COVID-19’s impact on medicine has been profound and may continue for a long time to come. What lasting effects will the pandemic leave on health care policy?
An education session during the June 2021 AMA Section Meetings offered some insight on that question for an audience of aspiring physicians. Here’s some key takeaways from the session, “Post COVID-19 medical legislation for medical students,” hosted by the AMA Medical Student Section.
Which temporary measures will stick?
The scope of legislation put forth during the pandemic was extremely broad. In most instances, measures were put in place as a matter of necessity. It remains unclear which will have staying power.
“As we go forward, it is going to be a challenge in terms of which things are going to be permanent versus which things are temporary in nature,” said Cynthia Brown, the AMA’s vice president of government affairs. “For instance, we look at payment issues with Medicare. There was a sequester in effect we got rolled back. I don’t think there’s much we can do about that, but things like telemedicine, I think we will try to keep permanent.”
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How cumbersome is the partisan barrier?
Both chambers of Congress feature slim majorities, and those could flip in the coming midterm elections. That presents a challenge, Brown said.
“A lot of things we are seeing right now on Capitol Hill are getting done with reconciliation, a simple 51-vote majority” in the Senate, Brown said. “A lot of policy changes people want to see can’t be done that way. They really have to be in a bipartisan package and that is going to affect the shape of what we do in the future.”
Jason Marino, the AMA’s director of congressional affairs, highlighted the work the Association did to create policy that appeals to both sides of the aisle during the pandemic.
“Last year there were five bipartisan COVID relief packages,” he said. “They added up to $3 trillion. The lobbying team at the AMA was working with committee staff and leadership staff on both sides of the aisle in the House and the Senate. Seeing early drafts, getting things done to benefit physicians and patients and when things went a little too far checking those.”
The AMA hopes to carry that momentum forward.
“You have to always be ready to work with everyone,” Marino said. “We play a good role at the AMA in bringing people together. We can be a good convener and validator on both sides. A lot of people trust physicians. I have a lot of hope going forward. You hear a lot on the news about the battles. Behind the scenes there are a lot of things that are constructively going on. It just takes some time.”
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Is expanded telehealth here to stay?
Telehealth use spiked dramatically during the pandemic. That increased usage was at least in part related to waived restrictions related to Medicare payment for telehealth.
Going forward, telehealth is a policy area to monitor, according to Nicholas P. Terry, executive director for the Center for Law and Health at Indiana University’s Robert H. McKinney School of Law.
“Telehealth will be one area to really watch post-pandemic,” he said. “Health insurers and employers are likely to be in favor of further liberalization of telehealth usage, whereas large health systems that have built out brick and mortar platforms may be circumspect.”
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