Preserving Patient-Centered Care Protections

February 16, 2017

The Honorable Paul Ryan, Speaker, U.S. House of Representatives
The Honorable Mitch McConnell, Majority Leader, U.S. Senate
The Honorable Nancy Pelosi, Minority Leader, U.S. House of Representatives
The Honorable Charles Schumer Minority Leader, U.S. Senate
The Honorable Kevin McCarthy, Majority Leader, U.S. House of Representatives
The Honorable John Cornyn, Majority Whip, U.S. Senate
The Honorable Steny Hoyer, Minority Whip, U.S. House of Representatives
The Honorable Richard Durbin, Minority Whip, U.S. Senate

Dear Speaker Ryan, Majority Leader McConnell, Minority Leader Pelosi, Minority Leader Schumer, Majority Leader McCarthy, Majority Whip Cornyn, Minority Whip Hoyer, and Minority Whip Durbin:

The Council of Medical Specialty Societies (CMSS), with 43 member societies that represent 790,000 physician members in the United States, recommends that the 115th Congress ensure that our patients continue to have access to affordable, high-quality health coverage, preventive services, and patient-centered care.

Our organizations, which together represent the majority of the nation’s physicians, have long advocated for access to meaningful health care coverage for all Americans. We believe that the primary goal of healthcare reform is to improve access to care for all Americans.

We are urging caution with respect to current calls for actions that would have a profoundly negative impact on our health care system and the more than 200 million people who currently have health care coverage through the individual, small group, and employer-based markets, as well as Medicaid. We as a nation have made tremendous progress toward extending health care coverage to the uninsured and to children. We also have implemented reforms that provide patient-centered protections that prohibit predatory practices by insurance companies that make the acquisition of health coverage overly complex and difficult for individuals.

Our organizations have long supported policies that promote access to health care coverage for all Americans. We remain steadfast in pursuit of this goal. Key reforms enacted over the past decade have driven the uninsured rate to historic lows, helped ensure access to essential benefits, and strengthened consumer protections for all Americans. We also recognize and support the need to improve current laws to foster more competition and choice, ensure well-functioning insurance markets, promote patient-centered care, expand choice of physician, ensure network adequacy, and encourage innovation.

Patients without adequate insurance receive less care, receive it later, and have worse outcomes than those with better insurance coverage. This circumstance also increases overall expenses for all Americans. Uninsured and under-insured families report that they are unable to meet their out-of-pocket financial responsibilities and often must forgo care in order to pay other bills.

As policymakers consider options for additional reform of the healthcare system, CMSS recommends the following principles as a policy framework that protects the interests of all Americans:

  • All Americans should have access to affordable and sufficient healthcare coverage regardless of their income or health status. To ensure protected access, the current ban on pre-existing condition limitations, elimination of annual and lifetime coverage caps, and maintenance of guaranteed renewability should be preserved.
  • Any efforts to reform the healthcare system at the national, state, or local levels should ensure that individuals with healthcare insurance can continue to access affordable insurance without interruption.
  • All individuals should have health insurance that ensures access to high-quality care that provides the full range of services needed by patients in a timely manner.
  • Policymakers should promote and protect prevention and screening services, as they are key to reducing mortality; policy makers should preserve the “no co-pay” access to screening services that currently exists.
  • Current efforts to improve quality, affordability, and access to care for patients and communities through value-based reform strategies should be continued; current efforts to improve value in health care should continue to be prioritized, and value-based reforms should be designed and implemented in a patient-centered way.
  • Healthcare reform efforts should engage patients and providers to obtain meaningful input in order to avoid unintended consequences during implementation.

CMSS urges you to work collaboratively, in a bipartisan and bicameral manner, to ensure that current essential patient-centered protections, particularly those cited above, are preserved.

Thank you for the opportunity to share these concerns and recommendations. CMSS remains dedicated to supporting the efforts of policymakers to strengthen the nation’s healthcare delivery system on behalf of all patients.

Norman B. Kahn Jr., MD
Executive Vice President and Chief Executive Officer