Last Thursday, February 16, Seniors Speak Out held another Facebook Live event to discuss what we can expect from Washington concerning healthcare in 2023. Joining me for this discussion was Shalla Ross, President of The Ross Group. You can watch the entire event by clicking here.
I started out explaining that Seniors Speak Out was created by the Healthcare Leadership Council’s Medicare Today as a resource for older Americans, caregivers, and advocates to encourage seniors to advocate for themselves and ensure seniors are educated on healthcare issues and access needs. I went on to point out that with the new Congress, including seven new Senators and over 80 new House members, there is an opportunity for some new perspectives in Washington. I reminded us all that the Biden Administration passed the Inflation Reduction Act (IRA) via a partisan vote and that the IRA would affect seniors. I pointed out that this bill included government price controls that will restrain the development of the most innovative and successful drugs for seniors. We have already seen drugmakers canceling some of their drug development programs due to the lack of economic incentives to undergo risky and costly research & development. I then turned the time over to Shalla Ross.
Shalla started out by pointing out that President Biden, in the State of the Union speech and with a spirited back and forth with Republicans, came to the conclusion that Social Security and Medicare cuts were off the table. In looking at this year Shalla said that due to the split Congress she didn’t expect the passage of any big healthcare legislation. She did point out that there are some areas where some progress could be made, including, mental health, the Fentanyl and opioid crisis, healthcare workforce shortages, health IT security, and disaster preparedness. She said that members of Congress will reintroduce some bipartisan bills including one to deal with the payment for vaccines after the COVID emergency legislation ends.
Shalla then discussed the implementation of the IRA which included price negotiations and the identification of the first 10 drugs that will face these negotiations. The number of drugs facing price fixes will expand to 60 drugs by 2029. She echoed the belief that drugmakers are already cutting their plans on developing new drugs due to the IRA and doesn’t see lawmakers changing the legislation to avoid this reduction in the development of new medicines. She pointed out that through Presidential executive order CMS is looking to expand some of the models with the goal to cut drug prices. She then talked about the Administration’s plans to change the Medicare Advantage program, even in the face of high inflation. Last year there were 346 members of the House that sent a bi-partisan letter to the administration telling them not to cut payments to Medicare Advantage and there is a similar letter being circulated this year.
After Shalla’s remarks I asked a few questions, the first one being . . . what did she really think could get done concerning healthcare this year and how could seniors get their voice heard on these important issues? Shalla said that she thought the workforce issue could see legislation, along with small fixes and implementation details of the IRA. She said that sending emails, calling, and scheduling meetings with members of Congress is vitally important. I echoed her sentiments pointing out that a member of Congress will drop everything to meet with a constituent.
I then asked Shalla if she thought the Republicans would try to reverse the IRA. She indicated that she didn’t see that happening. She did say that there would be multiple oversight hearings and there could be some smaller changes as it is implemented. She did point out that the IRA implementation isn’t following the normal rules of communication and that many stakeholders won’t be given the opportunity to give their input on the IRA implementation. I added that this departure from the normal communication methods robbed stakeholders of the right we have to give input on issues that affect us. I also voiced my displeasure concerning executive orders because they tended to sidestep the normal discussion and checks and balances that is an important part of how the government operates.
The next question concerned Senator Ron Wyden’s interest in expanding Medicare coverage to include non-medical services for people with chronic conditions. How would this impact seniors and their access to healthcare, such as telehealth and at-home care? Shalla said that finding the money to fund some of these non-medical services could be difficult, but she said that historically there has been a bipartisan push in areas like home services, nutrition, and transportation. She reminded us that even though it might cost money for these services it would certainly save money in the long run by keeping people out of the hospital and other more expensive institutions. Telehealth is an example of a place that has shown it can save money. I interjected that COVID-19 required us to take a “crash course” in telehealth, but it let us experience many of the efficiencies and money saving aspects of telehealth.
I then commented that President Biden didn’t give much detail in the State of the Union speech on his healthcare goals. I asked if she had an idea of what the Biden administration’s healthcare objectives were and what policies could be coming down the pipeline? She said that the President took a “victory lap” on his accomplishments and said he wanted to expand Medicaid in those states that have yet to expand. He highlighted the fentanyl crisis and how we absolutely needed to find a way to fight this serious threat. The President’s budget is coming out soon and it will shed some light on his objectives but overall, he was fairly light in the details around his healthcare priorities. She said that she thought there would be more executive orders. The President also mentioned surprise billing and how that law hasn’t worked as we thought it should.
I then stated that I would be remiss if I didn’t talk about the whole “we won’t cut Social Security and Medicare” part of the State of the Union speech. I pointed out that almost 50% of seniors have Medicare Advantage – which is Medicare! If we reduce the payments to Medicare Advantage, especially in these times of high inflation, we are cutting Medicare. The President can’t have it both ways. Shalla interjected that this is the place where our voices can have an impact by getting in touch with our members of Congress and telling them where we stand. I got back on my soap box about how important it is to tell Washington where we stand on the issues and, as a constituent, how important you are to your Senators and House Representative.
I ended by reiterating that Seniors Speak Out will work to keep you updated on the issues that affect you and will be a conduit to those in Washington who make the decisions that affect our healthcare.