NCHC, Health Centers, Physicians Urge Congress to Avoid the 2017 Primary Care Cliff

WASHINGTON, DC – At a Capitol Hill forum yesterday, The National Coalition on Health Care (NCHC), The National Association of Community Health Centers (NACHC), and three leading primary care physician societies urged Congress to avoid an approaching funding cliff for health centers and workforce programs.

“Chronic disease is extremely costly. Primary care is the affordable solution—one that works to improve outcomes while reducing costs,” stated NCHC President & CEO John Rother. “For lawmakers looking for a bipartisan approach to health care, strong, sustained support for primary care would be a great start.”

Yesterday’s event, entitled Primary Care: High-Value Care for Underserved Communities, was the second of three forums on critical primary care challenges, co-hosted by NCHC, NACHC, The American Osteopathic Association (AOA), The American College of Physicians (ACP) and The American Academy of Family Physicians (AAFP).

Federally Qualified Health Centers (FQHCs) and workforce programs in underserved rural and urban communities, such as the National Health Service Corps and Teaching Health Centers Graduate Medical Education, were highlighted for their vital roles and in a set of recommendations endorsed by NCHC and its co-hosting organizations.

“Community health centers and programs like the National Service Corps are bipartisan health care success stories. But for us to succeed, Congress must not take us over the primary care cliff,” says one of the event’s panelists Brenda Johnson, CEO of La Clinica Health Care, a community health center in Medford, OR.

Event panelists included Ms. Johnson; Dr. Kemi Alli, Chief Executive and Medical Officer of Henry J. Austin Medical Center in Trenton, NJ; Dr. William Golden, Medical Director of Arkansas Medicaid; and Dr. Julie Wood, Senior Vice President of Health of the Public and Interprofessional Activities at AAFP.

*A copy of the fact sheet with recommendations is available here.

The panelists’ presentations:
·         Dr. Kemi Alli
·         Dr. William Golden
·         Ms. Brenda Johnson
·         Dr. Julie Wood

Information on the upcoming third forum in this series, entitled Building a Stronger Primary Care Workforce, will be released in the coming weeks.

Rother Calls AHCA Failure Positive for Healthcare

“The failure of the House of Representatives to pass its ACA repeal and replace legislation is positive for healthcare and for the health and financial security of all Americans. We hope Congress will now abandon efforts to advance any bill that shifts hundreds of billions in federal Medicaid costs onto states and beneficiaries or leaves tens of millions fewer Americans with coverage – as this one would have.

“There is, however, still much that must and can be done to address costs that are far too high both for the federal budget and for individuals. The National Coalition on Health Care, which is made up of more than 90 major organizations representing providers, payers, and patients, believes that bipartisan progress toward improving the value of our health system is still possible. In particular, we urge Congress and the Administration to address the unsustainable high costs of prescription drugs, the need to better coordinate care for our sickest patients – those with multiple chronic conditions, and the importance of strengthening programs for disease prevention and population health. The stakes are too high to further delay constructive measures that can make healthcare more affordable.”

National Coalition on Health Care Urges A Fresh Start on Health Care Legislation

Statement by NCHC President and CEO John Rother regarding the Congressional Budget Office analysis of the American Health Care Act (AHCA)

“We need health care that is more affordable for all, but according to the nonpartisan Congressional Budget Office, the current House plan moves us in the opposite direction.  It is time for a fresh start.”

“The National Coalition on Health Care, a nonpartisan alliance of over 90 patient, payer,  purchaser and provider organizations representing more than 150 million Americans, urges Congress to reject the current House budget reconciliation proposal and pursue a different approach.

According to CBO’s independent analysis, the House plan would have the following real-world results:

  • 21 million fewer Americans with health care insurance in 2020 and 24 million fewer in 2026
  • A 60% lower tax credit for eligible individuals purchasing non-group coverage in 2020
  • An $880 billion cut in federal support for state Medicaid programs over the next ten years- effectively shifting these costs to states, their taxpayers, providers and beneficiaries

We also know from an earlier Centers for Medicare and Medicaid Services Office of the Actuary analysis that the House plan’s repeal of the 0.9% increase in the Medicare payroll tax for certain high-income taxpayers would mean three fewer years until the Medicare Hospital Insurance Trust Fund’s projected insolvency.

“These outcomes would impose very high costs on American families and block ongoing reform initiatives that move us toward a more affordable system.  We are particularly concerned that $880 billion in cuts due to reduced federal support for Medicaid expansion states, changes to Medicaid’s financing structure and cuts to home- and community-based services would imperil many positive delivery reforms that hold promise for a better performing, lower cost health system. Changes of this magnitude are also likely to disrupt the ability of physician practices, hospitals, nursing homes, community health centers, and mental health and substance abuse treatment providers to remain open and furnish needed care for patients with all types of insurance.

NCHC advocates a fresh approach to fixing what’s broken in American health care. After taking reasonable steps to stabilize the non-group market (the proposed State and Patient Stability Fund represents one worthwhile idea), Congress should focus on addressing the underlying causes of high health care costs:

  1. waste and unnecessary care,
  2. the high costs of prescription drugs,
  3. the lack of coordinated care for high-cost patients,
  4. Inadequate support for primary care, resulting in avoidable specialty care, hospital stays and institutionalization,
  5. lack of investment in population health.

“These five factors drive high costs without adding value, and are a more constructive focus for efforts to move our health system toward better performance and more affordable costs for everyone. NCHC is ready to work with the Congress and the Administration on an economically sustainable and politically achievable plan.”


  The National Coalition on Health Care (NCHC), the oldest and most diverse group working to achieve comprehensive health system reform, is a 501(c)(3) organization representing more than 80 participating organizations, including medical societies, businesses, unions, health care providers, faith-based associations, pension and health funds, insurers and groups representing consumers, patients, women, minorities and persons with disabilities. Member organizations collectively represent – as employees, members, or congregants – over 150 million Americans.


Some members of NCHC do not, or cannot, take positions either on specific legislation, strategies or on any policies outside their respective mission areas. However, all that can, do endorse broad policy positions in support of comprehensive health system change.

Effort to Stabilize Market Means Little if Coverage, Affordability Disrupted

Statement by John Rother, President and CEO of the National Coalition on Health Care

“We are pleased that the Department of Health and Human Services is considering regulatory and administrative steps to assure stability and affordability in the non-group and small group markets.  In the weeks ahead, with its member organizations, NCHC will evaluate how the specific provisions of this regulation impact affordability and stability.

“But no market stabilization effort can succeed if policymakers disrupt existing coverage arrangements rather than improving on them.” 

Read the full statement here.

NCHC Declares Opposition to Elimination of State Option to Expand Medicaid

WASHINGTON –This Tuesday morning, National Coalition on Health Care announced its opposition to the repeal or defunding of the state option to expand Medicaid in a letter submitted to the Senate Finance Committee and the House Energy and Commerce Committee leadership.

“Repealing or defunding the state option to expand Medicaid would endanger states’ progress in reforming their health systems, weaken health care access for vulnerable populations and detract from recent bipartisan federal legislative achievements,” stated NCHC President and CEO John Rother.

Read the full press release and letter here, or find the official copy of the letter on the Policy Correspondence page.

NCHC Applauds Important Steps in Mental Health Before the House of Representatives

“NCHC applauds the House of Representatives, especially Chairman Fred Upton (R-MI) and Ranking Member Frank Pallone (D-NJ) of the House Energy and Commerce Committee, for the important steps taken today to address mental health and substance abuse in the 21st Century Cures legislation.  These issues are among the greatest public health challenges facing our country today, adding not only to the costs of health care, but destroying families and communities.  And although we oppose the bill’s reductions to the Prevention and Public Health Fund, we are encouraged that Congress has found a path forward on these critical behavioral health issues.

“We are also pleased to see the inclusion of provisions that reform the Hospital Readmission Reduction Program and encourage interoperability of electronic medical records.”

Read full press release here.

NCHC Urges Congress to Preserve Provider Payment Testing and Expansion Authority

WASHINGTON – In a letter submitted Tuesday evening, the National Coalition on Health Care, the nation’s largest and most broadly representative alliance of health care stakeholders, called on Congress to preserve the Department of Health and Human Services’ flexibility to test alternative models of provider payment in Medicare and Medicaid and expand those that are successful.

A rollback of HHS’ capacity to test and expand new payment models would fracture the bipartisan consensus behind MACRA and make health care less affordable over the long term.” said John Rother, NCHC’s President and CEO.  “Instead, NCHC and its members hope to work with Congress and the administration to ensure that the testing and expansion authority, now housed at the Center for Medicare and Medicaid Innovation, is preserved and deployed as effectively as possible.”

Read full press release here.


Broad Stakeholder Coalition Presses Lawmakers to Move Forward with Chronic Care Bill

“By bringing down barriers to better care for the chronically ill in both Original Medicare and Medicare Advantage, this draft bill promises to spur delivery and benefit innovation across the health care system. The National Coalition on Health Care calls on the Finance Committee, and then Congress as a whole, to move forward expeditiously with meaningful chronic care legislation.

“Better chronic care is fundamental to ensuring health care affordability in the United States. NCHC and its members have long advocated for a strong legislative response, beginning with chronic care in Medicare. We commend the leadership and dedication of the Finance Committee, Chairman Hatch, Ranking Member Wyden, Senator Warner and Senator Isakson, and their staffs.

“Of course, the details of all these policies will be crucial; NCHC and its members will continue to work with Congress to ensure the strongest possible bill. But Senators Hatch, Wyden, Isakson, and Warner have given their fellow lawmakers a remarkable opportunity: to demonstrate that bipartisan commitment can produce constructive solutions to health care affordability challenges. Congress should take that opportunity…and with the cost of care steadily climbing, they should take it soon.”

Read full press release here.


NCHC CEO John Rother Calls MACRA Implementation a Win for Affordability

“Today’s final rule on MACRA implementation is a milestone in the shift away from volume-based, fee-for-service physician payment. It represents an important victory in ongoing efforts to improve the affordability of Medicare and health care generally.

“But with costs climbing in Medicare and system-wide, Congress should build on MACRA and make bipartisan chronic care legislation a top priority.

“NCHC will be examining the details of today’s regulation—and if necessary advocating for improvements.  But we know two things already:  First, physicians and other health professionals will face significant incentives to embrace new models of care and delivery. Second, due to statutory barriers, clinician practices and provider organizations are denied the tools needed to optimally respond to those incentives.

Read full press release here.

Medicare Enrollment Bill Takes Steps to Address Coverage and Affordability Gaps

Statement by National Coalition on Health Care President and CEO John Rother on the introduction of H.R. 6184, the Medicare Enrollment Protection Act, by Rep. Bob Dold (R-IL) and Rep. Kurt Schrader (D-OR)

“Medicare’s enrollment procedures can be confusing…and every year some beneficiaries inadvertently miss crucial deadlines to sign up for Part B. Missing this deadline can mean an increase in Part B premiums for the remainder of the beneficiary’s time on Medicare – a substantial shift of Medicare’s costs onto the enrollee.  Or it can create coverage gaps that may render ongoing care for chronic or other conditions unaffordable.

Read full press release here.