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Health Care Reform Takes Center Stage

Rep. Bart Gordon at ACEP's Leadership and Advocacy Conference

Rep. Bart Gordon at ACEP's Leadership and Advocacy Conference

Democratic leaders in the House and Senate released their long-awaited health care reform plans on June 9. The House released an outline that three major committees will work off of, while Senator Edward Kennedy (D-MA) released a full bill. Senator Max Baucus (D-MT), the other leading architect of reform legislation is expected to put out a bill before the end of June.

One of the key provisions of the Kennedy plan is a requirement that every person in America have health insurance. The legislation also creates a government run insurance program that would compete directly with private insurance companies. But as emergency physicians know, access to health insurance does not always equate to access to health care. If the primary care docs do not accept new patients with government insurance because of low reimbursement rates, they will eventually present in the emergency department.

ACEP’s Washington office– headed by Gordon Wheeler – has been working with the House and Senate committees responsible for developing health care reform legislation with the goal of assuring that emergency medicine’s issues are being addressed. In addition, ACEP recently launched a letter writing campaign urging members to contact Congress and demand that emergency patients’ needs are included in health care reform.

 ACEP is having some success in bringing emergency medicine’s issues to the attention of Congress, Mr. Wheeler said, and Senator Kennedy’s bill, “The Affordable Health Choices Act,” includes several provisions important to the specialty, including:

  • Reauthorization of the emergency medical services for children program ($25 million in 2010, to $30.3 million in 2014)
  • Design and implementation of regionalized systems for emergency care
  • Competitive grants for regionalized systems for emergency care response
  • Support for emergency medicine research
  • Mental health assessments, crisis intervention, counseling, treatment, and referral to a continuum of services, including emergency psychiatric care¸ community support programs, inpatient care, and outpatient programs.

In addition, Rep. Bart Gordon (D-TN), House sponsor of the “Access to Emergency Medical Services Act of 2009” (H.R. 1188) said recently that he would like to see language from that bill included in the House’s health care reform legislation. Rep. Gordon said that all of the bill’s provisions (listed below) should be considered:

  • The creation of a national bipartisan commission to examine factors that affect the delivery of care in emergency departments
  • The need for additional resources in support of emergency care delivery
  • The development of standards, guidelines and measures by the CMS to address boarding and ambulance diversion

Rep. Gordon is also encouraging the development of pilot programs to model effective and efficient trauma regionalization systems, especially in dealing with capacity and diversion issues. Rep. Gordon, a long time supporter of emergency medicine, is also concerned about emergency medicine workforce issues and reimbursement for emergency medical services. He recently sponsored “The Health Care Safety Net Enhancement Act of 2009” (H.R. 1998), a bill that would improve access to emergency medical services and provide liability coverage for emergency physicians when providing care to EMTALA patients.

Rep Gordon is also the sponsor of “The Medicaid Emergency Psychiatric Care Demonstration Project Act of 2009,” (H.R. 1415) legislation that would fund a demonstration project that allows Medicaid to pay for emergency psych services at non-publicly owned or operated institutions. The goal of the project is to help alleviate the psych bed shortage and move patients out of the emergency department and into treatment.

Debate on the numerous bills being discussed is expected to begin in July. At this juncture, it is unclear what the final health care reform legislation will look like, or if comprehensive health care reform will be successful this time around. ACEP will continue to lobby for emergency medicine’s interests and seek solutions to the critical problems confronting the specialty. This blog will continue to keep you informed of ACEP’s progress.

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