AGA patient and physician advocates visit Capitol Hill to push for prior authorization reform

Five patients and nearly 50 physician members of the American Gastroenterological Association recently traveled to Washington, D.C., to meet with lawmakers on Capitol Hill and urge them to advance legislation reforming prior authorization and other health insurance barriers.

^{Courtesy AGA}

AGA members from the state of Washington ready to advocate on behalf of GI. From left: Dr. Rachel Issaka, AGA President Dr. Barbara Jung, AGA Government Affairs Committee Chair Dr. Rotonya Carr, Dr. Omeed Alipour, and Dr. Carol Murakami.

In our first in-person Advocacy Day on Capitol Hill since 2019, AGA leaders and patient advocates from 22 total states met with House and Senate offices to educate members of Congress and their staff about policies affecting GI patient care such as prior authorization and step therapy. Federal research funding and Medicare reimbursement were also on the agenda.

In the meetings, the patient shared their stories of living with various gastrointestinal diseases, including ulcerative colitis and Crohn’s disease, and the struggles they’ve gone through to get treatments approved by their insurers. AGA physicians shared the provider perspective of how policies like prior authorization negatively impact practices. According to a 2023 AGA member survey, 95% of respondents say that prior authorization restrictions have impacted patient access to clinically appropriate treatments and patient clinical outcomes and 84% described that the burden associated with prior authorization policies have increased “significantly” or “somewhat” over the last 5 years. AGA’s advocacy day came not long after UnitedHealthcare’s announcement of a new “Gold Card” prior authorization policy to be implemented in 2024, which will impact most colonoscopies and endoscopies for its 27 million commercial beneficiaries. The group expressed serious concerns about the proposed policy to lawmakers.

^{Courtesy AGA}

AGA members from the state of Washington ready to advocate on behalf of GI. From left: Dr. Omeed Alipour, Dr. Rachel Issaka, AGA Government Affairs Committee Chair Dr. Rotonya Carr, Dr. Carol Murakami, and AGA President Dr. Barbara Jung.

AGA thanks the patient and physician advocates who participated in this year’s Advocacy Day and looks forward to continuing our work to ensure timely access to care.