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 January 2008
Note: Questions relating to state legislative activity or any of the items noted in ACS Cross Country may be directed to Mindy Baker, State Affairs Associate, at mbaker@facs.org. Georgia Board of Community Health Adopts General Surgery Regulation
Culminating months of comment; a public hearing that included extensive testimony in support of general surgeons by Georgia ACS Chapter representatives, the College, and other surgical and medical organizations; support for general surgery by the state’s governor; and last-minute objections from a hastily arranged meeting of the Georgia House Health and Human Services Committee, the state’s Board of Community Health officially adopted rules on December 13 to amend the Certificate-of-Need (CON) program. Through a unanimous vote and under the threat of a lawsuit from opponents of the amendment, the Board of Community Health recognized general surgery as a single specialty for purposes of applying for an exemption from the CON process when building ambulatory surgery centers. While this action represents an impressive victory for general surgery, there is considerable political antagonism surrounding the entire CON process, and it is likely that the legislature will get involved during the 2008 legislative session. For more information contact jsutton@facs.org. Michigan Universal Health Care Initiative Launched
California Cruising Down Health Coverage Road
After more than a year of negotiating with the governor and legislative leadership, the California Assembly passed legislation similar to the Massachusetts program to require all California residents to have health insurance starting in 2010. In theory, the $14.4 billion plan would be funded by an increase in the tobacco tax, a tax on hospital revenues to leverage federal matching funds, and a tax on employers that don’t provide insurance for their employees. These taxes would have to be adopted by the voters through a November 2008 ballot referendum, since tax increases must have a two-thirds vote in both chambers of the California legislature in order to be enacted–and that voting ratio does not exist. In addition, Senate leadership as well as business groups and others have serious concerns about the proposal passed by the Assembly, so it may not be taken up by the Senate any time soon. Federal News--The College Cost Reduction Act: An Unintended Burden on Residents?
by Jacob Moalem, MD, Vice-Chair, Resident and Associate Society of the American College of Surgeons, San Francisco, CA
On Sept 27, 2007 President Bush signed H.R. 2699, the College Cost Reduction Act. One of the provisions of this new law immediately abolished the 20/220 rule, through which many residents qualify for economic hardship deferment for the first three years of residency. Instead, the law creates a mechanism that will go into effect January 1, 2009, whereby borrowers may opt for a repayment program that would require the average resident to pay in excess of $4,000 annually. Alternatively, residents may choose forbearance, and have interest immediately begin capitalizing. Michael Maves, M.D, FACS, Executive Vice-President and CEO of the American Medical Association, has already expressed his strong opposition to this provision in a letter to the Senate's Majority Leader Harry Reid. This letter can be viewed at http://www.ama-assn.org/ama1/pub/upload/mm/15/hr2669_letter.pdf Intense lobbying efforts have been successful in achieving a temporary reprieve: The 20/220 pathway was extended through the fall of 2008. Nevertheless, with the average student loan debt continuing to rise (now $130,571) and an average monthly gross income of $3,180, any repayment program would represent an insurmountable burden for many residents. The mechanism established by H.R. 2669 is clearly less beneficial to residents than the current standard. A long-term legislative solution is urgently needed to ensure that economic hardship deferment, for which two-thirds of residents currently qualify, remains a viable option. One such solution was recently proposed by Sen. Richard Burr (R-NC), who introduced a bill, S. 2303, through which the 20/220 pathway would be reinstated and continue to benefit the thousands of residents who currently have their educational loans deferred. A similar bill, H.R. 4344, was introduced by Reps. Walberg (R-MI), Boustany (R-LA), McKeon (R-CA), Ehlers (R-MI), Price (R-GA), Kline (R-MN), and Lucas (R-OK) in the House. The AMA has published a useful resource that outlines the 20/220 pathway and all of the relevant information. This resource can be accessed at http://www.ama-assn.org/go/loandeferment
In the meanwhile, several lenders are not aware that the Department of Education is still allowing the economic hardship deferments to occur through the 20/220 pathway. If you are having trouble getting your lenders to provide the deferments to which you are entitled, you can contact the AMA RFS (rfs@ama-assn.org) for help. To help fight this critical battle, please contact your congressman by following this link: http://capwiz.com/ama/issues/alert/?alertid=10524271&type=co. In less than two minutes, letters to your Senator and Representatives can be generated and sent.
Past Issues of ACS Cross Country:
Revised January 9, 2008
by the American College of Surgeons, Chicago, IL 60611-3211 |
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