The latest wins came this month, when the Office of Personnel Management announced that government-contracted health insurers could start covering the cost of gender reassignment surgeries for federal employees, retirees and their survivors, ending a 40-year prohibition. Two weeks earlier, a decades-old rule preventing Medicare from financing such procedures was overturned within the Department of Health and Human Services.
Unlike Obama’s support for same-sex marriage and lifting the “don’t ask, don’t tell” ban on openly gay troops, the White House’s work to promote transgender rights has happened mostly out of the spotlight.
Some advances have gone unnoticed because they also benefited the much larger gay, lesbian and bisexual communities. That was the case Monday when the White House announced that Obama plans to sign an executive order banning federal contractors from discriminating against employees on the basis of their sexual orientation or gender identity.
In other instances, transgender rights groups and the administration have agreed on a low-key approach, both to skirt resistance and to send the message that changes are not a big deal, said Barbara Siperstein, who in 2009 became the first transgender person elected to the Democratic National Committee.
The American Medical Association has published a letter in support of the Congressmen who are attempting to overturn the Independent Payment Advisory Board (IPAB). I’m no longer a member of the AMA, but salute them for this move.
On behalf of the physician and medical student members of the American Medical Association (AMA), I am writing to express our strong support for H.R. 452, which was introduced by Representative Phil Roe, and would repeal the Independent Payment Advisory Board (IPAB). Accordingly, we strongly support the advancement of this important legislation through the Energy and Commerce Committee.
The AMA has consistently expressed its opposition to the IPAB on several grounds. The IPAB puts important health care payment and policy decisions in the hands of an independent body that has far too little accountability. Major changes in the Medicare program should be decided by elected officials. We have already seen first-hand the ill effects of the flawed sustainable growth rate (SGR) physician target and the steep Medicare cuts that Congress has had to scramble each year to avoid, along with the significantly increasing price tag of a long-term SGR solution. Adding additional formulaic cuts through IPAB is just not rational and would be detrimental to patient care, especially as millions of baby boomers enter Medicare.
The experience with the SGR also raises concerns about policy decisions based on projections that require subsequent adjustments to reflect more accurate data. In 2003, Congress had to take action to allow the Centers for Medicare & Medicaid Services to correct $54 billion in projection errors under the SGR target. The IPAB also imposes a rigid budget target that is prone to “projection errors” that would force Congress to produce billions of dollars in offsets due to inaccurate calculations.
We appreciate the need to reduce the federal budget deficit and control the growth of spending in Medicare. However, we believe that this can best be achieved by Congress working in a bipartisan manner to reform the delivery system and improve quality, access, and efficiency. At a time in which Congress is struggling to eliminate the SGR, it does not make sense to allow another rigid formula to be implemented that risks a bigger set of problems for a broader cross-section of Medicare services.
We thank you for your leadership on this issue, and look forward to working with you to repeal the IPAB and preserve access for seniors to their physicians.