After a fruitful 2022, expect healthcare policymakers to focus on implementation

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Despite the usual partisan bickering and election year posturing, lawmakers had a productive year enacting healthcare policy in 2022.

“This previously had a crowded Congress, and a lot of it ended up happening,” says 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 prices and the approach to drug pricing in 40 years. By negotiating the drug price controls in this bill, you would fundamentally redesign how drug pricing works and how markets work around drugs medical”.

White shared his thoughts during The Year Ahead in Health Policy, a webinar Jan. 18 sponsored by the Commonwealth Fund. Speakers reviewed highlights of the past year, such as the expansion of public healthcare programmes.

“For the first time in a very long time, we’ve seen significant expansions of both Medicare and Medicaid,” says Melanie Nathanson, principal of the Nathanson + Hauck School. On the Medicare side, mental health professionals who were unable to participate in the program are allowed to participate for the first time.

“On the Medicaid side, we have a mandatory permanent expansion of eligibility for children for 12 months. It’s really hard to expand these programs, so this may seem small compared to the historic change in drug policy, but it’s really very big.”

Sabrina Corlett, a research professor at the Center for Health Insurance Reform at Georgetown University, expects the expansion of premium tax breaks in the Affordable Care Act to have a far-reaching impact.

“As a result, we’ve seen an unprecedented rise in enrollment in the Obamacare markets,” she says. “This may help people who have lost Medicaid coverage this year as a result of the expiration of continuing coverage requirements. If they are eligible to enter the market, it will make this transition much smoother.”

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

“There was a lot of ‘will/won’t they’ lead up to the blanket appropriations bill,” he says. “Many people were pleasantly surprised by the level of bipartisanship and the measures that were ultimately included. Optimism should not be overstated, but hopefully it bodes well for the next Congress in terms of being able to get some partisan work done.”

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

“I pity the regulators, because they are going to be busy in 2023, 2024, 2025 and into the future,” White says. “The drug pricing piece is the thing Congress is paying the most attention to. The main reason is that the law says the Department of Health and Human Services can enforce the law outside of the normal rulemaking process.”

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

“I think we’re going to see a lot of administrative activity on issues like public health and the ongoing response to COVID-19, and the continued work on access to mental health, reproductive health and prescription drugs,” LaRosa says. “We also look forward to seeing new CMS innovation center models that will focus on lowering drug prices.”

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

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

In my opinion, 118y “Congress will be less powerful legislatively,” Nathanson says. 117y Congress delivered a lot on healthcare in 2022, but I think healthcare will always be a point of discussion. There will always be bipartisan successes. There’s still a lot to see, but I feel really optimistic about members of Congress in both houses, on both sides of the aisle, continuing to have conversations and polish the pieces of health care legislation that aren’t being implemented.

“I remind everyone that it takes a long time to get meaningful bills done. Just because something doesn’t get done in one Congress, that doesn’t mean one has to give it up.”

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