Legislative Successes in 2017: Rheumatologists lead the push in Congress for access to care, research funding, transparency in drug pricing

SAN DIEGO—The 2017 ACR/ARHP Annual Meeting, Nov. 3–8, presented opportunities to highlight its 2017 legislative advocacy victories, some of which were resolved just weeks before the conference began, as well as issues that are still outstanding.

Angus Worthing, MD, FACR, FACP

In the session, Legislative & Regulatory Update 2017, Angus Worthing, MD, chair of the ACR’s Government Advocacy Committee and an independent rheumatologist practicing in Washington, D.C., said, “A lot is happening on the advocacy front.” According to Dr. Worthing, the ACR has managed to achieve some recent successes, although one of its top priorities was to protect patients’ access to care in the face of legislative proposals to repeal the Affordable Care Act (ACA). Recent developments in D.C. suggest that some of the patient protections provided by the ACA are still in danger of repeal, if not this year, then next year.

The ACR will continue to advance its concerns by working in coalitions with other healthcare advocates and focusing on the need to maintain access to care and treatment, taking issue with specific provisions of legislation rather than positions on overall bills, Dr. Worthing said. The priority is to ensure sufficient, affordable, continuous coverage that enlarges access to high-quality healthcare for all and the continuation of essential health benefits. In the ACR’s view, proposals to repeal the ACA have not gone far enough to protect that access, he explained.

Key Advances in 2017
Other important legislative and regulatory advances in 2017 for the field of rheumatology, highlighted in the session at the Annual Meeting, include:

H-1B visas
At the ACR’s request, the American Medical Association’s House of Delegates passed a resolution requesting the overturn of a Trump administration proposal to stop allowing an additional fee to be charged for premium processing of H-1B visa waiver applications for physicians. The administration agreed to this request just in time for newly graduated medical fellows to make commitments to jobs in underserved areas, a critical issue for rheumatologists in particular, Dr. Worthing says.

There are only 5,000 practicing rheumatologists in the U.S., less than the current need, which is estimated at 6,115 rheumatologists, and demand is expected to exceed supply by 138% by 2030.¹ “One solution to the shortage of rheumatologists is for internationally trained physicians to work in underserved areas through the H-1B visa program, but the premium processing of their applications is essential if they are to commit to jobs by the June 30 academic year deadline,” said Dr. Worthing.