NCPA Executive Update

NCPA Executive Update delivers insights on legislative, regulatory, policy, and industry developments from NCPA CEO B. Douglas Hoey, Pharmacist, MBA, to NCPA members and pharmacy leaders every Friday.

Change Means Challenges and Opportunities | NCPA Executive Update | December 2, 2016

by NCPA | Dec 02, 2016

Dear Colleague,

Doug Hoey

It's hard to believe just a little more than three weeks have passed since the election. Washington, D.C., is atwitter with every announcement (and tweet) coming out of Trump Tower. The pundits are especially overheated with speculation about who President-elect Trump will appoint to key positions in his Administration.

This week, two of those appointments were announced: Secretary of Health and Human Services and Administrator of the Centers for Medicare and Medicaid Services. Both appointments will have a direct impact on pharmacists. The government is the biggest insurance payer in the country, so these positions are critical to pharmacy and the rest of health care.

Rep. Tom Price from Georgia is Trump's pick for HHS Secretary. Price is an orthopedic surgeon representing the Atlanta area. He was elected to Congress in 1996 and before that spent 10 years in the Georgia legislature. Georgia is a state strong with community pharmacists. The only pharmacist in the House of Representatives, Buddy Carter, is from Georgia—so there is no doubt that Price knows pharmacy issues and understands health care.

Last year, then-NCPA President John Sherrer and other Georgia pharmacy owners met with Price in his Atlanta-area offices. Although Price knows pharmacy issues, he has not signed on to any of NCPA's priority legislation including MAC transparency, pharmacist provider status, any willing pharmacy in Medicare, or a ban on retroactive DIRs.

The same day that the news about the HHS Secretary was announced, Seema Verma was designated to lead CMS. She would be Price's top lieutenant overseeing the $1 trillion Medicare and Medicaid programs. Like Vice President-elect Mike Pence, Verma is from Indiana and is credited for being the architect of Healthy Indiana, the state's Medicaid program. Proponents say Healthy Indiana has lowered Indiana's Medicaid bill while improving coverage. Critics would say it has reduced access to important services and increased costs for those who can least afford it.

No one knows for sure how these nominees will affect pharmacy and health care. But in the few days since the announcements, there has been a scramble to try to discern what will happen.

Price has been a vocal advocate for repealing the Affordable Care Act—consistent with President-elect Trump's promise to repeal Obamacare as one of his first orders of business. One of the premises of Healthy Indiana is requiring individuals to make health care purchases from the private insurance marketplace and for them to pay for a portion of whatever health care decision they make. This approach would be consistent with Medicaid block grants—giving states a finite amount of funding to decide how they will pay for health care for low income residents rather than the current model of states having to follow federal rules in order to receive funding.

Community pharmacies serve a disproportionate number of Medicaid patients, so any changes to their health care will have a direct impact on most NCPA members. It's always essential that pharmacy has a unified and coordinated voice, and there is no better example than now for all of community pharmacy's message to be united.

As you begin to plan for 2017, include contacting your members of Congress on a regular basis. NCPA will alert you with message points at the right time, but meanwhile take advantage of your locality to establish a relationship. Invite them to your pharmacy. They are probably not often thinking about independent pharmacies. Change that.

One thing that seems abundantly clear is that changes will be made and those changes are going to affect the services and economics for community pharmacy and its patients. There is a threat with changes that might be made, but there are also opportunities.

Whatever changes are made to Medicaid (and perhaps, but less likely, to Medicare) NCPA will be very active in representing the views of community pharmacists. Your outreach to your elected officials in Washington will be more important than ever. I know that's not a new message, but it's as important as ever that your lawmakers know your views. As I said a couple of weeks ago, relationships are crucial and establishing those connections sooner rather than later is important.

The election results are in and government will be changing. We can wait and see what government is going to do to us, or we can work to make the government work for the thousands of small business owners NCPA represents and the patients you serve.

Doug Hoey