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ACNM Policy Update - 7/29/2014

1.  August is Midwifery Advocacy Month!
2.  ACNM Update on Recent Supreme Court Decision Impacting Coverage of Contraception
3.  Recording of Joint ACNM/CMS Webinar on Efforts to Improve Maternal/Infant Health Now Available
4.  ACNM's State Government Affairs Team to Expand

1.  August is Midwifery Advocacy Month!

During the month of August, members of Congress will be home in their districts, making it an ideal time to visit with them.  In fact, many plan town halls or other types of open meetings with their constituents.  All you have to do is show up to the event and take the opportunity to speak to your legislator to put in a 30 second plug for midwifery.  

This year ACNM is focused on H.R. 4663, a bill to allow CNMs to certify the medical necessity of inpatient admissions for Medicare patients, and H.R. 4385, a bill to identify areas of the country experiencing a shortage of full scope maternity care providers.  All the information you need to put together a 30 second speech asking your legislator to cosponsor each of these bills is available here and here.   

If your Representative (or Senators) are not on the list below, then you will need to contact their offices directly to get details on local meetings they may be having.  You can find contact information for Representatives here, and for Senators here.
There is a subset of Representatives with whom it is critical that ACNM members make contact.  These are the Representatives who sit on the Health Subcommittees of the House Energy and Commerce and Ways and Means Committees.  These two subcommittees will have a very powerful say in the outcome for our two bills.  

To help constituents of these Representatives know where and when they can go to meet with these specific legislators, ACNM has put together a table showing the time and place for all of the currently planned public events being held by these Representatives.  If your Representative is listed in this table below, it is critical that you take the opportunity to go to that town hall meeting and talk with him or her.  

We strongly recommend that you find others to go with you.  So get as many of your CNM/CM, physician, and nurse colleagues as you can, round up your friends, family, clients, dogs, cats and goldfish and GO TO THOSE EVENTS TOGETHER!  Let these Representatives know how important it is for them to support women and children by  cosponsoring these two bills.  

Don't forget to take pictures and send them to [email protected].  And thanks for all you do to support midwifery!  

2.  ACNM Update on Recent Supreme Court Decision Impacting Coverage of Contraception

ACNM’s Position Statement on Reproductive Health Choices affirms that “Every woman has the right to make reproductive health choices that meet her individual needs,” and “supports each person's right to self-determination.”  At the same time, this Position Statement acknowledges “the wide range of cultural, religious and ethnic diversity of CNMs/CMs and their clients allowing for a variety of personal and professional choices related to reproductive health care.”

In a separate Position Statement on Health Care for All Women and Families, ACNM holds that “health plans must provide comprehensive health care benefits for all women and families.”  

Based on these Position Statements, ACNM joined several other organizations, including the Physicians for Reproductive Health, the American College of Obstetricians and Gynecologists, and the National Association of Nurse Practitioners in Women’s Health in filing an amicus brief, dated October 21, 2013, with the Supreme Court in the Burwell v. Hobby Lobby case.  The brief discussed the scientific evidence surrounding the medications and contraceptive devices in this case.

In its decision, the Supreme Court recently held that for-profit companies do not have to offer coverage through their employee health plan for forms of contraception to which they object on religious grounds.  

In response to the Supreme Court decision, Senators Patty Murray (D-WA) and Mark Udall (D-CO) introduced S. 2578, the Protect Women’s Health from Corporate Interference Act.  Companion legislation, H.R. 5051, was introduced in the House by Rep. Louise Slaughter (D-NY).  S. 2578 currently has 46 cosponsors, 45 of whom are Democrats and one of whom is an Independent.   The bill was debated by the Senate, but the votes were not present to cut off debate and vote on passage of the bill.  In the House, H.R. 5051 currently has 156 cosponsors, all of whom are Democrats.  Given Republican control of the House and objection to this bill, it is unlikely to be brought to a vote.  

While Congress may not pass this legislation, there is an Obama Administration resolution available.  In a regulation issued in 2013, the Administration addressed the question of coverage for contraception under plans offered by religious employers, such as churches or religious orders.  Under this regulation, specified types of employers may refuse to include contraception in the benefit package offered to their employees.  To ensure that women affected by this exception have access to all FDA-approved contraception, the regulation requires the insurer to separately provide for coverage of these items and services, without charging the employer and without cost sharing or premiums to the employees.

The  Administration will likely expand the reach of this regulation to include for-profit companies that have been exempted by the Court from the mandate to cover contraception.  In its opinion, the Court itself pointed to this regulatory solution, stating, “HHS itself has demonstrated that it has at its disposal an approach that is less restrictive than requiring employers to fund contraceptive methods that violate their religious beliefs.”  During a press conference held the day the decision was issued, White House spokesman Joshua Earnest said, “We’ll consider whether or not there’s an opportunity for the president to take some other action that could mitigate this problem as well.” 

Should the Administration choose to address this issue through regulation, it will begin that process with a proposed regulation that will provide for public comment.  ACNM staff members monitor the Federal Register on a daily basis and will identify any such proposal when it occurs.  We will update our members on both the content of the regulation and the opportunity for them to submit comments, should they desire.  We also anticipate that ACNM will submit comments on its own behalf.    

We believe regulations modeled on those that have already been issued can successfully provide a mechanism through which women can access the full range of FDA-approved contraceptive items and services, while simultaneously preserving the constitutional right to the free exercise of religion.

3.  Recording of Joint ACNM/CMS Webinar on Efforts to Improve Maternal/Infant Health Now Available

On July 29, 2014, ACNM and the Centers for Medicare and Medicaid Services (CMS) held a joint webinar to discuss efforts by the agency to address suggestions for improving maternal and infant health made by a recently convened expert panel.  The panel, which included ACNM member Susan DeJoy, CNM, made a range of recommendations and CMS has selected two for special focus.  During the webinar, CMS staff gave background on a several maternal and infant related projects underway, then focused particular attention on the specific recommendations from the panel selected for action.  

A recording of the event for those who could not attend is available here.  

4.  ACNM's State Government Affairs Team to Expand

Ok, so I am sorta pulling your leg with this headline, but this morning, Randy Kinzelman, husband of Cara Kinzelman, ACNM's Manager of State Government Affairs, gave our office a call to let us know that Cara is in labor.  So, we will have an honorary addition to the state government affairs team and Cara will be out on maternity leave until mid-October.  So if you have questions about state related policies, you are unfortunately stuck with me.  Hooray for Cara!

Should you have questions about these issues, please contact Jesse Bushman, ACNM’s Director of Advocacy and Government Affairs at [email protected] or 240-485-1843. 

Want to take action or get involved?  Contact ACNM's Government Affairs Committee.

Don't have the time or energy to get involved, but still want to contribute?  Support the Midwives-PAC.


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American College of Nurse-Midwives.
8403 Colesville Rd, Suite 1550 | Silver Spring MD 20910
Phone: 240-485-1800 | Fax: 240-485-1818
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