Thoughts

Thought Leadership Posts

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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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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