While his proposal for a new law to ban the sale of assault weapons grabbed the early headlines, a number of pieces of President Obama's plan to reduce gun violence involve physicians and the health care system.
Already drawing controversy, for example, is the president's announcement that he will "clarify that the Affordable Care Act [ACA] does not prohibit doctors asking their patients about guns in their homes."
In an article entitled "Obama: Doctors Should Ask About Guns in Homes," the conservative NewsMax publication says that provision "sounds like George Orwell's 1984." From the other side, The Atlantic reported that "the order actually just preserves a legal expectation for doctors to report on their patients that has existed for 37 years."
All in all, a review of the president's 23 executive actions and nine legislative proposals reveals much that will – or could – impact physicians and patients and the health care system. (See below for the official White House press briefing on the pieces of the plan.)
One piece is already a formal executive order signed by the president: "The Secretary of Health and Human Services (Secretary), through the Director of the Centers for Disease Control and Prevention and other scientific agencies within the Department of Health and Human Services, shall conduct or sponsor research into the causes of gun violence and the ways to prevent it. The Secretary shall begin by identifying the most pressing research questions with the greatest potential public health impact, and by assessing existing public health interventions being implemented across the Nation to prevent gun violence."
"And while year after year, those who oppose even modest gun safety measures have threatened to defund scientific or medical research into the causes of gun violence," the president said at his news conference, "I will direct the Centers for Disease Control to go ahead and study the best ways to reduce it – and Congress should fund research into the effects that violent video games have on young minds. We don't benefit from ignorance. We don't benefit from not knowing the science of this epidemic of violence."
The other six executive actions related to health care are:
- Address unnecessary legal barriers, particularly relating to HIPAA, that may prevent states from making information available to the background check system.
- Release a letter to health care professionals clarifying that no federal law prohibits them from reporting threats of violence to law enforcement authorities.
- Release a letter to state health officials clarifying the scope of mental health services that Medicaid plans must cover.
- Finalize regulations clarifying essential health benefits and parity requirements within the ACA exchanges.
- Commit to finalizing mental health parity regulations.
- Launch a national dialogue on mental health led by Health and Human Services Secretary Kathleen Sebelius and Education Secretary Arne Duncan.
And the two pertinent pieces of President Obama's legislative agenda on gun violence are:
- Help ensure that young people get the mental health treatment they need.
- Ensure health insurance plans cover mental health benefits.
The first item, according to the White House press briefing, is aimed at training teachers, school counselors, social workers, and others who routinely work with students and young adults.
Action, Feb. 1, 2013