Health policy forecast 2023: traffic jam with a chance of cooperation

With a Democratic president and slim majorities in the Senate and House of Representatives, how likely is federal health care policy to stall in 2023?

It depends on the question, said two experts who made their predictions in “What’s Next for Health Policy After the Election?” KFF sponsored the webinar with KFF Executive Vice President for Health Policy Larry Levitt and analysts Chris Jennings, Founder and President of Jennings Policy Strategies Inc., and Jennifer Young, Co-Founder and Partner of Consulting Tarplin, Downs & Young LLC.

Votes were still being counted when the online meeting began at noon on Nov. 15, and Georgians will have a runoff for a Senate seat, so exact splits were not available for the House of Representatives or the Senate. .

Regardless of the results, Young and Jennings predicted that federal lawmakers and the White House may make progress on some health issues, but others will stagnate.

TO THAT

Repeal and replacement of the Affordable Care Act is no longer the backbone of health care policy for congressional Republicans, Young said. It’s not a winning question and a Democratic president won’t sign it, she said.

The GOP’s Future of Health Task Force has members thinking about a positive, constructive, and proactive health care agenda “that lives in the realm of the doable rather than the hypothetical,” Young said. This group had the participation of caucus members to coalesce around the central themes of security for pandemic preparedness and supply chains; affordability, focused on transparency and competition; treatments, including research, development, innovation in medicine and access to medicines made in the United States; reduction in drug costs; electronic health records; preliminary authorisation; and modernization.

Common grounds

With Democrats barely controlling the Senate and Republicans controlling the House, issues such as mental health policies, opioid treatment programs, telehealth and technology are among the issues most likely to garner bipartisan support, Jennings said. Some members of the Senate may continue to advocate for the expansion of vision, hearing and dental care in Medicare, he said.

Possible traffic jam?

The election campaign was resentful, Levitt said, and both analysts called it a “stalemate.” He asked about the prospects for moving forward with bipartisan legislation.

“I think decent as long as people’s expectations are set correctly,” Young said. “You know, this isn’t going to be a Congress where you can achieve bold coverage goals in a bipartisan way.”

But Congress could buy time to analyze possible long-term solutions for the integrity and sustainability of the telehealth program, Young said. She agreed that bipartisan support could emerge for mental health support, changing Medicare payment rules for doctors and new drugs for Alzheimer’s disease.

Administrative action

Over the next two years, President Joe Biden’s administration will use its authority to pursue and promote its own agenda, Jennings said. When there is a polarized government and a perception of stagnation in Congress, the administration, the executive branch, pushes its agenda, regardless of party in the White House, he said.

The administration must address significant changes in Medicare benefits and design, restructure the ACA health insurance market extension, and eliminate or temporize the COVID-19 pandemic public health emergency. Expect drug companies to go to court, which will lead to actions by the judiciary, Jennings said.

Post-Hobbs issues

Levitt predicted little agreement on abortion rights by Democrats and Republicans. Young and Jennings predicted there might be bipartisan support for expanding Medicaid for the postpartum period, but there is a complication.

Some Republicans will be “very focused on any Medicaid money going to the states, (which) could displace existing state dollars that could then be used to fund their own support for choice-related issues,” Young said. “And I know it sounded convoluted as I explained it, because it’s inherently convoluted.”

Some Republicans will agree with an aggressive stance on abortion, but behind the scenes others will think the more aggressive rules don’t seem to be in line with what voters are saying, Young said. That likely won’t result in an immediate, dramatic pivot in party positioning, Levitt said. But as long as Republicans go too far on this issue, Democrats will try to take advantage of it, Jennings said.

Help with the COVID-19 pandemic

Between now and the next Congress, the outlook for additional federal spending on the COVID-19 response is slim, Jennings said, for a number of reasons:

• The public has complete exhaustion with COVID-19.
• People are ignoring almost all guidelines about the virus.
• The president indicated that the country is moving beyond COVID-19.
• There is federal money on the table for the COVID-19 response, which Republicans say has yet to be spent.
• The Lame Duck Congress usually doesn’t act until something absolutely has to happen, and there’s a bipartisan consensus.

“But that would be my unfortunate read,” Jennings said. “Although I believe the resources are needed and we regret the day we didn’t allocate resources for this, and I’ll say that for the record now. But it doesn’t look very good , seen the Congress.