The Council for Affordable Health Coverage (CAHC) hosted our 5th Annual Price of Good Health Summit on January 31, at the Planet Word Museum in downtown Washington, D.C. The Summit examined the dynamic relationship between public and private sectors, Congress, and voters in addressing the rising costs of healthcare. Special guest speakers included Congressman Kevin Hern (R-OK) and Elizabeth Fowler, Director of the Center for Medicare and Medicaid Innovation (CMMI).
The first panel of the day, “The Politics of Healthcare: Where we are as a country?” was moderated by Whit Ayres of North Star Opinion Research and featured CAHC’s Joel White, Mark Merritt of Proactive Strategies, and Jon McHenry from North Star Opinion Research. Panelists discussed the disconnect between voters and Capitol Hill where voters don’t feel like lawmakers care about them. Highlights from the panel include:
- Voters care about costs.
- Democrats are stronger on healthcare messaging than Republicans.
- Helping small businesses afford health insurance is a popular issue.
Director Fowler was the next to take the stage. She focused on CMMI’s plans for 2023 and beyond. Highlights from her session include:
- CMMI’s goal includes releasing at least three new payment models on advanced primary care, which is part of a larger effort to increase the number of specialists in value-based care.
- CMMI aims to reach 100 percent participation in accountable care organizations by 2030.
- Aligning financial incentives across the healthcare system is an important goal for CMMI, and the agency is committed to patient-reported outcomes measures in all models to capture what beneficiaries want from the system.
A discussion titled, “Healthcare Costs- How do we combat the affordability challenge?” followed Director Fowler’s comments. The panelists included David Merritt, Senior Vice President of the Blue Cross Blue Shield Association, David Johnson, CEO of 4sight Health, and David Levine, M.D., Chief Medical Officer of Fisher-Titus Medical Center, with CAHC’s Joel White moderating. Key takeaways include:
- Premiums have skyrocketed over the past few years and the incremental reform being discussed in Congress cannot fix a broken system.
- For years, lawmakers have layered policies on top of each other without reworking or taking anything away; It is important to look back and identify policies that do not function as intended.
- Healthcare costs are unsustainable because healthcare pricing is unsustainable- to correct this, we must attack rising costs to reduce the burden on individuals.
- An open, transparent market that incorporates interoperable systems for patient data is a crucial step to lowering costs. Data exchanges must be streamlined, health records should be accessible globally, and we must introduce more competition.
Congresswoman Pramila Jayapal (D-WA) was unable to join the Summit in person at the last minute but provided a short video of her prepared remarks. The Congresswoman touched on steps President Biden has taken to reduce healthcare costs. She also addressed the differences between public and private health coverage and touted the Congressional Budget Office’s estimate that Medicare for All would save $466 billion per year.
Next, Congressman Kevin Hern (R-OK) spoke to Summit attendees about public versus private healthcare and the path forward. He noted that free-market competition drives down costs and in business when a program is broken it gets replaced whereas, in D.C., you layer on another program. There is a disconnect between the people who pay and the value they get. The Congressman advocated for increased healthcare transparency, reduced paperwork burden on small businesses and physicians, and fighting against insurance consolidation.
Panelists Kevin Kuhlman, Vice President of Federal Government Relations at the National Federation of Independent Business (NFIB), Michael Bagel, Associate Vice President of Public Policy at Alliance of Community Health Plans, Marc Reece, Director of Public Policy for CVS Health, and moderator J.P. Wieske from CAHC took the stage for a more in-depth examination of public versus private health plans. Key takeaways from this panel included:
- Washington, Colorado, and Nevada are experimenting with standardizing health plans and setting targets through legislation to force savings downstream. However, reaching sufficient enrollment is a persistent problem.
- Beneficiary needs differ- in prices, doctor choice, and types of healthcare services.
- For those in the employer-based system, affordability remains a major challenge for small businesses. A small business tax credit for providing health coverage to their employees may help attract and retain talent.
Ryan Long, a Senior Policy Advisor and Counsel for Speaker Kevin McCarthy (R-CA) joined Conor Sheehey, a Senior Health Policy Advisor for Senate Finance Committee for an off-the-record conversation with Joel White about potential healthcare legislation we may see this year.
The day ended with CAHC’s Joel White moderating a panel on the future of drug pricing with Blase Polite, M.D., Chief Physician at the University of Chicago Medicine, Lori Reilly, COO of PhRMA, and Ben Shaberman, Vice President of Science Communications at the Foundation Fighting Blindness. Key takeaways included:
- Medicare Part-D is a successful government program but the Inflation Reduction Act (IRA) may put it at risk.
- Plans may shift to just two drugs in a class or drive up prices as a result of the disincentives created by the law.
- Drugmakers work to drive innovation by funding cutting-edge research, but because of the large financial risk, they need sufficient incentives to enter the marketplace.
- The IRA disincentivizes developing drugs for multiple indications, which delays potential access to treatment for millions of Americans. An example of this is the treatment of rare diseases – while each disease may encompass a small population by comparison, the number of conditions means rare diseases affect about 30 million people in the U.S. Rare diseases are not that rare, but rather the challenge to get treatments is.