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HEALTH ACTION NETWORK - ADVOCATES FOR BETTER HEALTH CARE SOLUTIONS

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This Week in Health Care Reform: May 26th, 2017

Senate lawmakers take up the health care law replacement mantle; the Administration extends insurance subsidy payments; a new white paper advances market-based solutions to address rising drug prices; and, value-based programs are expected to grow.

Week in Review

Senate Efforts: In anticipation of the nonpartisan Congressional Budget Office (CBO) scoring the House-passed American Health Care Act (AHCA), Republican leaders in the Senate convened a series of health care working groups in an effort to piece together a replacement bill of their own that they hope can pass the upper chamber.  Wanting to avoid the tumultuous negotiations that it took to pass the AHCA in the House, lawmakers in the Senate have held a number of closed-door sessions in their ongoing efforts to find a legislative path forward, going so far as to gauge whether or not a bipartisan solution can be found.  It’s against this backdrop, that a vested group of stakeholders has made known its intent to be a vocal part of the discussion, as a group of about a dozen Republican governors have offered up their own platform envisioning what a replacement health care bill should look like.  As for that CBO score, it was released late Wednesday evening, triggering immediate backlash from opponents and supporters, alike.  Politics notwithstanding, there’s growing concern that the sheer volume of political capital being spent in pursuit of these efforts will leave little left for other legislative priorities.

CSR Extension: On Monday, the Administration, along with House Republicans, asked a federal court for a 90-day delay in a lawsuit that threatens the cost-sharing reduction (CSR) subsidies connecting some 7 million low-income Americans with their health care coverage.  Those subsidies are an integral component of the market stabilization efforts that health plans – who face looming deadlines ahead of their continued, planned participation in the health insurance exchange marketplaces – and other stakeholders are urging decision-makers to implement.  While the extension offered some relief, uncertainty continues to undermine the predictability that, absent a long-term commitment to CSR funding, experts caution is fundamental to the sustainability of the exchanges.

Rx Recommendations:
Last week, the Campaign for Sustainable Rx Pricing (CSRxP) held a policy briefing unveiling the latest white paper examining the conditions that have only served to set prescription drug prices on a runaway trajectory.  Prepared by health policy expert, Avik Roy, the paper lays out how federal laws and regulations are largely responsible for artificially driving up the cost of medicines.  Citing global statistics, Roy points out that per capita spending on drugs in the U.S. ($1,327) is close to double that of the next highest spender on the list (Japan at $783).  He goes on to propose a handful of market-based reforms to not only bring down prices, but preserve innovation, as well, including streamlining regulations for biosimilar drugs and the continued push towards a more consumer-driven health care system.

Value-Based Design:
A new survey highlights the growing trend in value-based design currently reshaping our health care delivery system.  Performed by HealthLeaders Media, the analysis suggests that the number of patients in value-based programs could double in three years’ time (from 26 percent today to 52 percent by 2020).  The findings are consistent with what’s already being reported, as stakeholders continue to highlight the ways in which their focus on value-based care is transforming consumers’ relationship with their health care.      

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Looking Ahead

With the CBO score having been released, legislative next steps regarding the health care replacement bill can begin in earnest.  As lawmakers in the House and Senate work to reconcile their respective efforts, a growing chorus of stakeholder voices continues to offer up one way that policy-makers can offer up immediate relief for small business owners, middle class families, and seniors, namely, by abolishing the health insurance tax.
                                            
                                            

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