President Obama’s wide range of proposals to address gun violence in the United States included a clarification that physicians should be allowed to discuss firearm safety with their patients.
The plan states, "Doctors and other health care providers also need to be able to ask about firearms in their patients’ homes and safe storage of those firearms, especially if their patients show signs of certain mental illnesses or if they have a young child or mentally ill family member at home."
The clarification was issued in response to recent concerns that the Affordable Care Act prohibited physicians from asking about firearms in the home. That is not true, according to the White House, which also added that "the administration will issue guidance clarifying that the Affordable Care Act does not prohibit or otherwise regulate communication between doctors and patients, including about firearms."
Several groups representing physicians, including the American Psychiatric Association, the American Academy of Family Physicians, the American Academy of Pediatrics, and the American College of Physicians, praised the administration’s initiatives.
"We are glad that the president has clarified that doctors are not prohibited from asking their patients about guns in their homes," Dr. Dilip V. Jeste, president of the APA, said in a statement. "The APA has consistently advocated for such a position."
In a statement, the ACP said that "state governments must also do their part, by not imposing restrictions on engaging in such discussions with their patients, as some state legislatures have attempted to do."
"Family physicians need to be able to have appropriate medical conversations with our patients about gun safety, and researchers need the ability to study gun safety," said Dr. Jeffrey Cain, president of the American Academy of Family Physicians (AAFP), in a recent blog post, calling for a broader recognition of gun violence as a public health issue.
Physician organizations also said they supported the President’s executive order directing the Centers for Disease Control and Prevention to study gun violence. In his remarks, the president said, "While year after year, those who oppose even modest gun safety measures have threatened to defund scientific or medical research into the causes of gun violence, I will direct the Centers for Disease Control to go ahead and study the best ways to reduce it."
In addition, the proposal seeks $10 million from Congress for CDC to research the relationship between video games, media images, and violence, and $20 million from Congress to expand the National Violent Death Reporting System to all 50 states.
As part of the gun control package, the president also issued executive orders seeking reviews of gun locks and other safety technologies. He is asking Congress to reinstate the assault weapons ban and to limit large-capacity ammunition magazines.
Congress also will have to approve several other proposals, including $55 million for a new initiative (Project AWARE), which covers teacher training and coordination of referrals to make sure students get mental health treatment, $25 million for state-based strategies to support young adults with mental health or substance abuse issues, and $25 million for student mental health services. The president also wants Congress to provide $50 million to train 5,000 mental health professionals who can target children and young adults.
The proposal also emphasized the need for parity of mental health coverage with medical and surgical health benefits, and noted that the administration intends to issue soon the final regulations for the Mental Health Parity and Addiction Equity Act of 2008. Parity will be further fleshed out under the essential benefits requirements called for by the Affordable Care Act, according to the proposal. A final rule on the essential health benefits package is expected in February.
"We are heartened that the administration plans to finalize rules governing mental health parity under the 2008 Mental Health Parity and Addiction Equity Act, the Affordable Care Act, and Medicaid," said Dr. Jeste of the APA. "We strongly urge the administration to close loopholes involving so-called ‘nonquantitative treatment limits’ and to ensure that health plans deliver a full scope of mental health services in order to comply with the law."
The ACP said that it also has long supported parity and increased access to mental health services, especially for young adults. The organization said in its statement that it "agrees on the urgency of adoption of policies that include these and other measures and is committed to being part of the change outlined by the president."