AGA Washington Insider

A policy blog for GIs

Advocating for GI on Capitol Hill

Dr Rustgi with CassidyWith the many challenges facing gastroenterology, my visit to Capitol Hill on behalf of the AGA could not have been timelier. Like many of my predecessors, I came to Washington recently to meet with legislators to advocate on behalf of the profession in both the clinical and research arenas. With the implementation of the Affordable Care Act and recent cuts to upper GI endoscopy services, practicing clinicians are facing both financial and regulatory constraints. Additionally, with budget sequestration and fiscal challenges facing our nation, NIH funding has suffered, which impacts researchers and potential lifesaving discoveries in laboratories across the country. I was honored to meet with eight congressional offices to discuss these and other issues critical to gastroenterology and our patients.

Although the AGA faces many challenges, I walked away from my day on Capitol Hill feeling invigorated. I saw many opportunities for the AGA as I met with Congressional offices that are passionate about many of our priorities.

I had the pleasure to meet with Sen. Jack Reed, D-RI, who serves on the Senate Appropriations Committee and is a strong advocate for NIH funding. Sen. Reed was one of the lead sponsors of the legislation that created the National Commission on Digestive Diseases and has been a champion of research. He assured us that there is bipartisan support for NIH. With the Appropriations Committee operating under “regular order” this year, meaning we may actually see an NIH funding bill, Sen. Reed was optimistic that funding could improve.

Other strong supporters of NIH that I had the opportunity to meet with were Rep. Leonard Lance, R-NJ (pictured below right); staff of Sen. Bob Casey, D-PA; staff of Sen. Sheldon Whitehouse, D-RI; staff of Rep. Charlie Dent, R-PA; and staff of Rep. Anna Eshoo, D-CA. Many of these offices are not only champions of NIH, but also of GI cancers and diseases.Dr Rustgi with Leonard Lance

Rep. Lance has been a champion of pancreatic cancer research, as well as of colorectal cancer screening. He talked about his personal connection to colorectal cancer — his mother died young from the disease — and emphasized his support for coverage of colorectal cancer screening since his days in the New Jersey state legislature. The AGA looks forward to partnering with Rep. Lance on education and awareness to the benefits of colorectal cancer screening and other initiatives.

Rep. Lance has also partnered with Rep. Eshoo to create the Deadliest Cancers Caucus to raise awareness of those cancers with a five year survival rate of less than 50 percent. Many of these cancers are GI cancers, such as pancreatic, liver, esophageal and gastric. I look forward to working with both Reps. Lance and Eshoo in creating more awareness around these cancers and pushing for more research funding. I am excited that I will be back in Washington in March to kick off the Deadliest Cancers Caucus at a briefing on Capitol Hill.

I also met with Rep. Dent’s office, which was instrumental in working with the AGA on a successful briefing last summer on Capitol Hill on the gut microbiome. As the lead sponsor of H.R. 1070, the Eliminating Barriers to Colorectal Cancer Screening Act, Rep. Dent continues to be a strong advocate for gastroenterology and our patients. This bill would waive the coinsurance for Medicare beneficiaries if their screening colonoscopy becomes therapeutic.

And, of course, I met with Rep. Bill Cassidy, R-LA (pictured above left), a hepatologist and one of AGA’s strongest champions in Congress. We had a very productive meeting during which we discussed the recent Medicare cuts to upper GI endoscopy codes and our concern that these cuts were proposed in the Medicare Physician Fee Schedule Final Rule. By waiting for the final rule to publish these cuts, CMS not only did not provide the AGA and our sister societies the proper time to comment and offer alternatives, it also didn’t allow gastroenterologists the time to prepare for the impact that these cuts will have on their practices and their patients. Rep. Cassidy was sympathetic to the lack of transparency that the agency provided throughout this process. He offered to send a letter to CMS and to solicit members of Congress to join in the effort. We are grateful for Rep. Cassidy’s support and will be calling on AGA members to help in this effort to put pressure on the agency to provide a more transparent process that impacts physicians and their patients.

Rep. Cassidy and I also had a robust conversation on the lack of understanding and appreciation for science in Congress. Rep. Cassidy has sponsored medical students to be interns on Capitol Hill to learn the legislative process and to offer their expertise in science. We discussed collaborating on efforts to secure more internships on Capitol Hill for medical students to help influence health-care policy.

All in all, it was a successful day on Capitol Hill and I think there were many positive, tangible “takeaways” from the meetings. Like all successful advocates, I look forward to building upon these relationships to advance the science and practice of gastroenterology.


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