Opportunities for bipartisan healthcare reform, no matter who wins the election

Capitol Building on Capitol Hill

Healthcare policy put both candidates on the hot seat in the second presidential debate. Hillary Clinton maintained that she wants to build on the Affordable Care Act with a public option and Medicare-for-more, while Trump said he advocates for a repeal and replace of the ACA.

Regardless of which candidate is elected, however, there still is plenty of room for advances in healthcare reform. An article posted to the Health Affairs Blog examines three tiers of likelihood on bipartisan cooperation as it pertains to health policy, including:

Areas of routine business:

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  • The Children’s Health Insurance Program (CHIP) requires reauthorization, as it is set to expire in the second half of 2017. CHIP will likely feature debate about changes in funding and how long to extend the program, according to the authors.
  • The government will need to extend certain Medicare provisions, such as increasing Medicare payments to certain low-volume and rural doctors and hospitals.

Areas with bipartisan momentum:

  • The sitting Congress has cultivated “significant” bipartisan support for the 21st Century Cures Act, which could accelerate the transfer of advances in genetics to improved patient prescription treatments by shortening FDA approval time. Critics argue the legislation could result in less effective medications reaching the consumer market, but if the Senate can work out issues with financing new NIH research, the Cures act could pass during Congress’ lame-duck session, FierceHealthIT has reported.
  • Congress could encourage greater use of telehealth services by lifting certain regulatory barriers for qualifying participants in alternate payment models and Medicare Advantage. The Department of Health and Human Services has solidified the tie between telehealth and alternate payment models, especially among Medicare Advantage providers. 

Areas with bipartisan potential:

  • Congress could drive prescription drug costs down without stifling innovation by focusing on value-based payment strategies, especially for patients with multiple chronic conditions. This strategy has picked up steam in the private sector, exemplified by Aetna and pharma giant Merck recently agreeing to an outcome-based payment model for two type 2 diabetes drugs.
  • Providing consumer incentives as part of value-based insurance design models could be aligned “to maximize health system transformation,” the authors note.
  • Congress could move on a bill to foster competition among pharmaceutical manufacturers. Mylan has had little competition for its EpiPen, for example, and the consumer coupons the company hands out could lead to higher costs for payers.

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