Advocacy News

• Reconciliation's impact on health care
• Med student loan caps spark concern
• CAP opposes controversial patent bill
• Texas bill blocked by pathology advocacy
• Pathology amends Indiana blood retention bill
• Indiana health care law revised
• Trump taps Dr. Means as surgeon general

House committees are marking up budget reconciliation legislation this week as Republican leadership aims for a floor vote by Memorial Day.

Why it matters: The proposal would cut hundreds of billions of dollars from Medicaid and increase the number of uninsured patients by millions, according to a CBO analysis.

• Some Republicans say the proposal doesn’t go far enough, while Democrats will oppose any cuts to the entitlement program.
• The CAP signed a letter to lawmakers regarding concerns over the Medicaid proposal.

On Medicare, the House bill includes physician fee schedule updates based on the Medicare Economic Index (MEI), which continues to be a legislative priority for the CAP.

• However, the impact to Medicare pay is less than what a key advisory panel recommends.
• For 2026, the bill provides an update of 75% of the MEI, amounting to a 1.73% pay increase next year, according to CAP estimates.
• For 2027 and beyond, the bill ties 10% of the MEI to increase pay for future years. While the establishment of a regular inflationary update is significant, linking future updates to 10% of MEI would not keep pace with inflation.

What's next: The CAP is actively engaged in federal budget discussions to represent the interests of pathologists, and we’ll provide additional updates.

Go deeper: Read a summary of the bill from the House Energy and Commerce Committee. 

A student loan proposal in the budget reconciliation package could adversely affect those pursuing medical degrees.

Why it matters: The House Committee on Education and the Workforce reconciliation plan would cap loans at $150,000 and set a lifetime student loan cap at $200,000.

• Medical student loans can easily exceed those caps, making school unaffordable for some students. 

The big picture: An inability to borrow higher loan amounts could make higher medical education unattainable, further exacerbating the physician workforce shortage.

• The CAP is concerned that loan caps and restrictions could add to the financial strain of those looking to pursue a career in pathology.
• However, the CAP supports interest-free deferment for the first four years of residency, which is included in the proposal.

The CAP is once again opposing the Patent Eligibility Restoration Act (PERA; S 1546/HR 3152), citing concerns over the way it would restrict a patient’s ability to evaluate and understand their genetic makeup. 

Why it matters: If enacted, PERA would immediately limit clinical laboratories' ability to provide confirmatory testing and would increase patient costs for diagnostic tests. 

The big picture: Ten years ago, the Supreme Court ruled that human genes cannot be patented. PERA challenges this by aiming to restore patent eligibility, creating potential chaos in health care. 

• In 2024, Sens. Thom Tillis (R-NC) and Chris Coons (D-DE) made repeated attempts to pass PERA out of the Senate Judiciary Committee.
• The CAP, along with the Association for Molecular Pathology, actively opposed it.
• Sens. Tillis and Coons, along with Reps. Kevin Kiley (R-CA) and Scott Peters (D-CA) reintroduced PERA on May 1. 

Last year, 711 CAP members sent 1,600 messages to 93 senators in opposition to PERA before the bill was withdrawn. 

What’s Next: CAP members will receive an action alert to oppose PERA.

The Texas Society of Pathologists (TSP) and the CAP stopped Texas House Bill 3042 from threatening laboratory benefit management program regulations. 

Why it matters: The bill would exempt certain insurance programs from robust state law requirements, risking unfair insurance practices against laboratories and pathologists. The legislation favored the insurance industry, undermining protections provided by Texas law. 

• The bill would have excluded denials or reductions in payments for laboratory and pathology services as qualifying for Texas law protections against improper insurance industry actions. 

The big picture: Under Texas law, health insurance programs must comply with specific standards for determining medical appropriateness, directly involving physicians in the process. 

Go deeper: Watch a video of TSP President Raul Benavides, MD, FCAP, testifying against the bill on April 30.

The Indiana Association of Pathologists (IAP) and the CAP prevented an overly burdensome requirement over blood draw retentions from becoming law.  

Why it matters: The IAP and CAP partnered to amend a bill that would have required retention of all first-draw blood specimens for up to 30 days.

• The IAP's testimony on February 11 to amend the bill highlighted logistical challenges and potential complications.

The big picture: Following the IAP testimony, the bill was successfully amended to limit the criteria for retention and to establish any blood retention requirement based on a hospital-based protocol.

• The protocol requires specific notification on lab orders for patients admitted to the emergency room and treated for suspicious or violent circumstances, accidental injuries, or overdoses.
• The retention time frame is now the earlier of patient discharge, death, or a maximum of 21 days.

On May 6, Indiana Gov. Mike Braun signed HB 1194 into law.

The CAP and the Indiana Association of Pathologists (IAP) amended a comprehensive health care law to limit price disclosure to only 50 shoppable pathology and laboratory services.

Why it matters: Originally, the bill would have required publishing multiple prices for every CPT code for pathology and lab services.

Countering trends of narrowing networks of physicians, the new law requires the Indiana Department of Insurance to assess whether health plans meet network adequacy standards, including availability of specialty providers such as pathologists.

• CAP-supported network adequacy requirements overcame opposition from the insurance industry to become law in Indiana.

One more thing: Written estimates of scheduled, ordered, or referred services for patients will now be required within two business days, instead of five days.

On May 6, Indiana Gov. Mike Braun signed HB 1003 into law.

President Trump has named Casey Means, MD, as the new nominee for US Surgeon General.

Background: Dr. Means co-founded Levels, a digital health company using continuous glucose monitoring to track metabolic health. 

What's next: Previous nominee Janette Nesheiwat, MD, is expected to work at the Department of Health and Human Services in a new capacity.