BY BENEFITS PRO
A President Joe Biden health care industry strategy could usher in a new era of medical innovation, expanded health insurance coverage, slower provider consolidation, and a renewed initiative to rein in pharmaceutical costs.
But Biden will be up against the same obstacles that often thwarted his mentor, Barack Obama: a divided Congress, Senate veto power, and Big Pharma lobbying might.
That said, Biden may be able to offer just enough to most parties to get buy-in for a handful of his highest priority health reforms.
A report from the PwC Health Research Institute offers an early outline of Biden’s top objectives and the chances they will be achieved. PwC analyzed Biden’s health platform, as laid out during the campaign, and conducted in-person interviews and broad surveys to quickly publish a Biden health roadmap.
The report discussed the top line of the president elect’s health wish list and included ratings of high, moderate, and low to indicate each one’s likelihood of success. Among them:
- The mandated ramping up of a broad COVID response: High
- Increase premium tax credits for family plans: High
- A call for the production of related medical supplies and drugs: Moderate
- Limitation of drug launch prices and price increases: Moderate
- Limitation of health care system concentration: Moderate
- Stop surprise billing: Moderate
Other initiatives, such as creation of a public health insurance option, opening up the U.S. market to foreign pharmaceuticals, and negotiation of Medicare drug prices were rated “low” for the obvious reasons.
Without taking political sides, PwC’s outlook offered rosy days ahead for many health care players. Of course, low-to-moderate income Americans would benefit from expanded coverage, particularly in the wake of widespread COVID layoffs that pulled coverage out of under millions.
But others would benefit from expanded coverage, the report said.
“All health care organizations should prepare for the possibility that millions more Americans could gain insurance under Biden. His proposals, if enacted, would mean coverage for 97% of Americans, according to his campaign website. … This could mean millions of new ACA customers for payers selling plans on the exchanges, millions of new Medicaid beneficiaries for managed care organizations, millions of newly insured patients for providers, and millions of covered customers for pharmaceutical and life sciences companies.”
Biden’s proposal to lower the Medicare eligibility age to 60 should have plenty of employer fans as well: “If Medicare eligibility is extended to all Americans 60 to 64, it could increase Medicare coverage by up to 20 million Americans and reduce insurance costs for employers …”
But maybe not so much support from the provider side: “[B]ut it also could lead to a deterioration in payer mix for health care providers and possibly increase payroll taxes, depending upon how it is financed, according to one analysis.”
PwC fully expects Biden to direct manufacturers to produce virus tests, protective equipment, and related products, which, while taking choice out of the hands of industry, does push dollars right back into those hands.
Meantime, watch for Joe to seek to break down barriers to telehealth solutions as the nation (and world) continue the rapid adoption of virtual health. And, of course, he will target federal dollars for further vaccine research and distribution.
The nation can expect an Obama-type health strategy from Biden–but one that recognizes that times have drastically changed.
“[H]ealthcare executives cannot simply dust off their Obama-era playbooks. Biden will assume the presidency in a country that is very different than it was in 2009, when he became President Barack Obama’s vice president. The nation today is grappling with a pandemic that has killed more than 200,000 Americans in nine months, sickened millions more and dealt the economy a historic blow.”