended” for his work during the pandemic, adding “I think the state health officer needs to be a doctor.”

Those voting in favor of the bill in committee were Sens. Jim McClendon, Billy Beasley, Tom Whatley, Jack Williams, Sam Givhan, Donnie Chesteen, Garlan Gudger, and Linda Coleman-Madison. 

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