WASHINGTON, D.C. – With Congress delaying resolution of the federal spending legislation until at least early March, healthcare stakeholders are left waiting to resolve several priority issues once again. The delay creates an additional six-week window during which Congress could work to address at least some of these issues. However, the same challenges, including divisions over foreign aid and border security funding, and socially conservative policy riders, remain in place.
The unresolved health care issues range from reauthorizations of expiring programs or extensions of existing policies to more complex legislation addressing politically popular issues such as reducing the cost of prescription drugs. Additionally, there is an aggressive push from physicians to undo or mitigate cuts to their Medicare payments.
One of the top priorities is the reauthorization of the nation’s core bio-preparedness law, the Pandemic and All-Hazards Preparedness Act (PAHPA). Other issues include reauthorizations of support for substance-use disorder policies and funding for public health delivery and workforce programs. There is also growing interest in reforming the practices of pharmacy benefit managers (PBMs) and addressing telehealth policies.
One major question is what a final package addressing PBM transparency and reform could look like and when this legislation could potentially be enacted. Additionally, Congress must address Medicare coverage of telehealth without originating site restrictions, the ability of high deductible health plans with health savings accounts to offer telehealth pre-deductible, and the ability of ERISA employers to offer telehealth as a standalone benefit.
Looking ahead, the likelihood of many measures being wrapped up before St. Patrick’s Day remains modest, given the overarching focus on federal spending and the challenges that remain toward achieving a full resolution of FY24 funding decisions. Therefore, the most likely scenario for many areas may be resolution as part of a very active November and December lame duck session of Congress.