Abortion Care Among Key Topics at HOD
The California Medical Association (CMA) recently convened its 151st annual House of Delegates (HOD) meeting in Los Angeles, the first in-person meeting of the HOD since the pandemic. More than 500 California physicians gathered to debate and establish broad policy on current major issues that have been determined to be the most important issues affecting members, the association and the practice of medicine.
District XI, our District, represents the physicians of the North Valley, Butte-Glenn, Placer-Nevada, Yuba-Sutter-Colusa, and Sierra Sacramento Valley medical societies. Representing each of our component societies, District XI joined other district delegations at the House of Delegates to debate key issues, introduce policy from the district and offer our unique perspective of medical practice in our diverse region.
A featured event at each HOD session is the installation of CMA’s new officers. Santa Cruz internist and hospitalist Donaldo M. Hernandez MD, FACP, was installed as CMA’s 154th president while Redwood City OB-GYN Tanya W. Spirtos, MD, was named CMA president-elect. Los Angeles family physician Jack Chou, MD, was elected the new speaker of the CMA House of Delegates after serving three years as vice speaker.
California senator and pediatrician Richard Pan, MD received the 2022 Gary Krieger Speaker’s Recognition Award for remarkable contributions to CMA and its HOD. The award is hand-selected by the CMA Speaker of the House and was a worthy recognition, as Dr. Pan’s term in the state Legislature comes to a close, of his tireless work to improve the lives of Californians for the past 12 years.
In keeping with recent governance reforms, the House focused its efforts on selected major topics to streamline the policymaking process.
There were many physician workforce topics discussed and debated as California is facing a physician shortage that has reached crisis proportions and the COVID pandemic has placed additional pressures on an already strained system. The most interesting debate was regarding how the Dobbs v. Jackson decision is creating new workforce challenges, particularly for medical students and residents in states that restrict or ban abortion services.
A physician from Planned Parenthood in Orange County stated that there are 4 million unintended pregnancies every year and in one in five — 800,000 — the mother will want an abortion. However, nearly 250,000 of those patients live in states where abortion services are not available.
The discussion made clear that history shows that simply banning something will not stop demand. Also, in this case the decision will disproportionately affect people of color and those with low incomes. Orange County’s Planned Parenthood location has already seen a huge increase in patients from out of state, especially from Arizona, where abortions are restricted to 15 weeks.
States with total abortion bans account for 44% of OB-GYN residency program locations. There will be an entire generation of physicians educated in these states who will receive little or no abortion health care training. In addition to advocacy at the federal level, the delegates discussed related issues including telemedicine shield laws, vasectomy training, and residency programs that are located in restricted states but paying for abortion health care training in California.
Along with access to abortion care, the delegates debated policies to expand and strengthen the physician workforce so that every patient has timely access to affordable, quality care.
In 2019, the Healthy California for All Commission was formed and charged with developing a plan to move our state toward a unified financing system for health care delivery. The CMA is committed to universal access, but strongly believes that the health care system must be funded in a way that is sustainable so that health care coverage is not simply an empty promise and that all patients have equal access to quality care. The delegates discussed and debated a set of principles to ensure that any health care reforms will deliver high-quality, affordable and evidence-based care to all.
A recommendation that, ultimately, did not pass was the center of the meeting’s liveliest debate. It called on the CMA to “advocate for legislation for achieving universal coverage through a nonprofit unified financing system.” This was deemed a proactive approach to get rid of for-profit insurance companies and pre-authorization.
It was rejected because of the argument that it would limit how CMA could advocate for health care for all. However, one delegate said it best: “We should be reaching for the stars, not reaching for the floor.”
Over the last five years, California has committed to investing billions of new dollars into improving mental health services for all Californians across all delivery systems. The scope of these investments is sweeping, and implementation of many of the initiatives, along with growing the state’s mental health workforce, will take years to accomplish. Delegates heard from Diana Ramos, the newly appointed California Surgeon General who is also a long-time CMA member and delegate, about California’s efforts to improve and expand mental health care.
This year’s House of Delegates was a wonderful opportunity to connect in person with our colleagues. The lively debates and work of the House show that CMA and your Medical Societies are dedicated to improving the house of medicine and, therefore, our lives as a whole. All on the District XI Delegation are proud to serve you.
