Divided Congress Doesn't Have to Mean Gridlock Over Healthcare

As a result of the recent midterm elections, and as of this writing, it looks like the 118th Congress, which will be seated Jan. 3, 2023 will be split, with Democrats set to retain a slim majority in the Senate and Republicans taking control of the House by just a narrow margin of seats.

But divided government doesn't necessarily mean legislative gridlock.

There are several positive, incremental, and market-oriented healthcare reforms that could attract support from both Republicans and Democrats.

One area that shows particular promise is telehealth — care delivered remotely, whether through video conferencing platforms or over the telephone.

Telehealth's popularity has exploded.

Compared to a pre-pandemic baseline, utilization increased 38-fold through July 2021, according to research from consulting firm McKinsey.

The mass adoption of telehealth was a boon to patients and providers alike.

Patients, particularly those in rural communities, gained access to high-quality medical care without having to leave home. Physicians could use their time more efficiently — perhaps seeing more patients or taking care of paperwork during the hours they would have been commuting.

Hospitals, meanwhile, could supplement their onsite staff with a team of remote specialists from around the country, or even the world.

Such a telehealth surge would have been impossible had government officials not rolled back certain restrictions in response to the pandemic.

Many states suspended rules that prevented doctors from administering care to patients in other states using digital technologies.

At the same time, the federal government waived restrictions on telehealth for Medicare beneficiaries during the COVID-19 public health state of emergency.

But a number of states have reinstated their pre-COVID restrictions on telehealth.

Moreover, the federal state of emergency could end as soon as January.

The U.S. Senate, during the week of Nov. 15, 2022 voted to end it right away; President Biden has promised to veto the Senate measure, if the House also ratifies it.

All of this regulatory uncertainty has called the future of telehealth into serious question.

A premature conclusion to this healthcare revolution would be an enormous missed opportunity, especially considering telehealth's untapped potential for improving outcomes and access while lowering costs.

Consider the impact of new technologies such as home spirometers — devices which allow patients to monitor their lung health remotely and transmit the data to their doctor.

Research published in the Lancet, a medical journal, shows that the technology has enormous promise for managing interstitial lung diseases.

The 118th Congress has the chance to bring some much-needed certainty to telehealth by making many of the pandemic-era regulatory waivers and flexibilities permanent.

Republicans and Democrats in both the House and Senate have introduced legislation that would advance those goals in this Congress.

They'll need to press ahead in the next one.

Another issue ripe for action concerns the growing consolidation in the hospital market.

As of 2020, ten hospital conglomerates controlled around one-quarter of the nation's hospitals. This trend toward greater concentration has suppressed competition, driving prices up and quality down across the health system — outcomes both Democrats and Republicans can agree harm patients.

Consequently, boosting competition in the hospital market is a worthy objective for the next Congress. Lawmakers could, for instance, roll back provisions within Obamacare that prevent physician-owned hospitals from expanding — and make it harder for new physician-owned hospitals to open in the first place.

Finally, a legislative push for more price transparency in the healthcare sector could garner support from both parties.

By giving patients more information about the actual price of the care they consume, lawmakers could put downward pressure on overall healthcare costs while spurring competition between providers.

Price transparency has been a mainstay of Republicans' health reform agenda for years.

But, the Biden administration has also embraced it by issuing the first fines for hospitals that don't comply with federal rules requiring that they post their prices.

There's no denying that a divided Congress — to say nothing of a Democratic White House— presents some real challenges for enacting sensible market-oriented healthcare reforms.

But there are bipartisan strategies for improving our healthcare system at the margins —and ultimately advancing the interests of patients.

Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is "False Premise, False Promise: The Disastrous Reality of Medicare for All," (Encounter Books 2020). Follow her on Twitter @sallypipes. Read Sally Pipes' Reports — More Here.