What are key 2024 healthcare policy changes? Across the state and federal levels, healthcare issues are a legislative priority. Learn more below.
In the United States, the landscape of healthcare policies is complex and marked by many ongoing challenges. Healthcare services remain a critical concern at both the state and federal levels. Access to care, mental health, and prescription drugs are at the forefront of the issue. The COVID-19 pandemic intensified these issues, underscoring disparities and exorbitant costs. The federal government plays a pivotal role in healthcare policy. In particular, the federal government manages enrollment assistance and addresses health-related social needs. On the state level, priorities and objectives vary. For instance, some states prioritize advancing health equity. In other states, health equity is not yet a significant concern. Navigating these varied policies is critical for many Americans, particularly those living at or below the poverty level.
State-Level Healthcare Policy Priorities
Individual states significantly impact healthcare policy. They wield considerable influence in the shaping of healthcare services, coverage, and costs. States play a vital role in tailoring policies to address specific regional needs. They impact underrepresented communities, influence prescription drug costs, and determine access to medical care. Recognizing states’ role is essential for a nuanced understanding of the healthcare landscape.
Improving Eligibility and Enrollment Processes
With the ongoing implementation of the ACA, eligibility and enrollment to healthcare policies is an ongoing struggle. The ACA grants states the option whether to enroll in its provisions. As such, access to healthcare is unequally distributed across the United States.
Case Study: Access to Healthcare in Texas
Texas currently has the largest population of uninsured residents in the United States. Nearly five million people do not have access to health insurance in the Lone Star state. There has been an ongoing conversation and effort to reduce this statistic.
Texas lawmakers have demonstrated interest in reducing the number of uninsured Texans. In the past year, there has been a 37% increase in enrollment to the Affordable Care Act, also known as Obamacare. This is due in large part to the implementation of the federal Inflation Reduction Act (IRA). In 2024, advocates within Texas are hoping to continue this trend. They are pushing the state to expand access to Medicaid beyond children and adults with disabilities. Should the advocates succeed, an additional 800,000 Texans would receive access to healthcare.
Expanding Medicaid
Medicaid expansion requires a coalition of legislators and advocates on both the federal and state levels. This is due to certain provisions of the Affordable Care Act (ACA). As of 2024, the most effective way to expand access to Medicaid is through state-level action. The Governor must sign on to expanding Medicaid to nonelderly people with incomes up to 138% of the federal poverty level. The states that have not yet done so include: Alabama, Florida, Georgia, Kansas, Mississippi, Tennessee, Texas, Wisconsin, and Wyoming. These states remain the emphasis of policy advocacy to ensure increased access.
Consumer Protection
Consumer protection from inflated healthcare prices and price-gouging practices has been a hot topic of conversation. Ongoing litigation and negotiations with pharmaceutical companies aim to prevent pricing people out of necessary healthcare. Many of these efforts are taking place at the federal level. At the state level, many governors are taking initiative in consumer protection efforts.
Case Study: Consumer Protection Efforts in New York
In New York, Governor Kathy Hochul hopes to enact the most expansive prohibition against insulin cost-sharing in the nation. The proposal would completely eliminate insulin cost-sharing through legislation. It would provide financial relief and improve adherence to these life-saving medications. With 1.58 million New Yorkers diagnosed with diabetes, this is poised to make a significant impact if passed.
Governor Hochul is also championing legislation that would prevent hospitals from suing patients earning less than 400% of the Federal Poverty Level, which is $120,000 for a family of four. It would also expand hospital financial assistance programs for low-income New Yorkers and limit monthly payments and interest charged for medical debt.
Reproductive Rights
Since Roe v. Wade was overturned, reproductive rights have become a key issue across the United States. Thirteen states are set to address abortion in the 2024 elections. This includes:
- Arkansas
- Arizona
- Colorado
- Florida
- Iowa
- Maine
- Maryland
- Nebraska
- Nevada
- Montana
- Missouri
- South Dakota
- Pennsylvania
Voters in Colorado, Montana, and Nevada aim to uphold abortion rights through ballot initiatives. In Arizona, Arkansas, Florida, Missouri, Nebraska, and South Dakota, voters seek to expand abortion access. Iowa and Pennsylvania voters will consider constitutional amendments that would prevent abortion protection. Finally, both Maine and Maryland have referendums supporting abortion access. Maryland’s has already been approved for the 2024 state ballot.
Federal Healthcare Policy Priorities
The federal government is largely focused on making healthcare more affordable and accessible. Federal priorities include addressing social needs, expanding coverage, and ensuring access to care. Certain efforts to these ends are ongoing, due to the COVID-19 pandemic. These include reducing prescription drug costs, advancing health equity, and facilitating widespread vaccination. Measures are also in place to minimize out-of-pocket costs and provide enrollment assistance.
Expanding Access to Care
The FY24 budget includes Medicaid-like coverage for people in states that have not adopted Medicaid expansion under the ACA. It also includes financial incentives to ensure states with existing expansions maintain them. The budget also makes permanent the expanded ACA premium tax credits extended in the IRA.
COVID-19 Recovery
The COVID-19 pandemic is still ongoing and vaccinations continue to be necessary. Despite this, the federal government has deemphasized policy proposals for pandemic recovery.
Vaccination mandates and reporting provisions have drawn the ire of conservative lawmakers. Medicare currently requires that ambulatory surgical centers must report the COVID-19 vaccination status of their healthcare workers. On February 1st, a coalition of House Republicans introduced U.S. HR7216. The bill would effectively remove this reporting requirement. HR7049 also removes this requirement within the Veterans Health Administration. These policies are harmful to immunocompromised or elderly patients who are at greater risk of contracting COVID-19.
Reproductive Rights
The Biden Administration has placed a major emphasis on protecting reproductive rights. On January 24th, the administration released a series of statements related to this commitment. The Administration is committed to:
- Protecting access to abortion and abortion medication
- Ensuring access to Emergency Medical Care nationwide
- Expanding support for reproductive healthcare workers
- Defending reproductive rights in court
The administration has also created a Reproductive Rights Taskforce. Their most recent report outlines a multipronged approach to protecting reproductive rights both legally in practice. The Taskforce outlined practices to ensure access to medication abortion, the most widely used form of abortion care. The Taskforce also set forth best practices to:
- Enforce healthcare coverage for abortion procedures
- Provide education for patients and healthcare professionals
- Protect individuals’ ability to travel for abortion care when their states outlaw it
How Healthcare Issues Will Play Into the 2024 Elections
Healthcare issues will remain paramount in the 2024 election. For years, President Biden has championed healthcare. The ACA, IRA, and his commitment to reproductive rights signal this priority. Donald Trump, his likely opponent, has emphasized a private insurance framework for healthcare. Trump often touts his involvement in COVID-19 response, while Biden emphasizes his administration’s recovery process. These differences alone make healthcare a salient issue for the 2024 elections. Likewise, many healthcare-related bills forthcoming across the country and within Congress mean that the issue will continue to be salient.
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