With our nation welcoming a new president and federal administration, we should seize the opportunity to improve our health care system. At the Quality Institute, we work closely with our members, many of them on the frontlines of medicine, and we know how federal policies affect all of our efforts to improve safety, quality, and affordability of health care.
At our upcoming All Council Conference, Election Results 2020 Insider Briefing: Implications on Our Health Care System, we’ll discuss how the 2020 election will affect health policies including access, equity, transparency, and affordability. Quality Institute Board Member Rob Andrews, a former U.S. Representative and CEO of Health Transformation Alliance, will share his insights and I’ll continue the conversation by moderating a panel of experts that includes two Quality Institute Board Members and former New Jersey Commissioners of Health, Heather Howard and Dr. Shereef Elnahal, as well as Quality Institute Leadership Council Members Triste Brooks, President & CEO of Planned Parenthood of Northern, Central and Southern New Jersey and Michellene Davis, Executive Vice President & Chief Corporate Affair Officer of Robert Wood Johnson Barnabas Health.
There are sensible, impactful policy changes that President-elect Biden could implement immediately upon assuming office that do not require congressional approval — just political will. And there are needed changes that will take more time, consideration, and support from Congress. I am outlining my suggestions for change in this blog. Members and invited guests, I hope you join us at our conference, where we can discuss these and other issues critical to improving health care for everyone in the years ahead.
Here are my suggested policy changes that the Biden administration can implement on its own:
Approve pending Medicaid waiver requests. Several states, including New Jersey, have asked Medicaid to approve extending coverage for post-partum individuals from 60 days (the standard amount allowed under Medicaid) to six months to a year. These requests should be approved. Access to health care is critical in the first-year post-partum. This change would improve and save the lives of both new mothers and their babies.
Repeal the gag order on family planning at Title X funded facilities. This misguided regulation prevents health care providers who receive Title X funding from freely sharing comprehensive evidence-based reproductive health care information with their patients. Repeal will immediately improve care and support essential health care providers who serve individuals of limited means.
Strengthen the Affordable Care Act. The Biden administration must repeal administrative attempts to undermine the Affordable Care Act (ACA). These include allowing the sale of so-called “short-term health insurance” products that do not meet the requirements of the ACA. We need this and other changes to grow consumer trust and awareness and thereby strengthen the ACA. Eventually, hopefully, these changes will lead to a bi-partisan effort to improve the law more comprehensively.
Extend the Medicare payments for telehealth. Telehealth has enabled homebound residents, especially seniors and those with dependents at home, to continue to receive critical care during the pandemic. Medicare should continue to cover telehealth in the same manner as it has during the pandemic and should continue to include telephone-only telehealth for at least another year. Although we know that there is a digital divide that prevents large segments of our population from having access to high-speed internet with video capability, that should not be the basis to end this valuable approach to providing health care. Instead, we should implement means to ensure that it is effective, equitable, and patient-centric by measuring its outcomes and patient and caregiver satisfaction.
Continue the Drive Towards Greater Transparency. The current administration has started the push for price transparency across every sector of the health care system, from hospitals to pharmaceuticals to health plans. We now spend over $3.81 trillion dollars annually on health care. We all know that a portion of those dollars could be better spent on other things that keep people healthy such as consistent jobs, safe housing, clean air and water, and healthy foods. We must continue to pull back the curtain to see what is driving that spending and how to reduce it.
Here are policy changes that must be considered, but that will take longer and require Congressional cooperation:
End surprise billing on the federal level. New Jersey passed a surprise billing law, but the problem persists in ERISA plans, which are regulated by the federal government. Congress is weighing multiple and should pass one that protects the consumer and creates a method of negotiating the final claim to a reasonable amount — one that does not shock the conscience. Congressman Frank Pallone has been working across the aisle to get this done. Many states have found ways to rein in surprise billing and Congress needs to do the same.
Redesign Medicare and Medicaid to better support the elderly. We need to reassess what these two government programs cover to better support our elder communities. As seen in a pandemic, there are many advantages to keeping people in their homes, but Medicare generally does not cover the costs for care of teeth, hearing, eyesight, nutrition, or mobility – all things that are essential to living at home. Nor does it cover personal care. In addition, with two programs that have difficulty coordinating care and payments, the system creates coverage and payment gaps and perverse incentives. It is time to rethink the relationship and delineation between Medicare and Medicaid.
Enforce Laws, Expand and Continue Programs that provide access to behavioral health and substance use disorder treatment. We need to increase enforcement of mental health parity laws to ensure access to affordable, high-quality behavioral health services.
Substance use disorder, already at a crisis level before the COVID-19 emergency, has been increasing across the country in recent months. With dedicated and consistent funding for evidence-based treatment programs, as well as justice reform, including broader access and use of drug to move away from incarceration for drug use offenses, we can finally begin to address and treat the root causes of this disease.
The Biden Administration can increase federal investment in interventions for opioid use disorders, including Medication Assisted Treatment (MAT), which can be done in part by continued funding for investments started through the 21st Century Cure Act.
We have so much to discuss at our conference and as we move into a new year of work together. Please know you can reach out to me anytime.