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Our Nation’s Primary Care Academic Infrastructure: What Is Needed to Protect it During Obamacare “Repeal and Replace?”

 

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Hope Wittenberg, MA Director, Government Relations

When one thinks of the repeal of the Affordable Care Act (ACA), the major tax and coverage provisions required by insurance come to mind. Efforts by the new Trump Administration and Congress to repeal the ACA will obviously have a tremendous impact on these features of the law.

What is less known is other provisions of the law, many of which have an impact on academic family medicine–they affect workforce or primary care research, or both. These issues do not have large constituencies behind them–we may be alone or in slim company trying to maintain key portions of the law that impact our academic infrastructure.


Academic Primary Care Provisions in the Affordable Care Act

  • Establishment of payments for training provided to Teaching Health Centers, rather than hospitals
  • Reauthorization of Title VII Primary Care Training and Enhancement with an emphasis on the patient-centered medical home
  • Primary Care Extension programs to assist primary care practices regarding innovations and best practices
  • Medicare Graduate Medical Education (GME) provisions supporting community-based training within the confines of historic GME
  • Establishment of the Patient-Centered Outcomes Research Outcomes Institute (PCORI), to improve patient care and outcomes through comparative clinical effectiveness research
  • US Preventive Services Task Force (USPSTF) gained a new requirement that private insurance plans cover recommended preventive services without any patient cost-sharing

A Campaign We Must Not Lose

Assuming others will make the case for us is not an option. Working in partnership, STFM and the other CAFM organizations, along with our members, will need to actively engage on our key issues. If each of us does not get involved, we may not have the political might to support our position(s.) We do not have the luxury of large population size to assume that others will make the case for us. Members of Congress need many voices educating them about what we know–that the overall health of a population is directly linked to the strength of its primary health care system and workforce.  They need to hear why each of these provisions is important to the primary care infrastructure of the United States.

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