Congressional Inaction on Healthcare Harms Patients
Healthcare is one of the most important areas of public policy. It impacts matters of life and death, comfort and well-being. For decades, politicians have promised healthcare reform that would expand access to doctors and lower costs for patients; however, this has not materialized.
A recent Pew survey found that 60% of voters believe that healthcare is very important to their vote in November. Despite numerous opportunities for action this legislative term, Congress has failed to address any of the important issues within healthcare.
Telehealth access has been crucial for elderly patients getting the care they need during the pandemic. In 2020 alone, Medicare telehealth visits increased 63-fold from 840,000 in 2019 to 52.7 million. An analysis of telehealth usage lead the U.S. Department of Health and Human Services to conclude that “use of telehealth during the pandemic also demonstrates the long-term potential of telehealth to increase access to health care for beneficiaries.”
Despite the technology’s proven benefits, Medicare patient access to telehealth services is set to expire soon after the COVID-19 Public Health Emergency declaration officially ends. As the Centers for Medicare and Medicaid Services (CMS) noted back in March 2020, without temporary waivers provided by the Public Health Emergency declaration, “Medicare could only pay for telehealth on a limited basis: when the person receiving the service is in a designated rural area and when they leave their home and go to a clinic, hospital, or certain other types of medical facilities for the service.”
To anyone who has used telehealth, these regulations would seem absurd. Requiring individuals (not in a handful of rural areas across the U.S.) to go in-person to receive telehealth services would negate many of the benefits of telehealth. A 2017 study highlighted that telehealth visits saved patients and their caregivers “an average of $50 in travel costs and 51 minutes in waiting and visit time…” for an urban Chicago children’s health system. Elderly people are much more likely to have mobility issues. Waiving these regulations allowed tens of millions of them to have easier access their doctors and these changes during the pandemic were a massive success. Moving back to prohibitive regulations would harm these patients. These barriers will be reimposed unless Congress acts.
Bipartisan legislation to fix this problem has been proposed for these reasons. The Telehealth Modernization Act, for instance, would have allowed patients to receive any telehealth services from their home and expanded the types of providers allowed to offer telehealth visits. Despite its support, the bill was never a high enough priority to make it to the floor of either house of Congress.
The bipartisan Advancing Telehealth Beyond COVID–19 Act would have extended Medicare flexibility to 2024, at least pushing the can down the road for permanent changes. In July, it overwhelmingly passed in the House 416 to 12; however, the Senate never took it up nor considered it.
Another bill, the TREATS Act, would expand telehealth access to substance-use disorder Medicare patients. A recent study found substantial benefits to patients using telehealth to treat their substance-use disorder with the study’s authors noting that the results lend “support for permanent adoption [of telehealth].” Nonetheless, Congress has failed to pass legislation to keep this access available to patients beyond the COVID-19 pandemic.
Beyond Medicare telehealth reform, Congress has the opportunity to enact key changes that would increase healthcare options for millions of Americans. The RESULT Act would expand patient access to pharmaceuticals. If there is an unmet need in the U.S. for treatments for a condition with no FDA approved options, the bill would allow companies to provide medications and other medical products in the U.S. if the drug is approved in another developed country. It would allow the FDA to expedite approval by giving reciprocity to pharmaceuticals that have already undergone testing and approval abroad. This would be groundbreaking for consumers with no existing treatment options. Despite this, Congress has failed to even discuss the legislation.
There have been proposals to expand access to Health Savings Accounts (HSAs), increase the amount of pre-tax dollars individuals can put in those accounts for healthcare expenditures, and it would expand the types of expenses for which these funds could be used. The Personalized Care Act would do all of this, yet Congress has ignored it.
Congressional inaction on these life-or-death issues is a shame. Due to a lack of international reciprocity, patients have gone without treatments that could be available otherwise. The lack of HSA expansion has meant those plan options are available to fewer Americans. If Congress does not act on telehealth at the beginning of the next term, Medicare patients are likely to lose their easier access to their doctors and treatments.
The 117th Congress has done nothing that I can see has improved healthcare. Let’s work to make sure the 118th is not the same. We can demand our elected officials address the policy areas that matter the most to us and affect all of our lives. Without committee hearings and floor votes, there will be no improvement. This Congress has failed to deliver needed change.
Dr. Kendrick Johnson D.O. is a family physician and founder of Ark Family Health Direct Primary Care in Phoenix. Follow him on LinkedIn https://www.linkedin.com/in/kendrickjohnson/
