Thought Leadership

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

Which Key Health Care Issues Warrant Strong Consideration by Congress in a Year-End Spending Package?

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The midterm elections are behind us, and a lame duck session in Congress is here. What health care elements remain on the 2022 agenda? High-priority issues include: telehealth expansion, physician payments, changes to Medicare Advantage to help patients get more timely care, and certain Food and Drug Administration policies. In this blog post, we highlight policy areas key to supporting health for people with lower incomes that warrant strong consideration for inclusion in a year-end spending package....
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What Recent State Elections Mean For Health Care

While most eyes focused on control of the U.S. Congress and, in our world, what that means for health policy, a wide array of election outcomes at the state level will have a meaningful impact on access and care delivery for many years to come. Here we examine changes to state health policy in some key domains: Medicaid, access to abortion services, and health care costs. With Washington DC facing two years of legislative gridlock, implementation of these state-level developments – and new ones assuredly to come – will likely have as big of an impact on the quality of care that Americans receive than anything coming out of D.C....
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Making Prescription Drugs Affordable: Options for the Center for Medicare and Medicaid Innovation

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CMMI’s statutory directive to test models that improve health outcomes, quality, or costs makes the agency a natural partner in this effort. In addition, CMMI’s recent focus on increasing health care affordability aligns with the administration’s focus on lowering Medicare beneficiaries’ copayments for prescribed drugs, which often depend on their list price rather than the net price. The latter includes manufacturer rebates and is the price that payers pay for drugs. Below, we review a range of approaches CMMI could consider in order to reduce drug spending that include: 1) new models, 2) revisiting previous proposals, and 3) adjustments to existing models...
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Here Are Key Mental Health Provisions in the Bipartisan Safer Communities Act

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While advocates are pleased to see new funds authorized for mental health services, they worry that including it in this package reinforces the misconception that most gun violence is perpetrated by people burdened with mental health problems. The reality is that people with mental illnesses are more likely than other people to be victims of firearm violence rather than perpetrators. Only 3% to 5% of violent acts are committed by people with serious mental illnesses, such as schizophrenia, bipolar disorder, or major depression. Here we discuss key investments and policies contained in the gun safety law....
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To Promote Equity, Include These Key Provisions In Upcoming Nutrition Legislation

Federal nutrition programs reduce food insecurity and are critical to the health and well-being of one in four Americans each year, including nearly one in three children younger than five. These programs are especially important in the wake of COVID-19. Before the pandemic, food insecurity was higher among households near or below the poverty line, households with children, Black and Latino households, and households in large cities or rural areas. The pandemic increased food insecurity and other measures of food hardship, especially for Black and Hispanic households....
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What Is Congress Doing to Advance Behavioral Health Reform?

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In light of the well-documented mental health and substance use crisis and the exacerbating effects of the COVID-19 pandemic, congressional policymakers are considering a range of behavioral health policy reforms....
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President Biden’s Executive Order Protecting Access to Reproductive Health Services

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Two weeks following the Supreme Court’s Dobbs decision overturning Roe v. Wade, President Biden released an executive order (EO) mapping his administration’s planned response. The EO directs the U.S. Department of Health and Human Services (HHS) and other federal agencies to undertake actions to protect health care service delivery and promote access to reproductive health care services, including contraception and abortio...
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Biden Administration Outlines Comprehensive Equity Action Initiatives

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Several hours after taking the oath of office, President Joe Biden signed an executive order directing the federal government to advance racial equity and support for people of color and others who have been historically underserved, marginalized, and harmed by persistent poverty and inequality. The order affected more than 90 federal agencies, including the Department of Health and Human Services (HHS) and the Department of Housing and Urban Development (HUD). Each agency then assessed whether its programs and policies perpetuate systemic barriers to opportunities and benefits for people of color and other underserved groups, and whether new policies, regulations, or guidance documents will be needed to advance equity. These assessments informed the development of Equity Action Plans, released by the White House last month, that outline concrete strategies and commitments to address systemic barriers across the federal government....
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Biden Lays Out His Health Policy Agenda

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When President Joe Biden delivered his first State of the Union (SOTU) address to the nation recently, it was intended to tout legislative accomplishments and present his policy priorities and solutions. With Biden’s approval rating currently around 42%, the SOTU provided the president an opportunity to build public confidence in the administration’s ability to govern and address ongoing challenges — primarily the COVID-19 pandemic, the Russian invasion of Ukraine, and rising inflation. Throughout the March 1 speech, the president highlighted an array of health-related priorities, including proposals in the Build Back Better Act (BBBA) (H.R. 5376) currently stalled in the narrowly divided Senate. He discussed the administration’s updated COVID-19 response, measures to lower the cost of prescription drug prices and Affordable Care Act (ACA) coverage, strategies to address the mental health crisis, plans to improve the quality of care at nursing homes, and his renewed Cancer Moonshot initiative....
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Avoiding the Cliff: Medicare Coverage of Telemental Health and the End of the PHE

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The end of the COVID-19 public health emergency (PHE), currently scheduled for April 16, will affect the continuation — or expiration — of temporary Medicare flexibilities, including the expansion of telehealth. During the pandemic, Medicare beneficiaries have had access to a wide range of telehealth services, including telemental health, and uptake has increased substantially. Unfortunately, once the PHE ends, the authority for these flexibilities will no longer be in effect, meaning that many beneficiaries will lose access to services. Federal action to temporarily extend the current telehealth waivers would allow policymakers time to study whether they should make permanent changes regarding telemental health care coverage....
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Bolstering the Public Health Infrastructure in the Wake of COVID-19

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The COVID-19 pandemic has highlighted the impact of the chronic underfunding of the U.S. public health system. Despite research showing that investing in public health leads to better outcomes and calls for greater investment in public health, per capita spending before the pandemic totaled less than 3 percent of total health care spending. Here we describe federal policies currently under consideration as part of the Build Back Better Act (BBBA) that could address these concerns....
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Key Provisions of Drug Pricing Proposals

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As federal attention begins to turn again to the cost of prescription drugs, the 117th Congress has introduced and reintroduced a number of bills aimed at drug pricing reform. The provisions included in the current slate of bills mirror those that appeared in the previous legislative session, and would seek to reduce drug prices by enacting changes along the following dimensions: Drug price negotiation; Medicare Part D redesign; Medicare Part B and Part D inflation rebates; international mechanisms; generic drug promotion and anticompetitive behavior; and manufacturer reporting....
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