NCPA Identifies Essential ACA Provisions in Recommendations to Congress

As President-elect Donald Trump and congressional Republicans prepare their efforts to dismantle the Affordable Care Act (ACA), the National Community Pharmacists Associations (NCPA) has penned a letter to key representatives outlining its recommendations for future health care reform.

In the letter—addressed to House Majority Leader Kevin McCarthy (R-CA), Ways and Means Committee Chair Kevin Brady (R-TX), Education and the Workforce Committee Chair Virginia Foxx (R-NC), and Energy and Commerce Committee Chair Greg Walden (R-OR)—the NCPA focused on several provisions of the ACA that it believes should be maintained or expanded should the controversial law be repealed and replaced.

Highlighting the ACA’s role in improving access to necessary medication, the NCPA emphasized that a replacement bill “must preserve prescription drug coverage as an essential benefit to help reduce overall health care costs.”

The organization also stressed the need for “access to a robust pharmacy network that includes meaningful access to retail pharmacies, including independent pharmacy,” and recommended that a replacement bill retain ACA regulations that prohibit health plans from requiring the use of mail-order pharmacies, pointing to a 2013 report in which a patient’s relationship with a pharmacy’s staff was linked to greater medication adherence.

Additionally, the NCPA advised lawmakers to maintain ACA Section 10328, which strengthened Medicare Part D medication therapy management (MTM) programs, and encouraged them to build upon this provision in an effort to expand the pharmacist’s role on the health care team.

Other ACA provisions that the NCPA recommended be retained in a potential replacement include Section 2503, which amended the calculation of Average Manufacturer Price (AMP) and defines how AMP should be used to determine Medicare reimbursements; Section 3109, which provides an exemption from accreditation standards for pharmacies who derive less than 5% of their revenues from durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) billings; and Section 6005, which requires Pharmacy Benefit Managers (PBMs) to maintain higher levels of transparency.

“As Congress prepares the coming wave of health care reforms, we felt the voice of America’s more than 22,000 independent community pharmacies and the millions of patients they serve should be heard,” said NCPA CEO B. Douglas Hoey, RPh, MBA, in a press release. “These small business health care providers often reside in underserved communities, are highly accessible, and are critical to driving prescription drug access, adherence, and proper utilization.”

The NCPA sent a similar letter to Senate Finance Committee Chair and President Pro Tempore Orrin Hatch (R-UT) in response to the senator’s earlier request for suggestions on Medicare changes.

“We believe these common-sense, bipartisan measures will improve health outcomes, reduce costs and maintain access for patients,” Hoey stated. “We look forward to working constructively throughout the legislative process to achieve those goals.”

The possibility of an ACA repeal has prompted concerns from a number of individuals and organizations over the medical and economic consequences of the law’s dismantling. In an unrelated letter sent earlier this month, American Medical Association (AMA) CEO and executive vice president James L. Madara, MD, warned congressional leaders against repealing the ACA without a clear plan to replace it. Furthermore, a recent survey revealed that only 20% of Americans thought that the ACA should be repealed without a replacement plan, while 47% of respondents expressed support for the law and believed that it should be kept in place.