When President Biden signed the Dr. Lorna Breen Health Care Provider Protection Act on March 18, it was a bittersweet moment for all involved. It marked the culmination of two years of persistent advocacy to prioritize physician mental health, but the triumph of passing the bill is impossible to separate from the tragedy of losing Dr. Breen – a sister, a daughter, a friend, and an emergency physician colleague. Still, this law that carries her name is an important step to protect emergency physicians whose emotional health and wellbeing suffered even before this prolonged pandemic, and it helps preserve the memory and legacy of Dr. Breen and other health care providers who have suffered in silence.
From start to finish, ACEP was deeply involved in the process – helping develop the legislative language, pushing it through the legislative process, hosting hundreds of meetings with legislators during LAC21, persistent grassroots outreach by ACEP members, and collaborative efforts with other health care provider groups and the Dr. Lorna Breen Heroes’ Foundation, this legislative victory is a testament to our collective voice. Throughout this bill’s journey, your voices were heard.
Now that the bill crossed the finish line, let’s retrace the path of the race.
|MARCH 18, 2022||
President Biden signed H.R. 1667 into law.
|FEBRUARY 17, 2022||
The Senate approved H.R. 1667 by Unanimous Consent, clearing the measure to be sent to the President for his signature.
|DECEMBER 9, 2021||
The full House of Representatives passed H.R. 1667 in a bipartisan 392-36 vote. As a result of the changes made by the House to H.R. 1667, the Senate was then required to vote on the House-passed bill one final time.
|DECEMBER 7, 2021||
As the end of the year approached, Congress was faced with a number of significant, time-sensitive priorities all colliding at the same time, including the need to avert a nearly 10 percent cut to Medicare payments. Needing a legislative vehicle to help clear some wonky procedural hurdles, the House used the Senate-passed S. 610 bill, amending it by stripping out the entirety of the text of the Lorna Breen Act and replacing it with the Medicare fix (and some other provisions). They renamed the legislation the “Protecting Medicare and American Farmers from Sequester Cuts Act,” approved it, and sent it back over to the Senate for approval. Thankfully, our House bill was still in play.
|NOVEMBER 4, 2021||
The House Committee on Energy and Commerce held a legislative markup of nine health care bills, including the House version of the Lorna Breen Act (H.R. 1667). The Committee made some slight changes to the legislation to help align it with the Senate bill and incorporated some minor technical changes.
|AUGUST 6, 2021||
The full Senate approves S. 610 under Unanimous Consent! This was a huge step, generating a lot of momentum for the legislation.
ACEP then turned its focus to pushing for the House to take up S. 610. This is where it got tricky – (in most cases) the exact same bill needs to be approved by both the House and the Senate. Because the Senate bill underwent some carefully-negotiated, but relatively minor, changes before its unanimous approval, ACEP encouraged the House to consider the Senate version to ease its pathway to enactment. However, the House Energy and Commerce Committee had their own considerations they wanted to address and chose to consider the House version of the bill, H.R. 1667, instead. Unfortunately, this meant that even if passed by the House with minor changes, H.R. 1667 would still need to go back to the Senate for approval.
|JULY 25-28, 2021||
ACEP hosted its Leadership & Advocacy Conference, bringing members together for an in-person meeting for the first time since the beginning of the pandemic. Generating support for both the House and Senate versions of the Breen bill (H.R. 1667 and S. 610) was a primary focus of our meetings with legislators. ACEP members conducted 287 meetings with legislators and staff from 44 states, giving firsthand perspective on physician mental health concerns. These testimonials are so important; they remind legislators and staffers that this issue is not just about politics – it’s a real problem that affects real people. And just days later…
|JULY 16, 2021||
The Health Resources & Services Administration (HRSA) opened the grant application process for the health care provider mental health programs via the funding provided by the American Rescue Plan Act.
|MAY 25, 2021||
The Senate Health, Education, Labor, and Pension (HELP) Committee passed committee markup by a unanimous voice vote. Sen. Kaine specifically thanked ACEP for our efforts during the committee hearing.
|MARCH 11, 2021||
In a very unique development, the American Rescue Plan Act of 2021 (P.L. 117-2), a $1.9 trillion COVID-19 relief package passed by Congress through the “budget reconciliation” process, appropriated $140 million for provider mental health grants and education campaign funding under the Breen bill framework.
Why was this unusual? Congress typically passes authorizing legislation and then appropriates funding afterward. In this case, funding came first, but ACEP continued working to get the authorizing legislation passed that would provide additional guidance and clarity on how the funds should be distributed. Plus, the bill included a study regarding health care professional mental health and burnout and barriers to seeking appropriate care, provisions that were not eligible to be included under the budget reconciliation rules.
|MARCH 8, 2021||
The Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667) was reintroduced in the House by Reps. Susan Wild (D-PA), David McKinley (R-WV), Raja Krishnamoorthi (D-IL), Fred Upton (R-MI), Judy Chu (D-CA), Morgan Griffith (R-VA), Haley Stevens (D-MI), John Katko (R-NY), and others.
|MARCH 4, 2021||
The Dr. Lorna Breen Health Care Provider Protection Act (S. 610) was reintroduced in Senate of the 117th Congress by Sens. Tim Kaine (D-VA), Todd Young (R-IN), Jack Reed (D-RI), Bill Cassidy (R-LA), and others.
|AUGUST 22, 2020||
The Dr. Lorna Breen Health Care Provider Protection Act (H.R. 8094) was introduced in the House by Reps. Max Rose (D-NY), David McKinley (R-WV), Anthony Brindisi (D-NY), Denver Riggleman (R-VA), Gil Cisneros (D-CA), Morgan Griffith (R-VA), and Fred Upton (R-MI).
Ultimately, the legislation was not considered by the relevant committees, nor was it included in any of the COVID-19 relief packages or any other legislation that passed during the remainder of the 116th Congress.
|JULY 29, 2020||
The Dr. Lorna Breen Health Care Provider Protection Act (S. 4349) was introduced in Senate of the 116th Congress by Sens. Tim Kaine (D-VA), Todd Young (R-IN), Jack Reed (D-RI), Bill Cassidy (R-LA). ACEP staff helped secure specific legislative language to ensure health professional organizations (like ACEP) were eligible for grants to promote mental health among the health care professional workforce.
ACEP continues to work on the issue of mental health for patients and for health care workers alike on both the legislative and regulatory fronts. We are working with Senator Kaine on what he envisions as “Breen 2.0” to address some of the other lingering challenges affecting health care workers and how they seek and access mental health care treatment, and we continue working with various congressional committees that have recently turned their focus to the nation’s mental health crisis as well.
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