GOP Doctors Caucus looking at ambitious 2016

Last year, U.S. representatives Phil Roe, MD, (R-Tennessee) and John C. Fleming, MD, (R-Louisiana) learned an important lesson about the power of the GOP Doctors Caucus to affect legislation.

Efforts by caucus members helped to kill the onerous Medicare Sustainable Growth Rate formula. This year, the 18 member caucus has a more ambitious agenda, including repealing and replacing the Affordable Care Act (ACA), supporting efforts to curb opioid abuse, improving health care for veterans, and making health IT less onerous.

All of these issues are important but secondary to repealing and replacing the ACA, says Fleming, a family physician who represents Louisiana’s Fourth Congressional District.

Related: MACRA/MIPS is the problem, idividual health freedom is the answer

Last year, the caucus supported the effort to repeal the ACA, which President Obama vetoed. “But we expect that after the next president takes office, we’ll vote to repeal it again and, if we have a Republican in the White House, it will be signed into law,” Fleming told Medical Economics. “So until then, our main agenda is to put in place a replacement bill that would be market driven and patient centered.”

The co-chairmen of the caucus, Fleming and Roe expect the ACA replacement bill will combine elements of the American Health Care Reform Act, which Roe introduced in 2013, and the Empowering Patients First Act, which caucus member Tom Price, R-Georgia, introduced in 2009. The bills would establish insurance pools for individuals, expand health savings accounts, provide tax credits for individuals who buy insurance and reform medical liability laws to curb the practice of defensive medicine.

Further reading: As insurers leave Obamacare exchanges, doctors pay the price

To address opioid abuse, the doctors invited U.S. Surgeon General Vice Admiral Vivek H. Murthy, MD, to a caucus meeting. To Murthy, the members expressed their concern about the addiction epidemic, the rising number of deaths due to overdose and neonatal abstinence syndrome. Also, they encouraged Murthy to pursue his idea of producing a report on addiction this year. 

Next: what about Meaningful Use?

Under the Veterans Access, Choice and Accountability Act of 2014, Congress added residency slots for students in order to serve the nation’s growing number of veterans. 

On Meaningful Use, the caucus met with Karen B. DeSalvo, MD, national coordinator for health information technology. “She got an earful from us about how we believe CMS overreached on Meaningful Use,” Roe says.

Fleming’s experience with Meaningful Use in his practice is similar to that of many physicians. “The frustration and the anger among doctors about Meaningful Use is palpable, and I understand why,” he said. His family practice clinic in Minden, Louisiana, is about to implement its third EHR system to meet Meaningful Use requirements even though the first one—installed in 1997—boosted practice efficiency quite well. 

Further reading: Administrative costs are killing U.S. healthcare

“We were happy with it until Meaningful Use came along. Then, it became about satisfying government requirements rather than meeting physician and patient needs,” Fleming says.

Looking back on what the caucus gained from its experience opposing the SGR, Roe and Fleming learned they had leverage in the house. During deliberations over the SGR, Roe and Fleming wrote to John Boehner (R-Ohio), who was the Speaker of the House at the time, indicating the caucus’ support to eliminate the SGR.

The letter was instrumental in helping Boehner get other members of Congress and Minority Leader Nancy Pelosi (D-California) to support efforts to end the SGR. “Without that letter and their full support, I believe the bill wouldn’t have passed,” he says. 

Joseph Burns is an independent journalist in Falmouth, Massachusetts. What would you like to see the GOP Doctors Caucus take on in 2016? Tell us at medec@advanstar.com.