With a clean sweep of the White House and Congress likely, and a favorably disposed federal judiciary, Republicans are poised to effectuate their health care policy priorities over the next two years. This article takes a closer look at their likely congressional leadership and the policies they are likely to pursue....

Congress has until the end of the year to extend several expiring health care provisions, including COVID-19 telehealth flexibilities and funding for community health centers. But the parties will have to agree to policies that could help pay for these “must-do” items, perhaps by advancing bipartisan health policy priorities to help offset the extensions. The potential lame-duck health package could move with government funding due December 20. In this blog post, we highlight health policies that are primed for consideration this year....

More than 78 million Americans — nearly one of four — are insured by Medicaid. In 2020, an estimated 40 percent of the nonelderly adult Medicaid population experienced a substance use or mental health disorder. Consequently, expanding Medicaid coverage can improve health outcomes for people with behavioral health care needs. The Affordable Care Act’s Medicaid expansion, for instance, improved access to care for people with depression and other psychological distress. In the recent “minibus” appropriations package for 2024 (H.R. 4366), Congress included several behavioral health reforms, largely for Medicaid beneficiaries and individuals who receive care in community-based settings, with hopes that these reforms can increase the availability of behavioral health services for Medicaid beneficiaries and improve health outcomes....

Currently, many young people are experiencing considerable mental health challenges; Medicaid school-based behavioral health services can play a crucial role in their health and wellness. Federal policymakers have an opportunity to optimize federal resources and new Medicaid flexibilities for states to increase access to mental health services in schools. Collaborative models, such as the Centers for Disease Control and Prevention’s Whole School, Whole Community, Whole Child (WSCC) model, demonstrate how the education, school health, and public health sectors can work together to improve children’s health and well-being....

Following the enactment of the sweeping drug pricing provisions included in the Inflation Reduction Act (IRA), lawmakers are again attempting to address high drug prices, this time by focusing on pharmacy benefit managers (PBMs) in a bipartisan fashion. PBMs are third-party intermediaries responsible for negotiating prescription drug price discounts with drug manufacturers and managing prescription drug benefits on behalf of payers. They have come under scrutiny in recent years for their role in high drug prices. Congress has crafted several legislative packages that include reforms to increase transparency regarding the role of PBMs in the distribution chain for prescription drugs, overhaul how PBMs are compensated, and curb potentially anticompetitive behavior. In this blog post, we describe these legislative proposals....

The midterm elections are behind us, and a lame duck session in Congress is here. What health care elements remain on the 2022 agenda? High-priority issues include: telehealth expansion, physician payments, changes to Medicare Advantage to help patients get more timely care, and certain Food and Drug Administration policies. In this blog post, we highlight policy areas key to supporting health for people with lower incomes that warrant strong consideration for inclusion in a year-end spending package....

While most eyes focused on control of the U.S. Congress and, in our world, what that means for health policy, a wide array of election outcomes at the state level will have a meaningful impact on access and care delivery for many years to come. Here we examine changes to state health policy in some key domains: Medicaid, access to abortion services, and health care costs. With Washington DC facing two years of legislative gridlock, implementation of these state-level developments – and new ones assuredly to come – will likely have as big of an impact on the quality of care that Americans receive than anything coming out of D.C....

CMMI’s statutory directive to test models that improve health outcomes, quality, or costs makes the agency a natural partner in this effort. In addition, CMMI’s recent focus on increasing health care affordability aligns with the administration’s focus on lowering Medicare beneficiaries’ copayments for prescribed drugs, which often depend on their list price rather than the net price. The latter includes manufacturer rebates and is the price that payers pay for drugs. Below, we review a range of approaches CMMI could consider in order to reduce drug spending that include: 1) new models, 2) revisiting previous proposals, and 3) adjustments to existing models...

While advocates are pleased to see new funds authorized for mental health services, they worry that including it in this package reinforces the misconception that most gun violence is perpetrated by people burdened with mental health problems. The reality is that people with mental illnesses are more likely than other people to be victims of firearm violence rather than perpetrators. Only 3% to 5% of violent acts are committed by people with serious mental illnesses, such as schizophrenia, bipolar disorder, or major depression. Here we discuss key investments and policies contained in the gun safety law....

Federal nutrition programs reduce food insecurity and are critical to the health and well-being of one in four Americans each year, including nearly one in three children younger than five. These programs are especially important in the wake of COVID-19. Before the pandemic, food insecurity was higher among households near or below the poverty line, households with children, Black and Latino households, and households in large cities or rural areas. The pandemic increased food insecurity and other measures of food hardship, especially for Black and Hispanic households....

In light of the well-documented mental health and substance use crisis and the exacerbating effects of the COVID-19 pandemic, congressional policymakers are considering a range of behavioral health policy reforms....

Two weeks following the Supreme Court’s Dobbs decision overturning Roe v. Wade, President Biden released an executive order (EO) mapping his administration’s planned response. The EO directs the U.S. Department of Health and Human Services (HHS) and other federal agencies to undertake actions to protect health care service delivery and promote access to reproductive health care services, including contraception and abortio...