With its grassroots approach, the ACA is making great strides for chiropractors across the country

During the past year, the American Chiropractic Association (ACA) has been extremely active on Capitol Hill, advocating pro-chiropractic initiatives. These issues range from increasing access to chiropractic care in the Department of Defense (DoD) and Department of Veterans Affairs (VA) health care systems, empowering doctors in managed care plans, reforming Medicare, and expanding students’ access to loan reimbursement programs. As a result, we have had a number of important legislative victories.

Building on a successful National Chiropractic Legislative Conference (NCLC), we are now in the midst of a major legislative campaign, including ensuring the proper implementation of the new chiropractic benefit in the VA health care system, the inclusion of the chiropractic profession in the National Health Service Corps (NHSC), and the expansion of chiropractic benefits in the Medicare program.

The Best Defense is a Good Offense

As reported earlier, President Bush signed into law (PL 107-135) legislation this year that created the first permanent chiropractic benefit in the VA health care system. Knowing the negative attitude of VA, the ACA worked to ensure the department developed and implemented the new chiropractic benefit properly. The effort focused on the creation of a chiropractic advisory committee and the availability of chiropractic care at an adequate number of VA sites.

A key component in the legislation,which was modeled after the DoD demonstration project, was the creation of the advisory committee. This committee will give the chiropractic profession direct input on the development and implementation of the chiropractic benefit. Since the DoD demonstration was so successful and the DCs on the committee gained enormous experience developing and implementing a new benefit, the ACA and the Association of Chiropractic Colleges (ACC) decided to recommend these doctors with the addition of Carl Cleveland, DC, to the new VA advisory committee. Since the passage of the legislation, we have contacted the VA Secretary regarding this issue, as well as worked with members of the House VA Committee in support of the doctors we have endorsed.

To ensure that chiropractic care is available at an adequate number of VA sites, the ACA and ACC have been working with key members of the House Appropriations Committee. During these meetings, we discussed our concerns with the development and implementation of the new chiropractic benefit. Members of the committee understood our concerns and indicated a willingness to help.

The Old College Try

The Senate Health, Education, Labor, and Pensions (HELP) Committee worked on reauthorization legislation for the NHSC program. The ACA and ACC have been working to make doctors of chiropractic eligible for scholarships and loan repayment programs offered by the NHSC, which has not been easy. Senator Tom Harkin (D-Iowa) has been the lead champion on this issue. The HELP Committee was making a concerted effort to limit the number of providers that could participate in the NHSC. In fact, legislation drafted by the Senate HELP committee removed podiatrists and optometrists from the NHSC program.

On July 31, 2001, the ACA received information that a chiropractic provision regarding this issue had been included in the chairman’s base bill (chairman’s mark). Unfortunately, we also received information indicating that Senator Bill Frist (R-Tenn), a medical doctor, planned to offer an amendment that would strike the chiropractic provision. There were reports that Senator Frist planned to offer his amendment to kill the chiropractic provision as early as the next day. ACA staff confirmed this report with Senator Frist’s office. Along with the ACC, we immediately swung into action and alerted Senate offices and our key contacts. The ACA also initiated an intense grassroots campaign, faxing and emailing legislative alert bulletins to thousands of doctors across the country, which resulted in calls inundating the Senate.

On August 1, 2001, the Senate HELP Committee completed work on the NHSC reauthorization legislation. Although Senator Frist objected, the HELP committee moved to include doctors of chiropractic in the NHSC program for a 3-year period. This provision guarantees that DCs will receive loan reimbursement under the NHSC program. The action taken by the Senate HELP Committee was a significant victory.

While the committee removed the podiatrists and optometrists from the program, doctors of chiropractic, for the first time, will be eligible for student loan reimbursement. After the 3-year period, Congress will decide whether or not to make chiropractic a permanent part of the NHSC. It will be difficult for Congress not to make chiropractic a permanent part of the NHSC program. Once this happens, doctors of chiropractic will have a federal designation as primary care providers.

After the committee approved the legislation, it was cleared for consideration by the full Senate. But no further action has been taken on this issue due to the terrorist attacks on September 11. The House and Senate will likely continue action on this important legislation this year. The ACA and ACC will continue to work with key members of the Senate to ensure that the chiropractic provision remains in the bill when the NHSC legislation is considered on the floor of the Senate. We are also working closely with key members to have the House support the Senate provision.

All-Access Pass

The ACA continues its effort to expand patient access to chiropractic care and end the long-held discrimination against doctors of chiropractic in the Medicare program. To address this issue, Congressman Wes Watkins (R-Okla) introduced the Chiropractic Patients’ Freedom of Choice Act HR 902 in the 107th Congress, which would provide reimbursement for all Medicare services in their state scope of practice. We have initiated a grassroots and lobbying campaign in support of this legislation. As a result, this legislation has received strong bipartisan support in the House of Representatives. HR 902 currently has 64 cosponsors and has also been well received by the chiropractic profession. The ACA has received numerous emails and phone calls from doctors with their strong support.

The ACA urges all DCs, chiropractic patients, and organizations to help in the passage of the Watkins bill (HR 902). If you have not contacted your Senators or Representative about HR 902, please do so. Or if you have already contacted your Senators or Representative, keep the grassroots pressure on. Call the Capitol Switch Board at 202-224-3121.

Jay Witter IV, is the ACA vice president of government relations. He can be reached at: 800-986-4636, ext 214.