Healthcare Priorities For The Next Congress

What kind of healthcare reforms can we expect from the 118th Congress? The outlook is a bit cloudy.

At long last, Congress will likely turn its attention to things other than COVID-19. But Democrats have lost their legislative trifecta and will have to work with a House narrowly controlled by Republicans.

But if lawmakers are interested in actually improving the nation’s healthcare system, there are several reforms that can command bipartisan support.

Let’s start with expanded access to telehealth. One of the few good things to come out of the pandemic was the embrace of telemedicine by patients, providers, and payers alike. To ensure patients had access to vital health services while they were encouraged to stay home, federal and state authorities gave doctors more leeway on what services they could offer virtually. Medicare expanded reimbursement for telehealth procedures. As a result, telehealth use among Medicare enrollees increased 63-fold during the pandemic.

It’s easy to see why. Telehealth visits are particularly helpful for the 3.6 million Americans who delay care each year because they can’t get to a doctor’s office. They spare patients the hassle of taking time off work, commuting to and from the doctor’s office, and waiting in the waiting room. All that time has a real cost—about $89 billion a year, according to Altarum, a consultancy.

Congress’s year-end spending bill expands COVID-era telehealth flexibilities through 2024. But lawmakers can and should go even further—and make those flexibilities permanent. Similar legislation has attracted bipartisan support. And the December budget deal shows that Republicans and Democrats alike are on board with the idea in some fashion.

Expanding access to Health Savings Accounts is another way that Congress can improve Medicare. Right now, people covered by the program cannot contribute tax-free money to these accounts to use for future healthcare expenses. The tax-advantaged accounts can make out-of-pocket healthcare costs more affordable and benefit the entire healthcare system by encouraging people to shop around for the best value for their money.

Last April, Rep. Ami Bera, D-Calif., introduced the Health Savings for Seniors Act, which would let Medicare beneficiaries contribute to HSAs. Two of her Republican colleagues co-sponsored the measure. It’s worth dusting that bill off for the new Congress.

Medicare isn’t the only entitlement primed for reform. As part of the year-end budget deal, Democrats finally agreed to lift a COVID-era suspension of Medicaid eligibility reviews, which led to nearly 13 million ineligible individuals being enrolled in the program. This lack of oversight is both unnecessary and expensive. Improper Medicaid payments cost taxpayers over $80 billion last year.

The December wheeling and dealing by Congress is a good reminder that Democrats can be brought to the negotiating table for entitlement reform. And they may be even more willing to compromise in order to get something out of the last two years of President Biden’s term.

For example, Republicans may want to see what it will take to get even more Medicaid oversight, or additional flexibility for states to administer their Medicaid programs as they see fit.

It’s often said that the expression “may you live in interesting times” is both a blessing and a curse. When it comes to health policy, we are always living in interesting times. For everyone’s sake, let’s hope whatever Congress does in the next few years is the good kind of interesting.