AAFP Urges Swift Passage of Primary Care Patient Protection Act

Bill Would Cover Primary Care Visits That Patients Often Skip

May 23, 2018 03:01 pm News Staff – The AAFP this week called on Congress to pass the recently introduced Primary Care Patient Protection Act, which would make it easier for patients with high-deductible health plans (HDHPs) to see their primary care physicians.

Reps. Brad Schneider, D-Ill., and Elise Stefanik, R-N.Y., introduced the bill on May 17. It would require HDHPs to cover two primary care office visits each plan year. This would "bring necessary health services within the financial reach of millions of Americans," AAFP President Michael Munger, M.D., of Overland Park, Kan., said in a May 22 statement.

"Ensuring patients have access to a usual source of care, a family physician, and meaningful coverage will equate to better overall health at a lower cost," Munger added. "Being able to receive care in this setting will be less expensive for individuals and families than pursuing care at other sites, such as emergency rooms. This legislation removes a portion of the financial obstacle that may prevent people from pursuing primary care services when they are sick."

In May 21 letters to Stefanik(2 page PDF) and Schneider(2 page PDF) signed by Board Chair John Meigs M.D., of Centreville, Ala., the AAFP praised the bill as a "common sense, patient-centered, value-based proposal" that would allow persons and families with HDHPs certain access to their primary-care physicians.

The AAFP supports HDHPs as innovative coverage structures that reduce monthly premiums and make health care coverage more affordable to many Americans. In 2005, only a million people in the United States were enrolled in an HDHP; in 2017, 22 million Americans were covered by HDHPs.

However, high out-of-pocket costs can limit care for low- and middle-income Americans. The letter cited a 2016 CDC report that found "among privately insured adults aged 18-64 with employment-based coverage, those enrolled in an HDHP were more likely than those enrolled in a traditional plan to forgo or delay medical care and to be in a family having problems paying medical bills."

Noting that many patients end up in the ER when they delay or skip health care because of high costs, Munger pointed out that "research has shown that deductibles and copayments discourage people from getting the primary care they need."

In fact, a 2018 analysis conducted by the not-for-profit medical research firm West Health and NORC, an independent social research organization at the University of Chicago, found that about 40 percent of Americans reported skipping a recommended medical test or treatment. The same report found that 44 percent of those surveyed had said cost was the reason they had not seen a doctor when they were sick or injured over the previous year.

"Forgoing primary and preventive care is not only bad for an individual's health, it also is not economically sound," the AAFP wrote to Stefanik and Schneider. Coverage of regular primary care appointments, the Academy added, would prevent Americans from losing productivity and facing greater expense by ensuring that they did not wait to seek care until the need for it grew critical.

"The AAFP welcomes this legislation and urges Congress to act quickly on its passage," Munger said in his statement.