The Biden administration should prioritize reducing drug prices and expanding the Affordable Care Act, healthcare providers said in a new survey.
More than 30% of 140 executives polled in mid-January recommended that the Biden administration focus on reducing drug prices, while nearly 25% advocated expanding the ACA, according to an Advis survey. Closing the Medicaid gap and establishing a public option were lower on the wish list, with implementing a Medicare for All program garnering the least support.
"The C-suite more or less wants the status quo, but they need to operate at a break-even level or profit," said Lyndean Brick, CEO of the healthcare consultancy Advis, adding that high drug prices eat into providers' profit. "I think there will be a lot of bipartisan support for bringing the price of drugs down."
President Joe Biden signed an executive order Thursday to give Americans more time to sign up for a health plan through the ACA marketplace. The order also seeks to protect and strengthen Medicaid and the ACA by reexamining policies, demonstrations and waivers that obstruct coverage, like Medicaid work requirements.
On the drug pricing front, Biden delayed a rule finalized in December that would force community health centers to pass 340B drug discounts to patients. While the Trump administration aimed to lower out-of-pocket costs, providers worried that it could reduce access and jeopardize low-margin federally qualified health centers.
"That is a really onerous provision, and it could really hurt FQHCs and community health centers," Brick said.
Many healthcare executives expect the Biden administration to obligate drug manufacturers to offer 340B pricing, expand 340B eligibility and clear up any ambiguities in the program's rules and regulations, according to the survey.
Although there wasn't as much support for implementing a public option, which would allow working-age adults to choose a public insurance plan, half of the healthcare executives polled expect Biden to act on it. They also expect, to a lesser extent, scrutiny of healthcare mergers and acquisitions to continue to rise and legislation that allows more consumers to buy drugs from other countries.
The Biden administration will likely address surprise billing by boosting price transparency initiatives, executives said. Hospitals had to publish their payer-negotiated rates for at least 300 shoppable services starting Jan. 1, but many have either failed to do so or obfuscated the rates.
Advis also asked executives whether Congress should eliminate the filibuster. Nearly half said no, a third said yes and the remainder were unsure.
"Providers seem to expect to see some legislative activity, which overall should be positive for the industry," Brick said. "This filibuster really becomes key—if it's eliminated, there is going to be much more reform."
