Congress has limited time to act in 2024 in health care priorities

© Andrea Izzotti

Congress has limited time this year to act on key health care issues, according to The Commonwealth Fund.

The nonprofit published its “Forecast for Legislative and Regulatory Activity on Health Care in 2024” with four topics to watch for 2024. It came out the same day The Commonwealth Fund and the Bipartisan Policy Center hosted an online panel discussion about policy predictions for 2024, a presidential election year.

While the year still is relatively young, “the spending bills for fiscal year 2024 are likely the last vehicles for advancing major legislation this year,” the report said. There are four annual spending bills set to expire on March 1, and eight other a week later, the next six weeks could be crucial for health care legislation and policy.

The administration of President Joe Biden is laying out rules and plans for a second term, but if Republicans sweep Congress, any “final rules issued in the last 60 session days of 2024 could be overturned under the Congressional Review Act in 20205,” the report said.

Last year, the House of Representatives passed House Resolution 5378, known as the “Lower Costs, More Transparency Act” (LCMT Act). The Commonwealth Fund report said it has rules to strengthen price transparency requirements for hospitals, insurers, and pharmacy benefit managers. Medicare also must make consistent payment for physician-administered drugs in hospital outpatient departments or physicians’ offices, the report said.

Senate committees also have advanced health-related bills, but it was unclear if “party leaders will reach a spending deal for these health reforms to hitch a ride on,” the report said.

Authors Alyssa Llamas, vice president, Lena Marceno, director, and Lauren Testa, senior vice president in the fund’s Impact Health Policy Partners, said there are four issues to watch this year.

Medicare

This year will bring expiration of flexibilities that were granted for telehealth during the COVID-19 pandemic and extended after the end of the public health emergency.

Bonuses for physicians participating in alternative payment models also will expire. Combined with a 3.4% drop in the Medicare Physician Fee Schedule, those could prompt broader payment reforms, the report said.

Prescription drugs

Congress members have been examining practices of pharmacy benefit managers and if those push up prices of prescription drugs. But the House and Senate would have to reconcile “significant” policy differences in their proposed regulations, the report said.

Sept. 1 also could bring the negotiated maximum fair prices for 10 drugs selected for price negotiation under Medicare.

Behavioral health

There is bipartisan support for strengthening the behavioral health workforce, fighting the opioid epidemic, and improving on negative mental health and substance use outcomes. The House has passed legislation known as the “Support for Patients and Communities Reauthorization Act,” but the Senate has now. The U.S. Department of Health and Human Services and the Drug Enforcement Administration are expected to announce a decision to make permanent the telehealth flexibilities for prescribing controlled medications.

Access to care

“Incremental measures to improve health care affordability are ripe for bipartisan action in 2024,” the report said, with new price transparency rules for hospitals and health plans. Lawmakers must resolve differences in the LCMT Act and the bipartisan “Health Care PRICE Transparency Act 2.0,” which was introduced in the Senate in December last year, the report said.