If Republicans still rule the U.S. Senate after the Georgia runoff elections Jan. 5, Washington Democrats will probably tread water with any major healthcare legislation they try to pass during the expected Biden administration.
That doesn’t mean they have no chance of reaching shore.
The San Francisco-based Pacific Business Group on Health, a research firm that specializes in purchasing, has considered the situation from the vantage point of large employers offering health benefits to their workers.
At a post-election webinar, members of the company’s leadership team outlined three legislative battles these employers will likely be watching closely.
1. Prescription drug costs. In a poll taken during the webinar, 71% of employer attendees said reform of drug pricing should be a top federal policy for 2021, PBGH reports in its own coverage of the event. This response confirmed what session leaders had concluded from prior research.
“With a Biden administration and Republican-led Senate, it’s still possible that we’ll see movement on legislation improving transparency and even capping price increases,” PBGH staff write in the coverage. These and other actions “could lead to significant savings for large health care purchasers and, by extension, employees who receive health benefits on the job.”
2. Surprise billing. The webinar leaders, PBGH’s director and executive director of health policy, Shawn Gremminger and Bill Kramer, respectively, said this remains a serious problem in U.S. healthcare. And that’s something both parties agree on.
“Congress has been deadlocked, however, on the best way to limit the prices charged by providers who have not signed a contract to be ‘in-network’ with a health plan,” PBGH reports from the webinar. “If we can find a way to break the stalemate and set limits using existing local, market-based contract rates, there would be real savings for employers and protections for patients.”
3. High healthcare costs. As the cost of benefits rises, wages and core business investments stagnate or fall, PBGH points out, noting the resulting dampening effect on business growth and consumer spending.
“The COVID pandemic and the related economic recession are making this growing crisis completely untenable as unemployment soars and many employers face existential threats,” PBGH comments. “Large employers would welcome action to accelerate the transition from fee-for-service to value-based payment models, which would help shift provider incentives from volume to quality and value.”
This could be accomplished by administrative action to introduce, test and spread value-based clinician payment and care models, especially for primary care, PBGH adds.
“The days and weeks ahead will make clearer the configuration of our federal government post-election,” PBGH concludes. “We will have the opportunity to address the problems of high costs, inconsistent quality and racial disparities through administrative action as well as legislation, and the voice of employers will be an important influence in the upcoming health policy debates.”
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.