After decades of debate about health care reform and years of tireless efforts by APhA members and dozens of other pharmacy stakeholders as the Affordable Care Act (ACA) wound its way through the legislative, executive, and judicial branches of our government, the key date in the implementation of the law is now just a few days away. Whether the ACA is good, bad, or just ugly we won’t know for a long time, but we must do our best to serve our patients during this historic time.

As the ACA rollout continues, pharmacists in every town and state of our country can help our patients make the right decisions regarding their health insurance. On Friday morning, I participated in a meeting of pharmacy representatives with senior White House officials in the Roosevelt Room of the West Wing. Our focus was on how pharmacy might support the launch of new health care benefits and, in particular, how patients walking into pharmacies might find the experience.

We had a frank and open discussion in which we asked the White House that pharmacy risk be limited, information be shared quickly, government help be available at all hours (not just regular business hours), and a one-time override request be available to help pharmacies meet patient needs while coverage issues are being sorted out. We need FAQ documents now to distribute to our pharmacists and others. We noted that pharmacists handle all insurance questions, not just those about medication coverage, and asked that we have access to provider support numbers and Web resources. The pharmacy groups asked that the federal government encourage beneficiaries to verify and know plan information before heading into their pharmacy, as lines are forming already, and the days around the start of the year are incredibly busy for pharmacies anyway, let alone with the ACA launch.

During the meeting, Obama administration officials described several steps they are taking to help pharmacists during the ACA rollout. Deadlines have been adjusted, formulary information has been provided, requests of plans have been made to honor 2013 prior authorization in early 2014, and a process has been established for managing prescriptions for nonformulary medications. They suggested the HealthCare.gov website was dramatically better and that enrollee numbers are increasing. The government has allowed payments in January for coverage beginning earlier. CMS regional offices are mobilized and ready to help, and contact information for these will be distributed.

We have another call scheduled with CMS today, and we’ll keep APhA members updated as these events proceed.

Have a great holiday season!