Reflections on the ACA KCMS President,

Dr. Rajneet Lamba

I had just shared a new prostate cancer diagnosis with my patient.  He smiled.  Smiled!  “I just signed up for health insurance doc, my kids helped me through the website.” Despite the uncertainty held in his medical diagnosis, he felt fortunate to be an early enrollee in a Patient Protection and Affordable Care Act (ACA) compliant insurance policy via Washington Health Plan Finder, with a chance to dramatically limit his disease-related financial burdens. 
With a Supreme Court ruling on the ACA pending for November 10, it seems like a good time to reflect on the law’s impact this past decade.  The combination of expanding Medicaid coverage in our state to those making up to 138% of the poverty level and tax credits for those making up to 400% has led to an additional 600,000 Washingtonians with healthcare coverage[i].  When the new site went live in October 2013, it was overwhelmed with 8 million visitors in the first few days.  Many felt that the website’s operational inefficiencies reflected a government failure, while others acknowledged the impressive demand for this new supply of healthcare coverage.  Nationally, this program has insured an additional 20 million Americans and brought the uninsured rate to below 10% for the first time ever, while reducing uncompensated hospital care by 47%[ii].  Despite widespread concerns of financial repercussions for physicians, average physician salaries have continued to show increases until today’s current pandemic-influenced uncertainty[iii]
While uninsured rates declined for all ethnicities, racial minorities with histories of greater uninsured rates showed larger decreases in these rates, most notably with a decline in the national Latinx uninsured rate from 33% in 2010 to 22% in 2018[iv], making the ACA an effective piece of antiracist legislation.  Historic rates of unemployment have highlighted the importance of affordable insurance options outside of traditional employer-based models.  Keeping kids covered under their parents’ plans during equally historic youth unemployment remains important as well.  65million Americans have pre-existing conditions and remain eligible for health care coverage under the ACA and it is unclear how many more could potentially be discriminated against without the ACA, given the increasing identification of post-COVID-19 “long haulers”[v] with ongoing organ dysfunction and chronic symptoms.
The biggest criticisms of the ACA are likely that it is not transformational enough.  Bronze plan subscribers experience cost-sharing at 40% for non-preventative services, along with high deductibles and narrow networks that also reflect broader shifts in the insurance industry as a whole.  These concerns do not take away from the fact that coverage is overall increased and must include 10 categories of Essential Health Benefits including pregnancy, maternity, and newborn care and mental health and substance use disorder services among others provides free preventative services and serves as a catastrophic coverage backstop.  For those that would like to see more done, that is an important conversation to be had.   Attacks from a purely fiscal conservative viewpoint at this time seem more ideological than helpful in the midst of the pandemic.  The costs of further destabilizing the health care market and then implementing an alternative to this far-reaching bill would be inopportune, not offering an alternative seems worse yet.  I participated as a panelist in the Inland Washington State of Reform conference last month and had the chance to hear from many state health policymakers on the matter.  There is a very palpable concern that Washingtonians will suffer if federal ACA funds are removed from our state’s 2021 healthcare budget.
If you have your own stories or thoughts on the impact of the ACA on your practice/profession/patients, please write us and feel free to include if you would like your comments considered for publication in an upcoming KCMS Newsletter. 

Vote Yes on King County Prop 1  Harborview Health for All

Join KCMS, UMC, and many others in the effort to keep Harborview strong. 
A message from Jerry Bush, UMC CEO & President:
"Owned by the people of King County and operated by UW Medicine, Harborview Medical Center cares for the most vulnerable, trains future doctors, and is the state’s only Level 1 trauma and burn center. Harborview serves us all, and now, it needs updates and expansions. These include seismic safety, behavioral health services, and modern infection control and privacy standards. Learn more at Harborview Health for All – Yes Prop 1.
Your Yes vote on King County Prop 1 will put hundreds of local construction jobs to work and keep thousands of patients and first-responders healthy for decades to come.
Are you registered to vote in the 2020 elections? Check with the Elections division of the Washington Secretary of State to confirm you’re ready to receive your official ballot in the mail.
UMC is ready to put to work our 100 years of local expertise keeping our neighbors and first responders healthy. We hope you’ll join UMC in voting Yes on King County Prop 1, “Harborview Health for All.” 

New Members

Wendy H. Wong, MD, MPH

Dr. Wendy Wong is a board-certified emergency medicine specialist at Virginia Mason in Seattle. She attended Tulane University School of Medicine and completed her residency at Alpert Medical School of Brown University. 

Jessica A. Ivers, MD

Dr. Jessica Ivers is a board-certified pediatrician at the Polyclinic in Seattle. She received her medical degree at the University of North Dakota School of Medicine and Health Sciences, and completed her residency at Seattle Children’s Hospital.

Members on the Move

Dr. Garrison Bliss retired on September 1, 2020, after 40 years in medical practice. We wish you the very best in your retirement!
Are you a physician on the move? Let us know where you are headed!  Email

National Lead Poisoning Prevention Week 2020

More Information
Webinar Registration Details

Washington Joint Select Committee on Health Care Oversight

The Joint Select Committee on Health Care Oversight will convene for a virtual meeting on Monday, October 26th, at 1 PM.  Virtual Work Session:
1.   The COVID-19 outbreak and response.
2.   The use of telehealth during the COVID-19 outbreak and response.
3.   The impact of COVID-19 on the rate of uninsured individuals.
This meeting is being conducted virtually and can be viewed on TVW (link below)
Monday, October 26th, at 1 PM. Watch Here

ABP Portfolio Sponsor Webinar

Join the American Board of Pediatrics (ABP)  in discussing how we can work together to integrate work designed to eliminate health care disparities in children into the ABP’s Continuing Certification Program.
The ABP Portfolio Sponsor Virtual Webinar will include a presentation from ABP’s Vice President of Continuing Certification Keith Mann, MD, MEd, on early thoughts on helping physicians eliminate health care disparities in children as a component of Part 4 of Continuing Certification.  Afterward, other Portfolio Sponsors will share their diversity, inclusion, and equity work!  
If you have questions, please don’t hesitate to reach out to us at For registration information, click the button below.
ABP Portfolio Sponsor Webinar October 27, 2020 12:00 pm-2:00 pm ET

New Webinar E/M Coding Changes: What will happen to the physician's note?

Sponsored by the AMA and Nordic, on Wednesday, October 28 @ 10:30 AM CT,  esteemed panelists, Dr. Barbara Levy, a member of AMA’s CPT® Editorial Panel, and Dr. Craig Joseph, Nordic’s Chief Medical Officer, will discuss how physician organizations can maximize physician satisfaction and improve clinical documentation while adhering to the E/M rules effective in 2021. The panelists will also cover the high-level 2021 E/M modifications, specific changes to ambulatory note templates, and ideas to improve the documentation process. 
Webinar Link

'A challenging way to practice medicine': Death investigation in Washington faces grim reality

Featuring KCMS member & former Board Trustee, Dr. Carl Wigren MD, KCMS CEO Nancy Belcher, Ph.D., and lobbyist James Paribello. This story is the first in a three-part series examining the patchwork system of death investigation in Washington state. Listen to Part One and Part Two below, and visit for Part Three airing on Oct. 26.
Part One
Part Two

Value-Based Care Summit

Bree Collaborative and Washington Health Alliance sponsored by Cambia Grove are thrilled to announce a free virtual Value-Based Care Summit featuring keynote speaker Donald Berwick, MD, MPP, FRCP.

Join in on Thursday, November 12, to examine obstacles and barriers to change for all stakeholders, and actively promote and support a more rapid acceleration of value-based payment models across our state. Register below.

In Memoriam

Dr. Eric S. Merrifield - Obituary
Dr. E. Franklin Stone Jr. - Obituary
Dr. Eric Merrifield - Obituary
Dr. Edgar Stone - Obituary
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