What healthcare leaders should expect from Washington in 2022

Healthcare leaders may be wondering what they can expect from Washington in terms of funds or regulation, but analysts say it’s clear COVID-19 will remain at the top of the agenda throughout 2022.

The pandemic heads the list of issues to watch in terms of legislation and regulation. The Biden administration and lawmakers have their own goals and strategies for addressing the pandemic.

Here’s a roundup of what the healthcare industry should be watching for out of Washington.

COVID-19 relief

The rapid spread of the Omicron variant has triggered pandemic peaks in new cases and hospitalizations nationwide. The pandemic is clearly going to remain the top priority and advocates for healthcare will be looking to Congress and President Joe Biden’s administration for more help, said Lisa Kidder Hrobsky, the American Hospital Association’s senior vice president for legislative and political affairs.

“Our top priority is advancing help to hospitals that need it right now,” she said.

Some hospitals are still waiting for money from relief packages that have been approved.

With hospitals overwhelmed with COVID-19 patients and many systems delaying non-urgent surgeries, analysts expect lawmakers are going to consider new legislation to provide more aid to healthcare providers.

If there is another COVID-19 relief package, Hrobsky said the bulk of the work would need to be done by the spring. By late summer, lawmakers will recess and then focus on the elections in November.

Hrobsky also said there will be a push to build up the healthcare workforce in the wake of the pandemic. She said lawmakers in both parties understand the need to attract more doctors and there is support for more aid for graduate medical education.

Build Back Better

The Biden administration’s “Build Back Better” recovery plan offered big boosts for hospitals and the healthcare industry. But the prospects for Build Back Better are hazy at best.

In late December, U.S. Sen. Joe Manchin, a West Virginia Democrat, said he couldn’t support the package and has reiterated his problems with the package. The White House says it will continue talks with Manchin.

With the Senate divided 50-50, Biden can’t afford to lose any Democratic votes if he wants to see the package get to his desk.

The U.S. House of Representatives approved a $1.75 trillion package in November. The package included provisions to lower prescription drug prices, invest in public health infrastructure and would also offer more funding for graduate medical education. It’s unclear if it can get through the Senate.

For now, Congress has been focused heavily on the Voting Rights Act, noted Yvette Fontenot, a partner of Avenue Solutions, a lobbying firm.

“The hope is they will be able to turn to Build Back Better once they complete consideration of the Voting Rights Act,” Fontenot said in a Jan. 14 forum sponsored by the Alliance for Health Policy.

Analysts say the healthcare provisions in the Build Back Better package generally have strong bipartisan support, so they aren’t the elements holding up the bill.

If the bigger package can’t move, it’s possible lawmakers could focus on legislation focusing on the healthcare measures, since they are more popular with lawmakers. But the expectation is the administration will keep pushing for the Build Back Better plan.

The budget

Congress still hasn’t passed a budget for the 2022 fiscal year, and the federal government runs out of money next month.

In December, Biden signed a short-term spending plan to finance government programs through Feb. 18. At the time, some hoped that would be the last stop-gap measure and lawmakers and the White House could come together on a budget for the fiscal year.

Fontenot said she was skeptical lawmakers would be able to get a comprehensive 2022 spending plan done in a month. She expected Congress to do another short-term spending bill, a measure that could fund the government for another couple of months, and then try and focus on a budget for the fiscal year.

Lawmakers have proposed spending increases for health programs in 2022. Some have speculated if a bigger budget proves to be too elusive, lawmakers could opt for measures funding government programs at current levels through the rest of the fiscal year, which ends in September.

However, some analysts said lawmakers on the appropriations committees will be anxious to set some spending priorities while they can.

Funding for research

The Biden administration has proposed funding increases for the National Institutes of Health, the federal government’s primary source of funds for medical research.

Biden has also proposed the creation of a new agency called the Advanced Research Projects Agency for Health, or ARPA-H. This agency would be focused on cutting edge research with potential for major breakthroughs.

Funding for NIH remains a bipartisan priority, said Jennifer B. Alton, president of the Pathway Policy Group, a lobbying firm focused on biotechnology and public health. Alton said there’s also strong support for ARPA-H. A bipartisan bill that would pump billions into research - the Cures 2.0 legislation - would authorize the creation of the new agency.

Telehealth

The federal government eased restrictions on telehealth in the pandemic, allowing more people to access care via video or phone than ever before. Healthcare advocates have urged Congress and the Biden administration to allow permanent access to telehealth. Analysts expect that will happen.

“There is a really good possibility that some of these telehealth provisions will be permanent,” said Hrobsky of the AMA.

Pandemic preparedness

Lawmakers have shown interest in improving the nation’s protections against future pandemics, Alton said. She said some lawmakers are anxious to pass measures to boost domestic production of vaccines and other healthcare supplies.

“There’s concerns about our overseas reliance on products that we need,” Alton said.

In September, the Biden administration released its pandemic preparedness plan. The plan would spend $65 billion over 10 years to strengthen public health systems.

“Pandemic preparedness is one area where there can be bipartisanship,” Alton said.

Public health emergency

With the federal government declaring COVID-19 a public health emergency, healthcare providers have received waivers for some services, such as telehealth and home healthcare. On Friday, the White House announced it was extending the public health emergency for another 90 days. The latest extension took effect Sunday, NBC News reported.

Some analysts expect the Biden administration to extend the COVID-19 public health emergency through 2022.

Surprise medical bills

On Jan. 1, the “No Surprises Act” took effect. It’s a new federal law designed to protect customers from getting bills for medical services they didn’t expect if they are treated in an emergency department. The bill has been hailed as a win for consumers, but doctors and hospitals have sued over certain provisions. They contend the resolution process for billing disputes is unfairly tilted toward insurers.

Katie Keith, director of Georgetown University’s Health Policy and the Law Initiative, said the law will merit attention.

“We need to keep a close eye on how the actual implementation goes,” she said. “There are still going to be questions of enforcement.”

Health equity

The Biden administration has focused on improving health outcomes among minority and underserved communities. Analysts said the administration is examining all healthcare efforts with an eye on health equity. The White House has directed more funding toward diversifying the nation’s pool of doctors and nurses. The administration has also focused on maternal mortality.

That focus on health equity will continue, said Cindy Mann, a partner of the Manatt Health consulting firm.

“Expect activity around social drivers of health and equity,” Mann said.