How Will Midterm Elections Impact Health Care Priorities In Congress?

Congress is grappling with several big-ticket items and it's an election year.

By Susan Rupe

U.S. voters will choose a new Congress as the nation enters its third year of the COVID-19 public health emergency. What will it mean for health policies and priorities in Washington in the coming year?

Although Congress remains deeply divided on many issues, a few health policies do have bipartisan support, a panel at America’s Health Insurance Plans’ National Conference on Health Policy and Government Health Programs said Monday.

However, with the midterm elections looming in a few months, Congress has a narrowing window of time to enact health care legislation before its members turn their attention to Election Day.

With conventional wisdom saying that Republicans will take control of the House of Representatives, how will the health agenda in Congress change if the GOP is in the majority?

If Republicans take control of the House or of both houses of Congress, “you would expect to see the Biden administration stepping up its use of executive action and executive order on health care,” said Lori Denham, partner with Kountoupes Denham Carr & Reid. She predicted President Joe Biden will be more aggressive in his use of executive orders next year as the presidential election cycle begins to take shape.

Although most Republicans have been vocal in their opposition to the Affordable Care Act, one panelist said he believes GOP efforts to get rid of it are old news.

“I don’t think we’ll see a Republican effort to repeal the ACA,” said Steve Haro of Mehlman Castagnetti Rosen & Thomas. “All health policies moving forward will be in reaction to COVID-19 and having it become endemic.”

Here are some other health policy issues that could come before Congress this year.

Health Insurance Premium Subsidies

The American Rescue Plan expanded the premium subsidies for those who buy health insurance in the Affordable Care Act marketplace. But will those subsidies be extended by either a revised budget reconciliation bill or some other measure? Matt Eyles, AHIP’s president and CEO, said his organization wants to see the subsidies extended for as long as possible, but the panelists doubted Congress would agree with him.

“Right now, there is no bipartisan support for this,” Dunham said.

Anything that has the ACA label on it, “leaves a bad taste in Republicans’ mouths,” said Elena Tompkins of Tompkins Strategies. Still, she said, it may be possible to include subsidy extension in the budget reconciliation bill.

Prescription Drug Pricing

Legislation that would lower prescription drug prices is “the unicorn,” Haro said. “Whatever your party, no one will disagree with the concept that prescription drugs are expensive – the issue is, how do we get there? I don’t think we have consensus yet on how to do it.”

The Affordable Insulin Now Act would require insurers to cap patient out-of-pocket costs for insulin at $35 per month. The Senate is expected to consider this bill soon, and Tompkins said, “People are in a very uncomfortable position on it.”

“There’s a lot of support for the issue but I think there are Republicans who don’t want to see Democrats get too many wins at this point.”

COVID-19 Policies

“One of the most common statements I have heard from everyone I know is, ‘I am so done with COVID-19. That is where a lot of folks are,” Haro said. “The reality is that COVID-19 is not going away. The pandemic may end but that doesn’t mean the endemic won’t be here. We have to find a way to live with COVID-19.”

Haro said he doesn’t believe Washington has a master strategy to deal with COVID-19 in the long term.

“We pass policies mostly in reaction to the situation at hand. People will be open to what policies worked during the public health emergency and what needs to remain in place. I think long term that Congress will have to deal with the fact that COVID-19 is endemic. We will have to manage it like we manage the flu. We need to be unified on these policies.”

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected]. Follow her on Twitter @INNsusan.