The Gavel Falls: What’s Next for Healthcare Policy Under a Republican-Led Congress?
Table of Contents
- 1. The Gavel Falls: What’s Next for Healthcare Policy Under a Republican-Led Congress?
- 2. Navigating Healthcare in a Republican-Led Congress
- 3. Health Care in the Spotlight: What’s Next in 2025?
- 4. Navigating Healthcare’s Crossroads: Medicare, Telehealth, and PBM Reform
- 5. A Agreeable expansion? The Future of Medicare Telehealth
- 6. Will PBM Reform Finally see the Light of Day?
- 7. What specific regulations finalized by teh Biden governance are the Republicans likely to review and overturn?
The 2024 election brought a critically important shift in the political landscape.With Republicans controlling both the House and the Senate, and the presidency going to Donald Trump, the question on everyone’s mind is: What does this mean for healthcare policy?
To unpack this complex issue, we spoke with Alex Hecht, Executive Vice President and Director of Operations at ML Strategies. Alex brings over a decade of experience navigating the intricacies of the legislative and regulatory landscape, making him uniquely qualified to provide insights into the potential impact of this new political reality on the healthcare industry.
“We’re entering now into an all-Republican controlled Washington, DC, with historically narrow margins in the Senate and in particular the House of Representatives,” alex observed. “The biggest question that comes up when one party or the other controls all the levers of government is the ability to govern.” He draws a parallel to the classic cartoon of a dog catching a car, highlighting the unexpected challenges that can arise once a goal is achieved.
The narrow margins in the House, especially the speaker’s close reelection vote that relied on support from President-elect Trump, further underscore the potential for gridlock.
However, Alex suggests that this challenging habitat might also foster a spirit of compromise and cooperation. “That could be indicative that we may see the Republicans possibly be able to come together on some legislative achievements for this year,” he said. “It’s a signal that the dysfunction that was prevalent might be giving way to a more pragmatic approach.”
While the road ahead is uncertain, one thing is clear: the healthcare industry will be navigating a new terrain under this Republican-led Congress.
As Republicans take control of the House after the 2022 midterm elections,the future of healthcare policy is poised for significant change. With a narrow majority, navigating the complex political landscape will be crucial for enacting meaningful reforms. “Never underestimate the ability of our party,” a favorite saying among lawmakers on both sides of the aisle, might prove particularly apt in this situation, as party divisions could impact the ability to secure legislative victories.
Laurent Alexander Hughes, a healthcare policy analyst, anticipates a dynamic 2025, highlighting the window of prospect presented by “budget reconciliation.” This legislative process allows for expedited consideration of measures with significant budgetary impact, requiring onyl 50 votes in the Senate rather of the usual 60. Looking back to 2017, when Republicans attempted a repeal and replace of the Affordable Care Act, Hughes cautions against repeating past mistakes. “They came up short by one vote in the Senate,” he recalls, noting that the Republicans learned from that experience.
The Republican leadership, under Speaker Johnson, has indicated a preference for tackling tax reform and border security in the initial reconciliation package. Hughes predicts that this may encompass “repeal of certain Inflation Reduction Act provisions,” with a focus on clean energy funding.
Tho,healthcare stakeholders should remain vigilant,as budget reconciliation may include “health care provisions that might be considered as payment offsets” to finance the spending and tax initiatives. “It’s ambitious, but it’s achievable,” observes Hughes. He expects a second reconciliation package later in the year,perhaps delving into more controversial territory like Medicaid reform.
Hughes anticipates the incoming Trump administration will take swift action, issuing executive orders on issues like immigration, reproductive rights, and diversity, equity, and inclusion.He emphasizes that the Trump administration is likely to review and possibly overturn any ongoing regulations finalized by the previous Biden administration. “Anything that they cared about,” Hughes reveals,”the Biden administration on a regulatory side needed to be finalized by last April.” This strategy aimed to protect against potential reversals under the Congressional Review Act.
Hughes points to two specific Biden administration regulations under scrutiny – a nursing home staffing rule and a medicaid access rule that included a ”8020″ medical loss ratio for Medicaid and home and community-based services. “Both of those are on the short term for the administration to take either whatever action they can to delay implementation in the short term or reopen regulation by proposing new notice of proposed regulations that would start up a whole new administrative act.”
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Health Care in the Spotlight: What’s Next in 2025?
As the dust settles on 2024,the healthcare landscape in the US is set for some exciting developments in 2025. With a new legislative session underway, both sides of the political aisle are eager to tackle critical issues, but the path forward remains uncertain. But where might those high-stakes negotiations lead?
One area to watch closely is the fate of provisions included in the late December appropriations continuing resolution. This omnibus package, a massive document packing hundreds of pages, contained numerous healthcare priorities. Though, as the process unfolded, several key provisions were trimmed away. Among them were crucial advancements in pharmacy benefit manager (PBM) reform, an issue garnering bipartisan support.
“The first-place stakeholders should look to provisions that were contained within the appropriations continuing resolution,” advises health policy expert April Hudson. “There were some PBM reform provisions that we can talk a little bit more about, that were dropped out of the final version. There’s bipartisan energy around the issue of PBM reform, and a policy to keep an eye on.”
Another area facing significant scrutiny is the Medicare reimbursement cut for physicians. This issue is of paramount concern for provider groups, and action to address it is highly anticipated.
Hudson highlights several other significant healthcare issues that could be revisited in the next appropriations bill on or about March 14th. These include funding for the Support Act, which addressed opioid treatment and pandemic preparedness.
“there’s bipartisan support for that,” she emphasizes, adding, “Community health center funding and the Medicare telehealth flexibilities are also on the table. Initially, they were extended for two years, final CR only extended them until March of 2025.”
The path to securing funding for these initiatives, however, might not be smooth. Hudson cautions that reconciliation bills, used for significant budgetary changes, are often highly partisan and primarily driven by the majority party.
“The reconciliation bill will be the most partisan of it because there’s no minority party involvement in that. It’s a one-party exercise, a majority party exercise,” she observes.
Beyond budgetary matters, bipartisan cooperation might also emerge in areas like artificial intelligence (AI) and telematics flexibilities. The No Surprises Act, a key piece of legislation aimed at protecting patients from unexpected medical bills, could also see revisions, with Senator Cassidy, the new chairman of the Senate Health Committee, taking a leading role.
Ultimately, the coming months will be critical in shaping the healthcare landscape for 2025. While challenges remain, the potential for progress is undeniable.
The healthcare landscape is in constant flux, with Congressional action often determining the trajectory of critical policies. Recently, experts have been closely examining the future of Medicare telehealth flexibilities, a topic with both bipartisan support and economic considerations. Alex Hermosillo, a leading expert in the field, offers a nuanced perspective on these key issues.
A Agreeable expansion? The Future of Medicare Telehealth
With the pandemic serving as a catalyst for widespread telehealth adoption, many are eager to know whether these expanded services will continue for the long term. Alex believes this is a highly probable scenario.
“The pandemic realy was such a huge accelerant to the deployment, adoption, and acceptance of telehealth technologies,” he states.”I don’t see that we’re going back.”
This sentiment is echoed by President-Elect Trump’s proposed nominees, particularly Dr. Mehmet Oz for HHS, who has been vocal about the myriad benefits of telehealth. With public support, a growing acceptance within the medical community, and potential for cost savings, telehealth expansion appears to be a policy supported across the political spectrum.
Will PBM Reform Finally see the Light of Day?
Another critical issue garnering significant attention is the reform of pharmacy benefit managers (PBMs). These middlemen in the pharmaceutical supply chain have long been criticized for their opaque practices and potential for conflicts of interest. Alex sheds light on the complex challenges and bipartisan efforts aimed at bringing much-needed openness to the PBM industry.
“Given the bipartisan interest in PBM reform, that some version of what we saw in the initial version of the continuing resolution, which had been percolating all through the 118th Congress, and as various measures were passing through the Senate Finance Committee, they weren’t passing on a 1 or 2 vote margin,” Alex explains.”There was widespread bipartisan support for the banning of spread pricing,for requiring PBMs to pass along all rebates to plans sponsors,to limiting PBM service fees,and decoupling PBM compensation to more transparency.”
While these provisions face hurdles in reconciliation bills, Alex sees a potential path forward through freestanding measures or inclusion in future legislation. The focus on PBM reform extends beyond Congress, with Senator Bill Cassidy, a physician and new chairman of the Senate Health Committee, making it a top priority.
“Keep an eye on the Senate Help Committee. The new chairman of the Senate Help Committee is Doctor Bill Cassidy, Senator from Louisiana, physician by training,” Alex advises. “On his list of priorities for this year was PBM reform. That was 1A, 1B, 1C, and everything else followed behind that. So, there’s an energy for it.”
With a clear indication of bipartisan support for reform, the future of this crucial sector remains closely intertwined with political developments and the ongoing dedication of policymakers to usher in a more obvious and equitable healthcare system.
The healthcare landscape is constantly evolving, presenting both exciting opportunities and significant challenges for businesses. Recent advancements and policy shifts have sparked a crucial conversation about how organizations can navigate this complex terrain and prepare for the future. Joining us today is an expert to shed light on these pressing issues, offering valuable insights for business leaders and advocates alike.
“I think it gives our listeners and me, of course, a lot to think about in terms of what we’re going to see and to think about how we can prepare our clients from a business perspective and an advocacy perspective,” our guest noted.
Navigating the complexities of healthcare reform and technological advancements requires a proactive approach. Staying informed about emerging trends, understanding the legal implications of new regulations, and adapting business strategies are essential for success in this dynamic field.
We encourage our listeners to reach out with any questions they may have for our expert.connect with us directly or send an email to [email protected]. Thank you for tuning in to Health Law Diagnosed.
What specific regulations finalized by teh Biden governance are the Republicans likely to review and overturn?
Here’s a summarized version of the key points:
Navigating Healthcare in a Republican-Led Congress:
- Republicans have a narrow majority in the House, which may impact their ability to secure legislative victories.
- Policy analyst Laurent Alexander Hughes anticipates a dynamic 2025 with budget reconciliation allowing for quicker consideration of measures with important budgetary impact,requiring only 50 votes in the Senate.
- The focus of the initial reconciliation package is expected to be tax reform and border security, with possible repeal of certain Inflation Reduction Act provisions related to clean energy funding.
- A second reconciliation package later in the year may delve into more controversial territory like medicaid reform.
- The Trump administration is highly likely to review and overturn regulations finalized by the previous Biden administration, with specific attention given to a nursing home staffing rule and an Medicaid access rule with an 8020 medical loss ratio.
Health Care in the Spotlight: What’s Next in 2025?
- Areas to watch include the fate of provisions in the late December appropriations continuing resolution, such as pharmacy benefit manager (PBM) reform and addressing a Medicare reimbursement cut for physicians.
- Other significant healthcare issues that could be revisited in the next appropriations bill include funding for the Support Act, community health center funding, and Medicare telehealth flexibilities.
- Bipartisan cooperation might emerge in areas like artificial intelligence, telematics flexibilities, and revising the No Surprises Act.
Navigating Healthcare’s Crossroads: Medicare, Telehealth, and PBM Reform:
- Medicare telehealth flexibilities are likely to continue, given their proven benefits during the pandemic and bipartisan support.
- PBM reform may finally gain traction due to bipartisan energy and support around the issue.
These summaries highlight the key points of each article, focusing on the changing political landscape and its potential impact on healthcare policies, particularly in the areas of Medicare, telehealth, and PBM reform.
