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Better Care Reconciliation Act of 2017

ASHP Letter to Senate Leadership

June 29, 2017

The Honorable Mitch McConnell
Senate Majority Leader
S-230, U.S. Capitol
Washington, DC 20510

The Honorable Charles Schumer
Senate Minority Leader
S-221, U.S. Capitol
Washington, DC 20510

The Honorable John Cornyn
Senate Majority Assistant Leader
517 Hart Senate Office Building
Washington, DC 20510

The Honorable Dick Durbin
Senate Minority Assistant Leader
711 Hart Senate Building
Washington, DC 20510

RE: Better Care Reconciliation Act of 2017

Dear Leader McConnell, Leader Schumer, Assistant Leader Cornyn, and Assistant Leader Durbin:

On behalf of ASHP (American Society of Health-System Pharmacists), I appreciate the opportunity to present ASHP’s perspective on healthcare reform at the federal level. The Better Care Reconciliation Act of 2017 (BCRA), would repeal and replace certain provisions within the Affordable Care Act (ACA). Specifically, BCRA would make significant changes to Medicaid coverage and the structure  and amount of tax credit assistance, and it would allow for states to remove protections provided by essential health benefits, including prescription drug and mental health coverage. ASHP believes that “the mission of pharmacists is to help people achieve optimal health outcomes.” Pharmacists can achieve this aim only if patients have access to affordable healthcare. We believe that Congress shares the goal of affordable, accessible healthcare.

ASHP’s nearly 45,000 members are committed to providing patient care that helps patients achieve optimal health outcomes. ASHP helps its members achieve this goal by advocating and supporting the professional practice of pharmacists in hospitals, health systems, ambulatory care clinics, and other settings spanning the full spectrum of patient care. ASHP serves its members as their collective voice on issues related to medication use and public health. Thus, as the Senate evaluates healthcare reform options, we strongly encourage you to align the legislation with the “ASHP Principles on Healthcare Reform.” Specifically, in order to safeguard patient health through the provision of robust coverage, we believe the Senate should focus reform efforts on legislation that:

  • Promotes Access to Healthcare. ASHP advocates insurance coverage for all residents of the United States, including coverage of medications and related pharmacist patient-care services. Reforms should be crafted to protect patient access to the full continuum of care, from preventive services to acute and long-term care. This includes services such as substance abuse and mental health coverage, which are vital to combating the nation’s opioid epidemic.

  • Supports Provision of Affordable Medications. ASHP believes that safe and effective medication use should be a component of all proposed solutions to the central healthcare reform issues of access, cost, and quality. Under the ACA, medications are an essential health benefit — we strongly urge Congress to protect patient health by maintaining this benefit. Patients who cannot afford their medications do not take their medications. Medication nonadherence costs our healthcare system in both financial terms and in the form of suboptimal outcomes. As Congress moves forward, we suggest that any healthcare reform proposals include methods to reduce medication costs for patients, such as the adoption of the hospital formulary model that helps control costs by promoting the use of less-expensive generic medications and the expansion of therapeutic interchange of drugs when appropriate, through collaborative pharmacist-prescriber arrangements.

  • Utilizes the Medication-Use Expertise of Pharmacists. ASHP supports pharmacists as non-physician patient care providers, and we believe that all healthcare programs, both public and private, should fully incorporate pharmacists as full providers of care as it relates to medication use. Current and evolving care delivery models are team-based approaches that rely on the unique expertise of each team member. Pharmacists, as the medication-use experts, are a vital component of these care models, and they work collaboratively with physicians, nurses, and other healthcare professionals to ensure that medication use is safe and effective. Further, as the most accessible of all healthcare practitioners, pharmacists can provide basic access to care, especially in areas that are underserved.

  • Maximizes Existing Resources. ASHP encourages Congress to address potential access issues associated with the looming physician shortage by maximizing integration and utilization of all members of the healthcare team. Policymakers must support efforts to shore up the provider pipeline by investing in critical residency training programs, including programs dedicated to training pharmacists in managing the most complex therapies, such as oncology, organ transplantation, critical care, cardiology, infectious diseases, and geriatrics.

  • Supports Public Health Initiatives. ASHP strongly recommends the preservation of all existing funding for opioid abuse treatment and prevention, vaccination, antimicrobial stewardship, and other critical public health services. In particular, reductions in funding to the U.S. Centers for Disease Control and Prevention could cripple ongoing efforts to address these public health crises, threatening health outcomes on a national level.
All Americans need access to prescription medications and to pharmacist-provided patient care services to help them optimize therapeutic outcomes and reduce the risk of adverse events from medication therapy. Healthcare reform provides an opportunity to advance these goals. Pharmacists are a highly trained and valuable resource, yet they are currently underutilized. Healthcare reform discussions should focus on strategies to maximize efficiency and safety while providing patients with access to the full benefit of pharmacist-provided patient care services to achieve better healthcare.

We look forward to continuing to work with the Senate on ways to improve the Better Care Reconciliation Act of 2017. Should you have any questions or comments as the bill progresses, please contact me or have a member of your team contact Christopher Topoleski, Director of Federal Legislative Affairs, at 301-664-8806 or at [email protected]


Paul W. Abramowitz
ASHP, Chief Executive Officer