CMA Takes Position on Healthcare Reform Bills HR 3590 and HR 4278

CMA’s board of trustees voted on Friday, March 19, 2010, to support the following provisions in the federal healthcare reform legislation:

1. Expansion of healthcare coverage for California’s uninsured.
2. Continuation of current coverage for the insured, including health savings accounts.
3. 3.2 million Californians to be covered by private health plans.
4. Catastrophic-only coverage option for those under 30 years of age.
5. Option to extend parents’ coverage to children under age 26.
6. A state-based health insurance exchange that provides competition and a choice of plans and doctors.
7. Allows patients to privately contract with the physicians of their choice.
8. Provisions to make health insurance more affordable for low-income families.
9. Tax credits for small businesses to purchase health insurance.
10. Reforms on the for-profit insurance industry, which include an 85% medical loss ratio, requirements to have adequate provider networks, prohibitions on denying coverage for pre-existing conditions, and prohibitions on dropping coverage once a patient becomes ill.
11. Investments in primary care, including the Medicare 50% payment increase for primary care physicians (10% per year for five years), establishment of medical homes, and funding to train more primary care physicians.
12. 10% bonus payment per year for general surgeons in rural areas.
13. Additional 5% bonus payment for physicians practicing in underserved areas.
14. Medicaid rate increase to Medicare levels for primary care physicians.
15. Medicaid expansion that is 90–100% federally financed reducing state burden.
16. Medical home and accountable care organization payment increases.
17. Pathway for physicians to achieve anti-trust relief through accountable care organizations.
18. Investments in prevention and wellness programs.
19. Investments in the physician training and workforce programs.
20. Requirements for insurers to adopt uniform rules for physician billing issues.

CMA’s board of trustees voted to oppose the following provisions in the federal healthcare reform legislation:

1. The failure to repeal the current Medicare SGR payment formula.
2. The failure to include a Medicaid rate increase for all services and physician specialties.
3. The failure to update California’s Medicare geographic payment localities.
4. The Independent Medicare Payment Advisory Board (IPAB).
5. The lack of private contracting for seniors in the Medicare program.
6. Widespread implementation of quality reporting programs that are flawed and untested.
7. Allowing nurse practitioners to run medical homes within their state scope of practice laws.
8. A ban on future physician-owned hospitals.
9. Payment reductions for advanced imaging services.
10. Fraud and abuse initiatives that could be burdensome for physicians.

CMA’s board of trustees voted to continue to work to achieve separate legislation that will:

1. Repeal the current Medicare SGR payment formula.
2. Increase the Medicaid payment rates for all services and physicians.
3. Update the California payment localities (GPCI); consistent with CMA policy.
4. Allow Medicare patients to privately contract with physicians.
5. Improve quality reporting programs consistent with CMA policy.
6. Eliminate the IPAB.
7. Further expand coverage to uninsured Californians, consistent with CMA policy.