The three doubtless points that can prime Congress’ to do record subsequent yr no matter who wins the election

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No matter who wins the elections in November, there are doubtless three points which might be going to dominate the (non-COVID) healthcare debates in Congress subsequent yr.

The highest of that to do record? Shock billing reform, drug pricing reform and pre-existing situation protections, in accordance with Drew Voytal, affiliate director of authorities affairs for the Medical Group Administration Affiliation.

“These ought to look acquainted as a result of they had been sizzling dialogue subjects previous to when COVID actually barged its approach in and actually dominated the dialog within the work of Congress proper now,” Voytal mentioned, talking at MGMA’s annual convention on Monday. 

Every of those points has no less than some bipartisan assist and MGMA expects these discussions to return to the agenda in 2021, Voytal mentioned. 

That was among the many observations authorities relations specialists instructed medical practices to be looking out for within the coming months. 

Amongst different points to look at: 

Way forward for the ACA: With the potential affirmation of a Supreme Court docket Justice on the horizon, the ramifications for the Reasonably priced Care Act must be intently watched as the highest court docket prepares to think about the constitutionality of sure elements of the ACA in November. A ruling is anticipated in mid-2021, mentioned Matt Devino, affiliate director of presidency affairs for MGMA. 

It is essential for the plain impacts on eligibility for well being protection and minimal requirements for personal insurance coverage, Devino mentioned. However there’s additionally the truth that the ACA created the Middle for Medicare and Medicaid Innovation, or CMMI, which is the innovation arm of the Facilities for Medicare & Medicaid Companies that has led most of the fee fashions for value-based care.  

“There’s a lot at stake with this Supreme Court docket choice and why we’re watching it quite intently,” Devino mentioned. “The query being, if the ACA had been to go away, what occurs to CMMI, and what occurs to the way forward for value-based care?”

“Established order” versus “Blue Wave”: The 2 coverage specialists examined 4 eventualities for physicians teams, together with one through which President Donald Trump wins reelection and Republicans preserve management of the Senate, a situation they known as “establishment.” In that situation, suppliers ought to count on CMS to proceed its deal with its “Sufferers over Paperwork” initiatives and to take a restricted strategy to increasing entry in terms of well being reform, Voytal mentioned.

Ought to there be a “Blue Wave,” which they outlined as former Vice President Joe Biden profitable the presidency and the Democrats flipping the Senate whereas retaining management of the Home?

“With Democratic management throughout the board, we’d count on entry to protection expanded,” Devino mentioned. “The vp’s platform contains assist for a public possibility, Medicare eligibility being diminished to the age of 60, extra low-income help to acquire healthcare protection.”

There may be opposition for a single-payer or Medicare for all system, however there can be continued assist for value-based care, he mentioned. 

If Trump wins and the Democrats have management of Congress or if Biden wins and Republicans have management, count on a variety of gridlock, they mentioned. Within the former situation, there would doubtless be a deal with initiatives by CMS, however little would doubtless occur legislatively.

In the meantime, within the latter situation: “Main healthcare reform can be stalled once more as a result of the Senate can be below the management of Republicans and there must be main compromises between the 2 events,” Voytal mentioned.  

The one place the place there is likely to be some change? “Vice President Biden, if he is elected, would look to proceed value-based care however would search to face out from previous approaches from the Trump administration. So you can search for novel approaches,” Voytal mentioned. 

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