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AAP Federal Health Care Reform Update

Today, I share a memo from the Federal Affairs desk of the AAP that pediatricians and their staff should consider.   Normally, I gloss over stuff like this (admit it, you do, too), but the comments Obama has made about child health are important and I think this is the time to make your voices heard.  We saw CMS make some changes as the result of private pediatric feedback promoted on this blog, so we know that input is valuable.

Questions?   Contact info is at the bottom.


July 24, 2009

To:       AAP Chapter Presidents
AAP Chapter Vice Presidents
AAP Chapter Executive Directors

Fr:        AAP Department of Federal Affairs

Re:       Federal Health Care Reform Update


After a weekend of meetings with the conservative Blue Dog Democrats, the House Energy and Commerce Committee reconvened late Monday to debate and vote on amendments to the America's Affordable Health Choices Act (HR 3200). Even though Energy and Commerce was scheduled to continue debate through Tuesday and Wednesday of this week, the Blue Dogs succeeded in postponing the Committee's action to negotiate with Democratic leaders on cost savings, mandates on small businesses and the proposed public option. President Obama invited the Energy and Commerce Blue Dogs to the White House Tuesday afternoon to listen to their concerns and forge agreement on how to move forward.

Late Tuesday, Chairman Waxman (D-CA) announced that negotiations among Democrats may have reached a "turning point" with the agreement to create an independent board to evaluate and influence payment rates in Medicare similar to the existing Medicare Payment Advisory Commission (MedPAC). President Obama has endorsed a proposal by Senator John D. Rockefeller IV (D-WV) to strengthen MedPAC and make its recommendations law unless rejected by Congress. Despite support from members of the Energy and Commerce Committee, those committees with jurisdiction over Medicare (Senate Finance Committee and House Ways and Means Committee) have opposed to the idea for fear that the board could impose cuts that result in reduced services.

Republicans and Democrats in both chambers have expressed concerns regarding provisions in the bill as well as the speed with which President Obama and Democratic leadership are moving forward. On Friday six senators sent a letter to Senate leadership voicing their concerns over the timetable for floor action in the Senate. The six senators, Senators Snowe (R-ME), Collins (R-ME), Lieberman (I-CT), Ben Nelson (D-NE), Landrieu (D-LA) and Wyden (D-OR), represent some of the centrist/moderate Democrats and Republicans in the Senate. If health reform is to succeed it is imperative that these moderate members, especially the four Democrats that signed the letter, support the final health reform package.

The contention amongst Democrats in both chambers is causing party leaders to soften timelines for the legislation. Speaker Pelosi announced Wednesday that while she has no doubt that she has the votes in the House to pass legislation, whether or not they vote before they adjourn for the summer recess on July 31st remains to be seen. Due to ongoing negotiations in the Senate Finance Committee, Senator Durbin (D-IL), Majority Whip, stated late Wednesday that the Senate would postpone the vote until after the August recess. Chairman Baucus continues to meet with three Republicans, Senators Snowe, Ranking Member Grassley and Enzi to craft a bipartisan bill. Senator Hatch (D-UT) was a regular participant in the negotiations, but announced Wednesday that he has stopped attending the sessions.


On Monday, President Obama addressed a small group of pediatricians, nurses and a physician's assistant at Children's National Medical Center in Washington, DC. One of the points he raised during his remarks was the steady increase in the volume of visits to emergency departments (ED), specifically the impact these increases have on pediatric emergency visits, shrinking access and under-insurance, and the added burden and expense that unnecessary pediatric ED visits represent. Additionally President Obama spoke to the strains our health care system places on parents with sick children. Many families, even those with health insurance, can't afford routine visits for their children. Mr. Obama also mentioned that poor payment rates for pediatricians and primary care doctors contribute to barriers to care.

On Wednesday, to rally public support for overhauling the nation's health care system, President Obama convened a primetime press conference at the White House. Following days of reports regarding the divisiveness in Congress, Mr. Obama used the news conference to take his message out of Congress and straight to the public. He said for the first time that he would be willing to help pay for the plan by raising income taxes on families earning more than $1 million a year, and is opposed to taxing middle-class families. Additionally he signaled that he was also receptive to another idea under consideration in the Senate: taxing employer-provided health benefits, as long as the tax did not fall on the middle class. During his speech Mr. Obama reaffirmed several key points:

·       Overhauling the nation's health care system would benefit Americans and strengthen the economy.
·       A new health care system would be a necessary improvement, and will implement reforms that work for the American people.
·       American's that have insurance that they like will be able to keep it.


We must continue to act on behalf of our nation's children. Even though your members are working hard in Washington, they need to hear from you. Over the next weeks members of Congress and advocates in DC will be working to hammer out legislation and as a result we need to regularly reaffirm the importance of providing children with the services they need and deserve in health reform.

1. Call you local district offices to schedule a meeting during the August recess. Even though the recess is still a month away, schedules fill up quickly.
2. Call your member of Congress and tell them that children need comprehensive health care reform, and the time to pass health care reform is NOW!
3. Submit an Op-Ed to Your Local Newspaper. You can find suggested talking points and suggested tips on submitting an Op-Ed by logging into the AAP Members Center and clicking the Health Care Reform.
4. Forward this memo to other AAP Members!

Learn more about the issues in health care reform! Log on to the AAP Members Center Federal Advocacy Page to get the latest background information and tools you need to make a difference!

* AAP Health Care Reform backgrounder
* AAP Access Principles
* AAP Priorities on Health Care Reform
* Talking Points
* Chapter sign-on letter
* Specific Senate and House legislation and official AAP responses
* Kaiser Family Foundation side-by-side of the Senate and House legislation

Become a Key Contact! Unlike regular FAAN emails, Key Contacts receive regular, more specific emails from the Department of Federal Affairs, keeping them informed about the latest developments and ways to get involved.

Key Contacts are AAP members who have agreed to take their advocacy to the next level. By becoming a Key Contact, you will receive important assignments and can provide critical information to AAP based on your results. In the coming months, we will be calling on Key Contacts with specific requests to make an impact on the health care reform debate. Being a Key Contact requires a very small time commitment but can yield big results! Join today by logging into the AAP Members Center and going to the Federal Advocacy page.

The Department of Federal Affairs is here to support you, and we are more than willing to answer any questions you may have. Please contact Claire Bornstein (cbornstein@aap.org) or Erin Howard (ehoward@aap.org) if you have any questions.


Tags: cms, Uncategorized, aap, healthcare reform

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