The outcome of this week’s midterm elections is still unclear, but Republicans appear headed for a narrow majority in the House of Representatives.
Divided government means that legislation must have bipartisan appeal if it’s going to have any hope of advancing. On healthcare, there are a few policy initiatives that could attract support from Republicans and Democrats — including relaxing scope-of-practice rules for healthcare providers, expanding access to tax-advantaged Health Savings Accounts, and boosting the availability of telehealth services.
Consider scope-of-practice restrictions. Twenty-four states limit or restrict the ability of nurse practitioners to engage in at least one element of standard practice. States may mandate physician oversight of nurse practitioners or curb their prescribing authority.
These regulations limit the supply of care, especially primary care. That’s something we can ill afford, given that the country is already short some 17,000 primary care providers.
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A bipartisan group in the House introduced legislation in September that would boost 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 such as these that can increase the supply of care — and thus reduce its cost. Permitting seniors to contribute to Health Savings Accounts would help reduce costs from the demand side of the market. House members from both parties have sponsored legislation that would do just that.
HSA holders can make tax-free deposits to their accounts and then spend the funds on healthcare. The accounts empower people to be consumers of healthcare, just as they are in other markets. They can purchase the care that meets their needs rather than what their insurer will pay for. And they can shop around for the best deal.
Finally, there’s telehealth. Around 3 in 4 Americans believe patients should have access to virtual care after the pandemic, according to a Morning Consult survey. Nearly every healthcare practitioner agrees. Congress has taken note. Republicans and Democrats alike have called for enshrining many of the pandemic-era expansions of telehealth into law.
Sweeping health reform is probably not on the docket in a closely divided Congress. But there are still reforms that could make a real difference in patients’ lives that members of both parties should be able to get behind.
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Sally C. Pipes is president, CEO, and Thomas W. Smith fellow in Health Care Policy at the Pacific Research Institute. Her latest book is False Premise, False Promise: The Disastrous Reality of Medicare for All (Encounter 2020). Follow her on Twitter @sallypipes.
