Policy Playbook: Summer 2022 Update

Author: Summer Chavez, DO, MPH, MPM (UT Houston) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit)

Policy Playbook returns to emDOCs with a concise summary of the latest developments in emergency medicine-related health policy over the summer months. In today’s post, we’ll highlight the most important aspects of each topic.

Dobbs v. Jackson

One of the biggest stories of the summer was the Dobbs v. Jackson Women’s Health Organization Supreme Court decision. The decision effectively overturned Roe v. Wade, effectively deciding abortion is not a Constitutionally protected right and returned to the people/states to regulate this practice. It remains to be seen how this will ultimately affect providers and patients, but much of this impact will now depend on a combination of state laws, institutional practices, HIPAA, and Emergency Medical Treatment and Labor Act (EMTALA) amongst others.

The Centers for Medicare & Medicaid Services (CMS) released a policy to remind hospitals and physicians or their professional and legal duties under EMTALA—“If a physician believes that a pregnant patient presenting at an emergency department is experiencing an emergency medical condition as defined by EMTALA, and that abortion is the stabilizing treatment necessary to resolve that condition, the physician must provide that treatment. When a state law prohibits abortion and does not include an exception for the life and health of the pregnant person — or draws the exception more narrowly than EMTALA’s emergency medical condition definition — that state law is preempted.” This was reinforced by the Secretary of Health and Human Services, again stating, “Any state laws or mandates that employ a more restrictive definition of an emergency medical condition are preempted by the EMTALA statute.”

For more on post-abortion complications, please see podcast part 1 and part 2.

Inflation Reduction Act

This piece of legislation has several important implications for our patients. It creates a $35 price cap for a one-month supply of insulin on Medicare. Medicare will be empowered to negotiate high-cost drug prices. Medicare Part D recipients will also be protected by a $2,000 new out-of-pocket cap for medication costs. The law also strengthens health insurance premium subsidies under the Affordable Care Act (ACA), which will help to keep the uninsured rate at an all-time low (8%).

Promise to Address Comprehensive Toxics (PACT) Act

The bipartisan Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxics (PACT) Actwas signed into law on August 10, 2022. This bill expands benefits for veterans exposed to toxins and their families and attempts to remove some of the administrative burdens to obtain care.

Policy Playbook will return next month with more policy updates!