On April 16, 2021, Leavitt Partners held its bi-annual Political Checkpoint webinar, featuring Governor Mike Leavitt, Andrew Croshaw, Clay Alspach, and Sara Singleton. The topic of the discussion was focused on how the future direction of U.S. health policy has been changed by the events of the past year. Governor Leavitt provided a flyover of 20 predictions about the next five years in healthcare. Clay Alspach and Sara Singleton laid out the likely 2021 – 2022 policy agendas for the Biden administration and Congress. Andrew Croshaw wrapped up the discussion, summarizing how the market should be interpreting these developments to guide strategy.
20 Predictions About the Next Five Years in Healthcare
Even following uncertain times, we can start to see certainty. Governor Leavitt summed up what he believes is certain for the ongoing pandemic, health policy, the economy and payment, and a few factors that are likely “no matter what”.
Healthcare Policy Agendas
Over the past six months, there have been significant events that have real consequences on the policy choices that lay before Congress:
- The unemployment benefits in the December 2020 stimulus package created a March 2021 deadline that was used to pass the American Rescue Plan.
- The 2021 Georgia runoff elections that resulted in the Democrats winning control of the Senate created the opportunity for President Biden to advance different nominees than might otherwise have gotten through Congress, not to mention the opportunity to move more policy more quickly.
- The January 6, 2021 attack on the U.S. Capitol created even more distrust and less alignment between the parties, allowing reconciliation to be seen as the only way to pass important policy changes.
- The speed of science, EUA approval, and deployment of COVID-19 vaccines across the country has led to a more rapid economic recovery than might have been possible, particularly in the face of massive partisan gaps in compliance with public health guidelines.
The Biden health team is taking shape with key HHS positions appointed and confirmed, while the few remaining positions are close to being finalized. Although this is slower than usual for a new administration, the primary focus on COVID-19 management from the White House has already helped President Biden move part of his healthcare policy agenda forward. Beyond improving COVID management, he is using both executive and legislative action to reduce disparities in health and healthcare, restore the Affordable Care Act (ACA), and improve affordability of care and coverage.
President Biden’s full “Build Back Better” agenda is represented by three legislative packages, all expected to use the reconciliation process in some way, as well as the regular Appropriations/Budget process:
- The American Rescue Plan Act of 2021 was passed in March, building previously enacted COVID aid and providing $1.9 trillion in mandatory funding, program changes, and tax policies, to help the country recover from the pandemic.
- The American Jobs Plan as announced calls for significant infrastructure investments in broadband, VA hospitals, home care workers, and supply chain.
- The American Families Plan is anticipated to be announced soon but is expected to feature more significant expansions to health insurance, and action on drug pricing.
- The annual appropriations process is underway with the release of Biden’s “skinny budget” (meaning more detail to come, as well as how Congress receives it) sending policy signals to increase funding to the National Institutes of Health, the Centers for Disease Control, and new investment in health research and innovation.
The policy debate in Congress is likely to focus on broader expansions to the ACA, expanding Medicare (via an age-defined buy-in) and Medicaid, and how to improve health equity by focusing on race and rural health disparities.
Implications for the Market
A lot has happened in the healthcare arena over the past four months that has accelerated trends that existed previously – virtual care, value-based care, growth in public payer programs, deficit spending. We also see changes to attitudes among the public and among policy makers that results in less bipartisanship and willingness to compromise in the short term. As we look further out, our changing attitudes about health equity and health security presents a significant opportunity for value-based care models in a cost-conscious, post-COVID world, where equity and prevention matter even more.
For on-going updates and insights into how health policy is impacting the industry, learn more about Leavitt Partners weekly policy intelligence updates hosted by Jennifer Colamonico through our D.C. Direct membership. Each week, we spend 45 minutes providing comprehensive, focused intelligence and analysis from Washington, D.C., on legislation, administrative rules and guidance, and personnel. Learn more here.
Our mission at Leavitt Partners is to advance value to make health care more affordable, sustainable, and effective. We invite community members and industry experts to join us in future dialogue on the healthcare climate. View our upcoming schedule of Future Frame discussions here and join us for our next broadcast on Thursday, May 6 on LinkedIn Live. Andrew Croshaw, Josh Trent, and other Leavitt Partners leaders will discuss the emergence of long-COVID and the challenges and opportunities for healthcare organizations.