Healthcare was a top issue in the 2020 elections and continues to be a priority for President Biden and his allies in Congress. In a recent webinar, members of our multidisciplinary healthcare team, Thora Johnson, Sarah Donovan, and Yardley Pollas-Kimble, addressed some of the questions that are top of mind regarding the potential changes in store for our healthcare system.
Q: What are some of the administration's priorities surrounding healthcare policy?
A: A chief priority of the Biden administration is to ensure that vulnerable groups have access to healthcare. Many individuals are still not aware of the healthcare plans available to them through the Affordable Care Act (ACA), so there has already been a big advertising and marketing outreach for ACA open enrollment. We are also likely to see some shoring up and enhancement of the ACA Plan, and to make any enhancements permanent. For instance, Biden's Health and Family Proposal builds on the ACA by improving access to affordable healthcare and lowering prescription drug prices. There is also a push in Congress to either revamp or eliminate short-term limited-duration insurance plans.
Another priority area for this administration is to address debilitating diseases and epidemics. This involves ensuring that the National Institutes of Health (NIH) have the funding necessary to conduct research into prevalent diseases such as cancer, diabetes, and Alzheimer's, or to address the opiate crisis. There is also a push to allow the Centers for Disease Control and Prevention (CDC) to address gun violence by treating it as a public health crisis. Finally, the administration is focused on addressing racial disparities in healthcare and is already directing resources to achieve equity in data collection for racial and ethnic populations and to reduce mortality and morbidity rates among minority populations.
Q: What has the Biden administration achieved so far in terms of advancing its healthcare goals?
A: The American Rescue Plan Act of 2021 (ARP) is the first piece of legislation to really address or enhance the ACA. Among its provisions are ACA enhanced subsidies for unemployment insurance (UI) recipients and for individuals with higher income levels; tax credit holidays and subsidies for individuals who have a qualifying life event (such as a job loss or a reduction in work hours); temporarily enhanced COBRA premium subsidies; fiscal incentives for states to expand Medicaid and benefits coverage; a temporary 5 percent increase in Federal Medical Assistance Percentage (FMAP) for states; short-term additional funds to states to enhance Medicaid services; and extended special open enrollment for the ACA.
Q: How likely is it that we will have a public healthcare option in the near future?
A: That is a question that is top of everyone's mind. All we know for sure is that during his election campaign, President Biden mentioned that he supported a public option, and there are some bills and proposals out there already. But it's not possible to say at this time whether any of these will come to fruition. It's also unclear whether a public option would be single payer or some version of Medicare for All.
Q: Is there likely to be any reform of the 340b drug pricing program?
A: The 340b drug pricing program requires drug manufacturers to provide outpatient drugs to certain eligible healthcare organizations at a reduced price. These include community healthcare centers, children's hospitals, and other entities that might need some financial assistance. Over the years, however, there have been claims (mostly from Republicans) that the program has expanded beyond its original intent – that it is now providing discounted drugs to contracted pharmacies and so on. So, there have been calls to restrict the program. It is so essential for safety net hospitals and similar entities, however, that it's unlikely that the program will be curtailed significantly under the Biden administration. But there will almost certainly be more oversight to ensure the program is fulfilling its intent.
Q: What is the likelihood that the Medicare eligibility age will be lowered?
A: During his presidential campaign, Biden proposed lowering the Medicare eligibility age from 65 to 60, and there have been some proposals since he was elected to bring the eligibility age down to 50. But these are just proposals for now, and we're not seeing a lot of buy-in from Congress so far on this issue. Lowering the eligibility age continues to be a priority for the progressive wing of the Democratic party, however, in addition to expanding Medicare to include vision, dental, and hearing so they are likely to keep the pressure on President Biden.