On the Issues
In October 2017, the administration issued a report titled Reforming America’s Health care System Through Choice and Competition which makes the argument that advanced practice registered nurses (APRNs) are as capable as physicians to provide some of the same health-care services and that doing so would offer clear consumer benefits, especially in rural and underserved areas. The administration continues efforts to reform how Medicare pays providers while enhancing Medicare Advantage policies.
In October 2017, the Trump Administration declared the opioid crisis a public health emergency. Since then, the administration has worked with federal agencies including the Substance Abuse and Mental Health Services Administration which awarded millions of dollars in grants to state and local partners to support prevention, treatment, and recovery activities; the Health Resources and Services Administration which has awarded millions of dollars to community health centers, rural community organizations, and academic institutions to support delivery models at the community level; and the Centers for Disease Control and Prevention, which has awarded millions of dollars to states, territories, tribes and partners to bolster prevention and data collection. Together these agencies, along with partner agencies, are helping to supply the necessary resources to communities to curb the epidemic.
The President also signed the SUPPORT for Patients and Communities Act (H.R. 6) into law in 2018. One provision of this legislation gives nurse practitioners and physician assistants permanent authorization to prescribe medication-assisted treatment (MAT) for opioid substance use disorder if they complete an education course to obtain a waiver from the Drug Enforcement Agency. It also gives clinical nurse specialists, certified registered nurse anesthetists, and certified nurse-midwives five-years authority to prescribe MAT if they obtain the same waiver.
The administration, through prescribing guidelines, has also worked to decrease the number of opioid prescriptions that are written, which has decreased the number of opioids available in communities. They have also supported efforts to supply Naloxone to first responders and other health care providers. Regarding treatment and recovery services, the administration has supported work to increase innovative therapies and non-addictive pain management alternatives for varying diagnosis and geographic locations. The administration issued an American Patients First report that included proposals to reduce drug costs.
Health Care Reform
The President supports repealing the Affordable Care Act (ACA) and supported replacing the ACA with the American Health Care Act (H.R. 1628), which the House of Representatives passed in May 2017. The legislation would have created a new federal grant program to provide $100 billion for states to use to stabilize their markets. The legislation did not get passed into law.