After a productive year in 2022, healthcare policymakers expected to focus on implementation

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Despite the usual partisan bickering and election year, legislators had a productive year enacting health care policy in 2022.

“This has been a busy convention in the past and a lot happened,” said Joel White, president and CEO of Horizon Government Affairs. “I would say the most important thing was the Inflation Reduction Act. That was the biggest change in drug pricing and the approach to drug pricing in 40 years. With the negotiated drug price controls in that law, it will fundamentally redesign the way drug pricing works and how markets work around prescription drugs.

White shared his insights during The Year Ahead in Health Policy, a Jan. 18 webinar sponsored by The Commonwealth Fund. Panelists discussed highlights of the past year, such as the expansion of public health care programs.

“For the first time in a very long time, we saw significant expansion for both Medicare and Medicaid,” said Melanie Nathanson, director at Nathanson+Hauck. “On the Medicare side, mental health professionals who otherwise could not participate in the program can participate for the first time.

“On the Medicaid side, we have a mandatory permanent extension of 12 months of continuous eligibility for children. It’s very difficult to expand these programs, so that might seem small compared to a groundbreaking change in drug policy, but it’s really quite big.”

Sabrina Corlette, a research professor at the Center on Health Insurance Reforms at Georgetown University, expects the expansion of premium discounts in the Affordable Care Act to have far-reaching consequences.

“As a result, we’ve seen unprecedented enrollment in the Obamacare marketplaces,” she says. “This may help people who lose Medicaid coverage this year due to the end of the continuous coverage requirement. If they qualify for the marketplace, that transition will be much smoother.”

Josh LaRosa, policy director at Wynne Health Group, was impressed by Congress’ ability to come together on a variety of policy issues.

“There was a lot of ‘do they want/don’t they want’ leading up to the omnibus credit law,” he says. “Many people were pleasantly surprised at the level of bipartisanship and the measures that were eventually included. Not to be overly optimistic, but hopefully bodes well for the next Congress in terms of their ability to deliver some bipartisan work. “

Now comes the difficult part of actually implementing this new legislation.

“I feel sorry for the regulators as they have a busy 2023, 2024, 2025 and beyond,” says White. “The piece on drug pricing is the thing that Congress is paying the most attention to. The main reason is that the law says the Department of Health and Human Services can implement the law outside of the normal regulatory process.

The Biden administration has several issues on its agenda for 2023.

“I think we will see a lot of governance activity on issues like public health and the ongoing response to COVID-19, and continue to work on access to mental health, reproductive health and prescription drugs,” says LaRosa. “We are also looking for new models from the CMS innovation center that are aimed at driving down drug prices.”

Much of the work ahead will be done behind the scenes.

Read more: Divided Congress likely to lead to incremental health care policy changes

“In my mind, the 118e Congress will be less legislatively robust,” says Nathanson. “The 117e Congress did a lot on health care in 2022, but I think health care will always be a talking point. There will always be twofold successes. There’s still a lot to see, but I feel really optimistic about members of Congress in both chambers, on both sides of the aisle, continuing to have conversations and refining pieces of health care legislation that haven’t been implemented

“I remind everyone that it takes a long time to get meaningful bills done. Just because something is not done in one congress does not mean that one should give it up.”

After a productive year in 2022, healthcare policymakers expected to focus on implementation

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