Thought Leadership

Our wide array of published insights drive the debate in Washington.

Prospects for Drug-Pricing Reform Under a Biden–Harris Administration

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The Biden administration has put forward a new slate of policy priorities, but one remains from the prior administration: prescription drug pricing. Despite many attempts, the Trump administration largely failed to deliver sweeping drug-pricing reform. President Biden has set out to enact similar reforms for lowering drug costs and can capitalize on a Democratic majority in Congress. However, the administration may need to rely on a patchwork of policies, rather than comprehensive legislation to rein in drug prices....
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Support for States’ COVID-19 Response Efforts in the American Rescue Plan

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On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 (ARP) (P.L. 117-2) — the latest COVID-19 relief package and first one enacted by the current administration. Committing nearly $1.9 trillion, the law provides relief to American families that have lost jobs or lack affordable health insurance coverage during the pandemic. It also provides significant funding for states’ pandemic response efforts — something missing from previous relief measures — and for Medicaid programs....
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Advancing the Public Option in 2021: Leveraging Existing Federal Authority to Assist State Efforts

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Having consistently placed a federal public option at the core of his campaign’s health care platform, President-elect Biden will seek to deliver on this promise after he takes office. The term “public option” holds different meanings for different audiences, but usually refers to a new form of health insurance coverage that presents an alternative to existing commercial plans and includes a stronger government role in oversight and administration. The goal is to expand access to quality, affordable coverage...
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What’s Next for Health Care Policy Under a Biden Administration

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When President-elect Joseph R. Biden Jr. is sworn into office in January 2021, he will bring an ambitious health care agenda in the face of a thinly divided Congress. While control of the US Senate remains uncertain, we can begin to draw some conclusions about how President-elect Biden will prioritize the various aspects of his platform, the means by which he may pursue them, and their probability of enactment....
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Investing in Providers During the Pandemic: How Have Federal Dollars Been Distributed?

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The COVID-19 pandemic has wreaked havoc on the U.S. economy and put countless businesses at risk of failure. The health care industry has been hit particularly hard because of drops in revenue driven by decreases in elective care, stay-at-home orders, and the costs of preparing for a pandemic, such as increasing hospital capacity and purchasing personal protective equipment. Recognizing these challenges, and the critical role the industry plays, Congress and the U.S. Department of Health and Human Services (HHS) acted quickly to support the health care system and frontline workers in three primary ways: provider relief funds, the Paycheck Protection Program, and the Medicare Accelerated and Advance Payment Program....
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Democrats Will Adopt Their Health Care Platform Next Week — Here’s What It Says

After four years in the veritable wilderness of the Trump Administration and Republican-controlled Senate, Democrats have some pent up policymaking zeal to express. If Joe Biden succeeds in winning the presidency and the party takes control of the upper chamber, which polls suggest is within reach, they will have a wide avenue to institute these aspirations. Next week, the party will convene for its National Convention, primarily in virtual isolation, of course. Amid the made-for-TV, they will formally adopt the Party Platform that they preliminarily endorsed in late July....
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Washington Begins Horse Trading over Next Phase of COVID-19 Aid

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Negotiations in Congress over the next COVID-19 aid plan are expected to start after the July 4 break, and a package is likely to pass before Congress adjourns for the August recess. In total, we expect the bill to include up to $3 trillion in funding based on the House proposal, the HEROES Act. The Senate, House, and Trump administration proposals are starkly different, so the exact contents of the final legislation remain to be seen. The main political pull is essentially between those who want the aid to be mostly about funding economic recovery and those who would focus on boosting medical care and public health....
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The Benefits of Telehealth During a Pandemic — and Beyond

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Medicare began including telehealth as a benefit nearly 20 years ago, but has used it only on a limited basis. This was in large part because of statutory restrictions that limited coverage to rural beneficiaries who received care by certain practitioners in designated sites, which did not include the beneficiary’s home. Now, in the wake of the COVID-19 outbreak, policymakers are looking to telehealth as critical to ensuring that Medicare beneficiaries can still access care while reducing the risk of coronavirus transmission....
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You’re Doing It Wrong: What Changes In Medicaid And SNAP Reveal About The Trump Administration’s Investment In The Social Determinants Of Health

The Department of Health and Human Services (HHS) defines the social determinants of health as the “conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” The concept, which comes from the global public health field, is at its best when it is understood to encompass an individual’s social location—their race, ethnicity, sex, class, ability, orientation, culture, and how each of these identities impact them in their community context. It was created to identify and serve the most vulnerable among the world’s populations and to address the inequities that disproportionately impact their lives and their health. ...
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Five Reasons Medicare For All (Or Anything Like It) Won’t Pass In 2021

While conventional wisdom, and some presidential candidates, have already begun to temper these expectations, my goal here is to document five reasons why Medicare for All (M4All), Medicare buy-in, or federal public option legislation cannot pass in the near future. My hope, in doing so, is that we Democrats spare ourselves the precious time, internal acrimony, and political fallout that Republicans faced when their lofty ACA repeal promises went unfulfilled....
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CMS Releases Advance Notice For Medicare Advantage And Part D Plans

Last week, the Centers for Medicare & Medicaid Services (CMS) released Part II of its Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part D Payment Policies for Calendar Year (CY) 2021 (fact sheet). The agency also released its proposed rule on policy and technical changes to MA and Part D for CYs 2021 and 2022 (fact sheet). A press release for both developments is available here. This post focuses on summarizing the Advance Notice component of this package of policies....
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The Forecast for Legislative and Regulatory Activity on Health Care in 2020

As the impeachment trial has concluded with the acquittal of President Trump, Congress is now returning to some sense of normalcy. On the health care front, policymakers will need to secure a deal relatively quickly on top-priority issues like prescription drug pricing and surprise medical billing. The apparent deadline for final legislation in both regards is the May 22 expiration date of funding for several public health programs (e.g., community health centers), which many are eyeing as the last real opportunity for meaningful reform this year. Many doubt whether Congress will produce much after that date because of compressed schedules to accommodate party conventions and an extended recess in October. However, health care is in the forefront of voters’ minds. ...
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