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10 predictions for health-care regulation and legislation in 2020


As presidential hopefuls jockey for position leading up to election day, health care is set to be perhaps the most hotly debated topic in 2020.

As the pool of presidential candidates continues to make headlines, there will be no shortage of conversation about how to improve the current U.S. health-care system. Candidates will debate everything from rural health care to opioids to cybersecurity.

Several existing bills are also likely to come back into focus as both sides of the aisle push their agendas. 

While there’s no way to predict what will happen, we have our ears to the ground in Washington and see several issues to keep a close eye on in 2020. Here’s what we’ll be watching:

1. Medical bill transparency: Many Americans who have made a trip to the hospital may have seen surprise charges on their bill. These unexpected medical charges tack on dollars and put additional financial pressure on not only patients but insurers as well. A bill aiming to eliminate surprise medical charges gained steam in 2019 but failed to get through both chambers of Congress before the end of the year. Given the bipartisan support behind it, resolving this issue will likely stay top of mind for President Donald Trump and all legislators, with the possible passage in early 2020.  

2. Access to health care in rural America: Nearly 60 million Americans call rural areas home. Yet only 10 percent of physicians practice in these areas. The expansion of telemedicine could help alleviate these access issues. Senators Elizabeth Warren and Bernie Sanders say the answer to the affordability factor is Medicare for all. But no matter who wins the presidency, providing quality health care to rural America will remain a priority for Republicans and Democrats alike.

3. Improving mental health care: Providing better access to mental health will continue to be a focus come election season. Mental health affects so many areas of society, from homelessness, gun violence, domestic abuse, and more. A clear distinction has emerged in the White House between treated and untreated mentally ill individuals, as untreated mental illness presents a much higher risk to society. Providing better access to care for untreated individuals has come into the spotlight for lawmakers and will remain a priority in 2020.

4. Cures 2.0: A bipartisan pair of U.S. Representatives are pushing what they’re calling “Cures 2.0,” an expansion on 21st Century Cures Act aimed at speeding the time it takes to get FDA-approved drugs and devices covered by Medicare, Medicaid, and private payers. Skepticism remains as to whether the U.S. Senate has the appetite for passing Cures 2.0 legislation. If this movement picks up momentum, consumers and health-care providers could benefit from an accelerated approval process.

5. Battling opioids: With the total number of Americans who have died of an opioid overdose eclipsing 400,000, legislators will continue to look for solutions to the issue in 2020. The spotlight will likely shift onto healthcare providers and how they can better leverage federal and state funding to treat opioid-addicted patients. President Trump has taken steps to make it more financially viable to treat substance abuse disorders with federal money. However, providers still need more guidance on how to address this health epidemic.

6. New Democrat health-care plans: There are 15 Democratic candidates currently on the ticket, each with their plans for the U.S. health-care system. So far, their policies vary widely. But health-care organizations today are wise to begin thinking about how these new plans could affect their business. While it’s far too early to start making any changes, the potential for a policy set forth by a candidate, like Sens. Bernie Sanders (I-Vt.) or Elizabeth Warren (D-Mass.), or even less industry-altering plans from Joe Biden and others, to truly shake up the landscape warrants some early-stage discussions.

7. Cybersecurity spotlight: Cybercriminals continue to target health-care providers with cyberattacks, ransomware, and fraud scams that lead to millions of dollars in damages. On average, a cyberattack costs health-care providers $1.4 million in lost productivity, reputational damage, and service disruptions. As providers continue to lean on electronic health records and other technology, they will need to invest in the next wave of cybersecurity technology to ensure their systems and sensitive patient information are protected.

8. The continued fight for lower drug prices: President Trump has continued to push for lower pharmaceutical drug prices. He even recently announced he would allow states to import drugs to fight climbing prices and has repeatedly blasted Democrats for failing to do enough to support his mission. Regardless of who’s responsible, U.S. drug prices remain some of the highest in the world, and this issue won’t stop being discussed any time soon. 

9. Medicinal marijuana mania: The mania over medical marijuana and cannabidiol (CBD) is showing no signs of slowing. However, the FDA has been extremely slow in offering guidance on this budding industry. As more states legalize medicinal use, regulators will look to do better in weeding out bad actors and providing a framework for more excellent safety. 

10. Immigration and health-care: Immigration touches every industry, and health-care is no exception. The U.S. Department of State expects some Employment-Based permanent residence categories may become oversubscribed in early 2020 — including some foreign national — leading to a backlog. As one might imagine, this is just the tip of the immigration iceberg. 

With the presidential election in sight, 2020 is looking like another transformative year for the U.S. health-care industry. With significant new ideas and impending change on the horizon, the need for strong partnerships and advocates in Washington and at the state level has never been greater. 

Michael P. Strazzella is the practice group leader of Federal Government Relations at Buchanan Ingersoll & Rooney

Tags Bernie Sanders Donald Trump Elizabeth Warren Joe Biden

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