US Senate Healhcare Bill Update


REHAB Rollback

Congress positioning to repeal Affordable Care

By; Carla Wilhite, ASAP Vice Chair


In a bill sponsored by Senators Lindsay Graham and Bill Cassidy, a plan is afoot this week or early next week to vote on substantially eliminating major sections of the Affordable Care Act law, including the essential health benefits of habilitation, rehabilitation care, durable medical equipment, and prosthetics.

States would also be allowed to apply for waivers to determine what is or isn’t an essential health benefit, and the law would also impact people with pre-existing conditions. This jeopardizes other essential health care benefits like maternity care, prescription drugs, and mental health services.

The law would also substantially affect Medicaid, by eliminating Medicaid expansion. The law would be replaced with state block grants, which states could use however they choose to fund health services. Cost-sharing subsidies and tax credits would also be eliminated under the bill.

Poor, rural, and socially disadvantaged states like New Mexico could be hardest hit, where health care would almost certainly become less accessible and affordable. Even New Mexico’s Republican Governor Susana Martinez, has said the Graham-Cassidy bill is bad for New Mexico.

Even more extreme, over time the bill constrains spending and ratchets the block grants downward, almost guaranteeing less care will be available in the future.

If two or more republican senators vote NO, the bill is dead. As of now, three Senators are undecided. Concerned occupational therapy practitioners and their clients should urgently contact their Congressional representatives to voice their support for voting NO to the Graham-Cassidy bill.

U.S. Senators:

The Honorable Tom Udall
United States Senate
531 Hart Senate Office Building
Washington, D.C. 20510-3101

DC phone: 202-224-6621
DC fax: 202-228-3261
Contact Form:
Meeting requests:
Twitter: @SenatorTomUdall


The Honorable Martin Heinrich
United States Senate
B40D Dirksen Senate Office Building
Washington, D.C. 20510-3104

DC Phone: 202-224-5521, DC Fax: 202-228-2841
Contact Form:
Twitter: @MartinHeinrich


District 1: The Honorable Michelle Lujan Grisham
United States House of Representatives
214 Cannon House Office Building
Washington, D.C. 20515-3101
DC Phone: 202-225-6316; DC Fax: 202-225-4975
Contact form:
Twitter: @RepLujanGrisham


District 2: The Honorable Steve Pearce
United States House of Representatives
2432 Rayburn House Office Building
Washington, D.C. 20515-3102
DC Phone: 202-225-2365; 855-4-PEARCE (732723); DC Fax: 202-225-9599
Contact Form:
Twitter: @repstevepearce


District 3: The Honorable Ben Ray Lujan
United States House of Representatives
2446 Rayburn House Office Building
Washington, D.C. 20515-3103
DC Phone: 202-225-6190, DC Fax: 202-226-1528
Contact Form:
Twitter: @repbenraylujan




AOTA Update on Health Care Reform

The following is a message from AOTA President, Amy Lamb, on the AHCA bill currently under review in the United States Senate.


Dear Colleagues and Students;

I want to draw your attention to a message from AOTA that outlines today’s actions in the House of Representatives on changes to the Affordable Care Act. I wanted to personally share this, which will also be posted on the AOTA website, as I know that these changes are of great importance to you and our profession. AOTA has concerns about the bill, but I encourage you to express your views to your elected officials no matter what your views are. Please watch the AOTA website for updates. Together we can make occupational therapy’s voice heard.


Amy J. Lamb, OTD, BS, OT/L, FAOTA

AOTA President

May 4, 2017

Today the House of Representatives passed the American Health Care Act (AHCA) by a vote of 217 to 213. The AHCA is intended as replacement for the Affordable Care Act (ACA) also known as “Obamacare.” The bill does not fully repeal “Obamacare” but makes significant changes to its basic elements as well as completely overhauls the Medicaid program. If put into law, the bill will have significant impact on occupational therapy practitioners and clients. The bill now moves to the Senate where it must be voted on as it is or with changes. It will not become law until a final version is agreed to in both chambers and signed by the president.

Throughout the repeal and replace debates AOTA has had two priorities: that any changes ensure access to affordable health insurance, and that they ensure access to meaningful coverage and benefits, so that people can live healthy, independent, fulfilling lives. This means access to occupational therapy in insurance and in the Medicaid program. The bill passed by the House today does not appear to achieve either of these priorities.

AOTA has worked with Congress and encouraged advocacy on this bill since January. The process has had many starts and stops and much uncertainty. AOTA tread carefully to promote our concerns and maintain open dialogue with all parties. AOTA staff and membership have met with members of Congress to discuss key issues. AOTA has joined with coalition partners to raise awareness for shared concerns. AOTA has provided regular updates to members and afforded opportunities to contact members of Congress. Since January, 4,500 messages on health care concerns were sent by members of AOTA.

The work of AOTA has addressed the importance of essential health benefits (such as rehabilitation, mental health, and preventative care), the importance of Medicaid (including its role in supporting special education services in schools, the importance of the essential role of mandated benefits such as Early and Periodic Diagnostic and Testing Services for children, and Medicaid’s essential role in providing health care coverage for people with disabilities and mental health issues) and protecting insurance availability of coverage for people with pre-existing conditions. At this point, the timeframe for Senate action is unknown. There may be a swift move to vote on this bill, or Senators may take time to debate and discuss the implications of the AHCA as passed. There may also be procedural questions about some of the bill’s provisions that would prevent or stall Senate consideration.    

With a specific bill in play, components of the bill, if signed into law, will have a direct impact on occupational therapy practice and access. For instance if the final version does not provide availability of affordable insurance that fully covers occupational therapy, consumers will not seek services. AOTA staff will work hard, including empowering AOTA membership to express their views, to improve the legislation and to ensure it meets the priorities of occupational therapy.

You can go right now to the AOTA Legislative Action Center and write or call your Senators about these key priorities or any other issues of concern to you. In the upcoming days you can attend Congressional town hall meetings to discuss the importance of these priorities—like access to rehabilitative and habilitative services such as occupational therapy—whether through the essential health benefits or through Medicaid coverage.

To read more about the bill and its provisions and to stay up to date on the latest actions and efforts, please visit:




Occupational Therapy Practice Act Pocket Vetoed! 
How We're Protected From & Impacted By the Legislative Blow
What Happened in the 2017 Session?
  • With the help of a strong NMOTA Legislative Committee, many generous volunteers, and the American Occupational Therapy Association (AOTA), we introduced a succinct, comprehensive Scope of Practice Bill on 1/26/17, House Bill 253: "Occupational Therapy Scope of Practice Act" (OTSOP).
  • OTSOP was sponsored by Representatives Liz Thompson & Deb Armstrong, both physical therapists who strongly support our profession. 
  • Throughout the legislative process, our bill received strong bi-partisan support. OTSOP received a total of 116 'Yea' votes, and 1 'Nay' votes this session.The bill passed unanimously through all House and Senate Committees, and unanimously through the Senate Floor, receiving only 1 'Nay' vote on the House Floor.
Rep Bill O'Neill remarked in Senate Judiciary Committee hearing: "Congratulations, it's very challenging to get such strong support for a scope of practice bill. You essentially do not have any opposition." 
  • A bill becomes a law when it passes through all assigned committees both Senate and House chambers, and is signed by the Governor (see flow chart below). 
  • We needed the Governor's signature to make our OTSOP a law, and effectively update our definition of what we do as licensed practitioners! 
  • Gov. Martinez did not sign HB253, our Scope of Practice Act by Deadline 12:00pm, April 7th, 2017- effectively pocket vetoing the bill. 
  • She did not outright veto the bill, and therefore, does not have to provide commentary on her decision (see links below for more resources). 
  • However, The NMOTA Legislative Committee, AOTA Representatives, and lobbyist, Linda Siegle are inquiring with the Governor and key legislators. We are actively planning our next advocacy moves to ensure our bill is signed when re-introduced. 


The Impact on You & Our NM Practice:
  • We can still practice, bill for provision of our skilled services, and become licensed practitioners! 
  • In 2015, our lobbyist, Linda Siegle, was able to get a bill passed that stated if any Scope of Practice Bill is not signed into law, the affected healthcare organization will function under its previous Scope of Practice for the next 10 years. 
  • This means, we still have a licensure process, including a functioning State Occupational Therapy Boards & Commissions Office to review applications and provide licensure. 
  • We still have a definition of what OT does in New Mexico, legally in place through 2025.
  • However, the current legal NM Occupational Therapy SOP (from 2005) is outdated, and needs revision. That's why in 2015 and 2017 your NMOTA Legislative Committee has worked hard to update the SOP and get changes signed into law. 
THE Risks & Rationale for SOP Updates: 
When and Why Are We Legally Obligated to Review and Update our Scope of Practice?
Our last Scope of Practice (sponsored by Sen. Mimi Stewart) was signed by Governor Richardson in 2005. Every 10 years, healthcare providers are to review and update their scope of practice, and submit any revisions as a bill to be signed into law. This process, called "sunsetting" is common and has happened successfully in the past. 

We were due to update our SOP in 2015; however, Gov. Martinez pocket vetoed the bill in 2015. We were able to get an extension bill passed that carried our previous Scope of Practice from 2005.
If the extension bill had not been passed in 2015 we would not have a licensure process, nor an active Scope of Practice in the State. This is dangerous, as it effectively impacts our ability to:
  • receive reimbursement from insurance,  
  • advocate for our presence in many settings,
  • protect consumers from unscrupulous practice, 
  • ensure practitioners are well-trained and meet a threshold for education, ethics, and continuing education,
  • maintain our profession and ability to practice in the state. 
We would have been the ONLY state the US, North & South America, Europe, Asia and WFOT practicing countries to lose a Scope of Practice & licensure process. 
Thankfully, we will all be able to return to work & school with confidence that our advocacy community is strong, our profession is supported and protected. Know that NMOTA and AOTA are collaborating and working hard to ensure this does not happen again. 
Want to Join the Advocacy Team?
E-mail This email address is being protected from spambots. You need JavaScript enabled to view it. to join our Legislative Team and contribute to our strategic planning, legislative advocacy, and use your voice to impact our profession!

Lobbying Expense

icon government
Just as freedom isn't free, neither is lobbying on behalf of the OT Profession in New Mexico. The direct cost of NMOTA's advocacy for occupational therapy practice is shouldered by 300 members; paid for through memberships, conference income, and the volunteerism of a few dozen.

But well over 1200 licensed occupational therapy practitioners benefit from the NMOTA legislative effort, which will cost well over $12,000 this year alone. Because House Bill 192 will not simply walk through the House and Senate without a shepherd to keep it in front of the legislators.

Do the math. A membership in NMOTA is cheap insurance to make sure occupational therapy is a licensed, respected, and protected health profession in New Mexico. Let's call a truce on all the excuses we use to not join our professional practice community.  Click the link below!



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