What might the new Congress do on healthcare?

TThe outcome of this week’s midterm elections is still uncertain, but Republicans seem to be heading for a narrow majority in the House of Representatives.

It means that if the divided government is to have any hope of progress, the legislation must have bipartisan appeal. In the healthcare space, there are several policy initiatives that could receive support from Republicans and Democrats, including loosening enforcement coverage rules for healthcare providers, expanding access to tax-advantaged Health Savings Accounts, and increasing the availability of telehealth services.

Consider application scope restrictions. Twenty-four states limit or restrict nurse practitioners’ ability to engage in at least one element of standard practice. States may require medical supervision of nurse practitioners or restrict their prescribing powers.

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These regulations limit the provision of care, particularly primary care. Given that the country already has a shortage of 17,000 primary care providers, this is something we cannot afford.


A bipartisan group in the House passed legislation in September that would increase access to care for Medicare and Medicaid beneficiaries by removing barriers to practice for nurse practitioners and other advanced practice registered nurses. Congress should explore ideas like these that could increase the supply of care and therefore reduce its cost. Allowing seniors to contribute to Health Savings Accounts will help reduce costs on the demand side of the market. Members of Parliament from both parties sponsored legislation to do just that.

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HSA holders can make tax-free deposits into their accounts and then spend the funds on healthcare. The accounts encourage people to become healthcare consumers just like any other market. They can buy care that meets their needs rather than what the insurer will pay. And they can shop for the best deal.

Finally, there’s telehealth. According to a Morning Consult survey, nearly 3 in 4 Americans believe patients should have access to virtual care after the pandemic. Almost every health worker agrees. Congress took note. Both Republicans and Democrats have called for many of telehealth’s pandemic-era expansions to be passed into law.

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Comprehensive health care reform is probably not on the agenda in a closely divided Congress. But there are still reforms that can make a real difference in the lives of patients and that both parties need to get behind.


Sally C. Pipes is President, CEO, and researcher in Thomas W. Smith’s Health Care Policy division at the Pacific Research Institute. his last book
False Premise, False Promise: The Disastrous Reality of Medicare for All
(Encounter 2020). Follow her on Twitter @sallypipes.


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