White House releases executive order on artificial intelligence regulation
On Dec. 11, the White House released a long-anticipated executive order (EO) on artificial intelligence (AI) policy and regulation. The EO seeks to limit the ability of state lawmakers to regulate AI technologies in favor of a minimally burdensome national policy framework for AI regulation.
The EO directs administration officials to engage in several efforts to challenge or otherwise discourage state action on AI regulation. Included among the directives is an effort to evaluate existing state laws for conflict with administration policy on AI, the creation of an AI Litigation Task Force tasked with challenging state AI laws, and a restriction of federal funding to states with onerous AI laws. The EO takes a particular interest in state laws that may result in AI developers or deployers “altering” truthful outputs of AI models to meet a state’s prohibition on algorithmic discrimination, which the White House has deemed unfair and deceptive acts or practices. Finally, the EO directs preparation of draft legislation to establish a uniform federal policy framework that preempts state laws. Such language must preserve state authority related to child safety protections, AI compute and data infrastructure, state government procurement and use of AI, and other topics to be determined.
AMA pushes House leaders to include physician-owned hospital changes in health care bill
On Dec. 12, the AMA joined 41 other national medical specialty societies, state medical associations and health insurers on a letter (PDF) urging House Republican leaders to pursue legislation that would expand access to “provider-owned hospitals.” House Republican Leadership utilized the term “provider-owned hospitals,” however, it was intended to be synonymous with the more commonly used “physician-owned hospital” terminology. This letter was in direct response to House Republican leadership releasing at the end of the week of Dec. 8 a collection of health care reform policies the full House of Representatives should consider to lower insurance premiums in lieu of an extension of Affordable Care Act Advanced Premium Tax Credits (ACA APTCs).
The cosigners of this letter have supported two important pieces of legislation, specifically H.R. 4002, the Patient Access to High Quality Health Care Act, and H.R. 2191/S. 1390, the Physician-Led and Rural Access to Quality Care Act. While H.R. 4002 would fully repeal the existing ban on physician-owned hospitals enacted as part of the Affordable Care Act, H.R. 2191/S. 1390, permits construction of new physician-owned hospitals so long as they are at least a 35-mile drive away from a Critical Access Hospital. H.R. 2191/S. 1390 would also permit existing physician-owned hospitals to expand their current campus. The sign-on letter was strategically agnostic as to which potential legislative option House Republican leadership should pursue.
A condensed legislative calendar due to the upcoming winter holiday, congressional district work period and competing priorities forced GOP leadership to only include policies related to expanded access to association health plans, health reimbursement accounts, and cost-sharing reductions within H.R. 6703. House Republicans crafted the bill with a focus on policies that were either priorities during the first Trump administration or previously considered either by a committee of jurisdiction or the full House of Representatives. Despite not being in the underlying version of H.R. 6703 as introduced, Rep. Victoria Spartz (R-IN) filed an amendment to overturn the current ban on physician-owned hospitals within the House Rules Committee. The amendment, however, was not considered during debate on H.R. 6703. While only select health care concepts originally floated by the House Republican leadership were ultimately included in the Lower Health Care Premiums for All Americans Act, which passed the House of Representatives on Dec. 17 by a vote of 216 to 211, AMA and the other organizations that cosigned the letter were encouraged by the new legislative attention hoisted upon physician-owned hospitals. AMA will continue lobby Congress to ultimately enact either H.R. 4002 or H.R. 2191/S. 1390.
AMA opposes changes to regulations impacting immigrants’ access to public benefits program
The AMA sent a letter (PDF) to Secretary of State Marco Rubio opposing proposed changes to public charge requirements. A public charge determination is made when the Department of Homeland Security decides that an immigration applicant is likely to become "primarily dependent on the government for subsistence." The changes would strip 2022 regulatory language that establishes clear criteria and definitions for making public charge determinations and would provide immigration officers with more discretion. The changes are estimated to result in 432,000 fewer individuals enrolling in Medicaid and the Children’s Health Insurance Program (CHIP), 447,000 fewer individuals enrolling in the Supplemental Nutrition Assistance Program (SNAP), and approximately 9 billion dollars fewer in federal and state public benefits being paid out each year.
In the letter, the AMA points out the potential detrimental downstream impact this could have on public health, local economies, and access to care for immigrant communities and all Americans, as well as concerns over possible discrimination for individuals living with disabilities and health conditions. The AMA calls on the administration to reverse the changes, or at a minimum to make efforts to mitigate confusion and adverse consequences by releasing replacement guidance before removing regulatory language, allowing for a transition period to educate individuals and immigration officers on the changes, and clarifying that U.S. citizens and legal immigrants will be able to continue to lawfully access public benefits for which they are eligible without negatively impacting immigration statuses of family members, which is a concern particularly for U.S. citizen children of immigrants.
