This Week in Healthcare Reform: December 18th, 2020

Lawmakers continue to work towards a compromise on a new relief package; meanwhile, the coronavirus pandemic has exposed vulnerabilities in our health care system; data on health spending last year points to a worsening trend; and, open enrollment comes to an end.

We encourage you to stay involved as implementation efforts surrounding health care reform progress.  Visit the Health Action Network and be sure to let us know what’s on your mind.

Week in Review

COVID Relief: As Congress looks to wrap up year-end legislative business, a bipartisan, bicameral group of lawmakers has been working behind-the-scenes to advance a coronavirus relief package.  Those efforts resulted in the cobbling together of a slimmed-down package coming in at around $900 billion.  That proposal includes a new round of stimulus checks and additional funding for unemployment benefits.  What it doesn’t include is funding to address the contentious issues that have complicated negotiations for months – specifically, state and local funding and liability protections for businesses.  While the contours of the proposal have been broadly laid out, lawmakers continue to work feverishly ahead of government funding running out at midnight tonight.  

Vulnerabilities Exposed: While our response to the COVID health crisis has forced us to rethink how and where we access health care, what’s really behind those systemic changes is the vulnerabilities in our health care system, writ large, that have been exposed by the pandemic.  Beyond the shift to telehealth, coronavirus has shined a spotlight on the challenges that continue to fragment care delivery across and between geographies.  But, as the distribution of vaccines – first, Pfizer’s, followed by Moderna’s this week – promises to set us on the path towards recovery, experts believe that COVID has wrought permanent changes on our health care landscape in more than a handful of ways.  The aforementioned embrace of health technologies will usher in the widespread adoption of digital medicine.  This isn’t to say that traditional brick-and-mortar sites-of-service won’t have a role to play, as experts also point to market dynamics paving the way for a more focused retail approach to care delivery.

Health Spending: A new analysis from the Centers for Medicare & Medicaid Services’ (CMS) Office of the Actuary show that health expenditures rose by 4.6 percent in 2019.  According to CMS’ data, that rate of growth was in line with the 4.7 percent seen in 2018 and consistent with the average annual rate of spending growth of 4.5 percent that had been observed since 2016.  Nevertheless, last year’s growth rate still managed to outpace inflation.  While hospitals remained the most expensive part of the system, last year’s numbers did offer some unusual insights into what’s driving that increased spending.  Unlike in previous years, when rising health care prices represented the biggest driver of spending increases, what CMS found was that last year, utilization of medical services accounted for a larger share of the rise in spending.  (It’s worth noting that the analysis only takes into account spending trends through the end of 2019 and does not factor in the impacts of COVID-19.)

Open Enrollment Closes: Ahead of open enrollment season, signs pointed to improved coverage options for consumers looking to shop on the Affordable Care Act’s (ACA) insurance exchange marketplaces.  However, despite the benefits of expanded insurance coverage, Americans still struggle with high health care costs, driven largely by trips to out-of-network facilities, such as emergency rooms.  Nevertheless, as open enrollment neared Wednesday’s deadline, the ACA’s popularity continued to climb, an increase perhaps reflected in the daily tally of consumers signing up for coverage, which was running about 14 percent ahead of last year’s pace, despite the lack of marketing and cuts to navigator programs helping steer consumers through their coverage options.


With the New Year right around the corner, experts take a look at what to expect in health care in 2021, from clinical operations to digital tech – and, hopefully, on the other side of the coronavirus health crisis.

This will be our final newsletter of the year.  Look for us again in your inbox on the other side of the calendar.

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Stay safe and be well!  And, have a wonderful holiday season!