Nurses work to stem the opioid crisis

  

Nurses see firsthand the devastating effects of the opioid crisis on their patients, communities, and perhaps even themselves or their families. ANA members have been forthcoming in their stories about access, treatment, and the pain they have dealt with each and every day working to fight this crisis. That’s why many are cheering the Trump administration’s work on the crisis, with the First Lady leading the administrative efforts for declaring it a national emergency, as nurses team with emergency responders, policymakers, law enforcement, and other stakeholders in the fight to turn the tide on the devastating effects of opioid abuse in local communities.

The statistics are sobering: 64,000 Americans lost their lives to drug misuse in 2016. The number of people misusing prescription opioids in 2015 is even more alarming, 12.5 million people. There is hope—however, a comprehensive approach is needed from the ground level all the way up through state and federal governments in order to address the crisis. ANA supports nurses who are facing this crisis head on through targeted continuing education, support of federal legislation that supports nurses to practice to the full extent of their training and education, and supporting/advocating for policies that allow APRNs to prescribe medication assisted therapy, which has proven effective in stemming substance use disorder.

Within the walls of Congress, there are currently over a hundred of bills aimed at addressing varying aspects of the opioid crisis. Two in particular are at top of ANAs priorities for opioid legislation. In the Senate ANA has signed on to support is Combating the Opioid Epidemic Act, introduced by Bob Casey (D-PA) and Ed Markey (D-MA). In the House, Reps. Paul Tonko (D-NY) and Ben Ray Luján (D-NM) introduced H.R. 3692, the Addiction Treatment Access Improvement Act with support from ANA and our nursing partners. The latter bill aims to build on the Comprehensive Addiction and Recovery Act in order to allow clinical nurse specialists, certified nurse midwives, and certified registered nurse anesthetists to practice to the full extent of their training and education in prescribing buprenorphine.

Buprenorphine, however, is just one piece of the puzzle in treating opioid dependency. As with all medications used in Medication Assisted Therapies (MAT), it is just one part of a comprehensive treatment plan that includes addressing the underlying issues through counseling and participation in social support programs. Nurses play a primary role in comprehensive treatment plans and will continue to be integral in treating the most vulnerable populations throughout the country. ANA urges you to continue to voice your support in this fight by contacting your representatives and asking them to support H.R. 3692.

 

Senate Attempts to Stabilize Healthcare with Bipartisan Agreement

  

Yesterday, Senate HELP Committee Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) announced they had reached a short-term deal bipartisan healthcare legislation. This legislation would stabilize individual insurance markets and protect patients and families from premium spikes and uncertainty caused by the Trump Administration’s two decisions last week intended to destabilize the ACA marketplaces.

The deal negotiated by Alexander and Murray would fund payments to help lower costs for families, provide added flexibility to states, protect essential health benefits for patients, and restore investments for open enrollment outreach.

The bill would:

  • Restore Cost-Sharing Reduction payments and the certainty that is crucial to continued market stability and affordability for families. Insurers have raised rates by as much as 30% because of the uncertainty around CSR payments and continue to threaten exit from insurance markets.
  • Restore certainty to health care markets by ensuring CSRs will continue through 2017, 2018, and 2019.
  • Include steps to ensure 2018 enrollees receive the financial benefit of CSRs for the coming year.
  • Require the Department of Health and Human Services (HHS) to increase funding for outreach and enrollment assistance activities for 2018 and 2019; this is a top priority for ANA with Open Enrollment beginning November 1.
  • Put in place extensive reporting requirements to make sure HHS is held accountable for implementing Open Enrollment in 2018 and 2019.

Most importantly, the bill would generally keep in place essential health benefits and protections for pre-existing conditions with the exception of consumers who qualify for catastrophic plans.

The legislation will need 60 votes to pass through the Senate and ultimately Majority Leader Mitch McConnell will determine if the bill goes to the floor for a vote. In addition, lawmakers will need to convince the President that this bill will benefit the consumer and not the insurers. To date, the President has responded with mixed reviews.

President Trump Deals Yet Another Critical Blow to Healthcare System

  

Yesterday President Trump dealt yet another critical blow to the healthcare system established under the Affordable Care Act by announcing his administration would end critical Cost-Sharing Reduction (CSR) payment subsidies. These payments – projected to total roughly $9 billion in 2018 and $100 billion over the next 10 years – are made to help offset costs of co-payments, co-insurance, and deductibles for low-income Americans who enroll in individual health insurance coverage under the ACA’s exchanges.

The decision to end these payments will result in higher costs for low- and middle-income Americans and will threaten the ability of these individuals to afford coverage. The administration has treated these payments as a political bargaining chip for months; ending them, in combination with yesterday’s Executive Order on association health plans, will have an immediate and negative impact on Americans’ ability to access critical healthcare services. ANA reiterates: the Trump administration is making a deliberate attempt to undermine the system put in place by the ACA for political gain, at the expense of some of the most vulnerable Americans.

Individuals enrolled in health insurance coverage through the ACA’s individual marketplace with household income between 100% ($12,060 for an individual and $24,600 for a family of four) and 250% ($30,150 for an individual and $61,500 for a family of four) of the Federal Poverty Guideline are currently eligible for cost-sharing reductions. CSRs reduce the amount that low-income individuals pay out-of-pocket for co-payments, co-insurance, and deductibles. In effect, these cost-sharing reductions currently make it more likely that these individuals get critical preventive and other healthcare services and avoid more serious and/or chronic health issues long-term.

The Commonwealth Fund reported in March 2016 that as many as seven million individuals might have plans that are aided by  CSRs, representing a significant portion of the individuals who signed up for coverage through the individual exchanges under the ACA. This Commonwealth Fund report also noted that – according to government data – out-of-pocket healthcare spending declined significantly in 2014 (the year the ACA was implemented). In short, it is abundantly clear that the ACA’s cost-sharing reductions have in fact helped low-income individuals receive critical healthcare services.

We will continue to urge Congress and the administration to work toward market stabilization and to strengthen the existing system – which has resulted in coverage for tens of millions of Americans since 2014 – and to put an end to these attempts to sabotage Americans’ healthcare for political gain. ANA is committed to working with Congress and the administration on legislation and policy which aligns with our four core principles of health system transformation. The President’s actions this week fly in the face of ANA’s principles and will cause significant harm to millions of American families.

(Photo: Matt Rourke/AP)