WASHINGTON — The Republican health care agenda was dominated for years by the all-consuming goal of repealing former President Barack Obama’s Affordable Care Act but that singular focus seems to have faded.
“For once, repeal-and-replace isn’t the defining backbone of Republican health policy in Congress,” said Jennifer Young, a co-founder and partner at Tarplin, Downs and Young, a strategic consulting and policy development firm. “It took us years, but I think we have learned that repeal-and-replace was not a winning issue.”
Young, who worked in senior Health and Human Services positions during the George W. Bush administration, spoke during a post-election webinar hosted by the Kaiser Family Foundation focused on the direction of health care policy in the new Congress.
Young pointed to a House Republican task force working on health care that includes Rep. Beth Van Duyne, R-Texas.
Van Duyne is among members of that task force focused on doctor-patient relationships.
In an op-ed over the summer, Van Duyne joined her colleagues in writing they plan to prioritize eliminating federal mandates that restrict how much time doctors spend with patients.
They also are hoping to end COVID-19 vaccine requirements for providers and ease the complexity of electronic health records.
“We will build upon the Trump administration’s regulatory success by modernizing quality metrics for providers and eliminating outdated, duplicate, or overly burdensome administrative requirements,” the group wrote.
More sweeping proposals from either the left or right are unlikely to advance given the reality of divided government, with Democrats controlling the Senate and White House and Republicans holding the House.
But Rep. Michael Burgess, R-Texas, said he expects to look at ways of promoting transparency and addressing consolidation in the health care industry.
“People should know what things cost and where the dollars are going,” Burgess said.
Burgess, an OB/GYN, is among the relatively small number of doctors serving on Capitol Hill. Congress should address provider reimbursement rates in the next session, he said.
“Medicare cuts that have just been so devastating to our doctors at a time when they’ve come through the pandemic,” Burgess said. “They did everything we asked them to do. They were on the front lines. They put themselves at great personal risk and now there’s cuts in the physician fee schedule, there’s cuts in the sequester. All of that’s going to have to be dealt with.”
Democrats included health-related provisions in their Inflation Reduction Act aimed at reducing the cost of prescription drugs. GOP critics say those moves are likely to hurt innovation and the development of new medicines and Republicans could try to roll back some of those changes.
They include limiting monthly cost sharing for insulin to $35 for those on Medicare and requiring the government to negotiate prices for some drugs under Medicare.
Drug companies also will be required to pay rebates to Medicare if their prices rise faster than inflation. The bill also included a three-year extension of expanded subsidies under the Affordable Care Act.
Extending coverage
Rep. Colin Allred, D-Texas, has described what Democrats did in the legislation as a way of expanding Medicaid in states such as Texas that have refused to do so. Allred said 1.8 million Texans gained coverage from the expanded subsidies.
“We still have the highest uninsured rate in the country in Texas,” Allred said. “We’re still over 20 percent uninsured in Dallas County alone and that still has enormous ripple effects for us as a community.”
Allred said those subsidies are “really important for families” and that higher rates of uninsured people result in higher costs to hospitals, worse health care outcomes and greater vulnerability to COVID-19 surges.
Despite Republicans backing off full repeal of the ACA, he expects to see some efforts to roll back those subsidies.
“It’s been an ongoing fight and I expect it to be a fight in every single Congress,” Allred said.
