Regardless of who wins the elections in November, there are likely three issues that are going to dominate the (non-COVID-19) healthcare debates in Congress next year.
The top of that to-do list? Surprise billing reform, drug pricing reform and preexisting condition protections, according to Drew Voytal, associate director of government affairs for the Medical Group Management Association (MGMA).
"These should look familiar because they were hot discussion topics prior to when COVID really barged its way in and really dominated the conversation in the work of Congress right now," Voytal said, speaking at MGMA's annual conference on Monday.
Each of these issues has at least some bipartisan support and MGMA expects those discussions to return to the agenda in 2021, Voytal said.
RELATED: 3 ways a Biden White House could impact healthcare
That was among the observations government relations experts told medical practices to be on the lookout for in the coming months.
Among other issues to watch:
Future of the ACA: With the potential confirmation of a Supreme Court Justice on the horizon, the ramifications for the Affordable Care Act (ACA) should be closely watched as the top court prepares to consider the constitutionality of certain parts of the ACA in November. A ruling is expected in mid-2021, said Matt Devino, associate director of government affairs for MGMA.
It's important for the obvious impacts on eligibility for health coverage and minimum standards for private insurance, Devino said. But there's also the fact that the ACA created the Center for Medicare and Medicaid Innovation, or CMMI, which is the innovation arm of the Centers for Medicare & Medicaid Services that has led many of the payment models for value-based care.
"There is a lot at stake with this Supreme Court decision and why we're watching it rather closely," Devino said. "The question being, if the ACA were to go away, what happens to CMMI, and what happens to the future of value-based care?"
"Status quo" versus "Blue Wave": The two policy experts examined four scenarios for physicians groups, including one in which President Donald Trump wins reelection and Republicans maintain control of the Senate, a scenario they called "status quo." In that scenario, providers should expect CMS to continue its focus on its "Patients over Paperwork" initiatives and to take a limited approach to expanding access when it comes to health reform, Voytal said.
Should there be a "Blue Wave," which they defined as former Vice President Joe Biden winning the presidency and the Democrats flipping the Senate while retaining control of the House?
There is opposition for a single-payer or Medicare for all system, but there would be continued support for value-based care, he said.
If Trump wins and the Democrats have control of Congress or if Biden wins and Republicans have control, expect a lot of gridlock, they said. In the former scenario, there would likely be a focus on initiatives by CMS, but little would likely happen legislatively.
Meanwhile, in the latter scenario: "Major healthcare reform would be stalled again because the Senate would be under the control of Republicans and there would have to be major compromises between the two parties," Voytal said.
The one place where there might be some change? "Vice President Biden, if he's elected, would look to continue value-based care but would seek to stand out from past approaches from the Trump administration. So you could look for novel approaches," Voytal said.
