CHPRE Summer Lecture Series: Policymaking Priorities for State and Federal Governments During COVID-19
September 16, 2020 / by Sarah Mae Dizon
Policy experts spoke on the various needs of doctors, practices and health care providers at an online panel hosted by the College’s Center for Health Policy Research and Ethics.
As a part of the Center for Health Policy Research and Ethics’ (CHPRE) Health Policy Summer Lecture Series, four panelists discussed policymaking for the short and long term in the wake of the COVID-19 pandemic.
From Capitol Hill, Dr. Len Nichols emeritus professor of health policy and moderator, was joined by Audrey Smith, a legislative assistant to Senator Joe Manchin, and Stuart Portman, a health policy advisor for the Majority Staff on the Senate Finance Committee. Executive Vice President and CEO designee of the American Academy of Family Physicians, Shawn Martin, was also on the panel to speak on the future of primary care. Lastly, the panel was joined by Hemi Tewarson, the Division Director at the National Governor Association’s Center for Best Practices.
“One of the things I wanted to talk about today is what you don’t necessarily see on the headlines,” Smith began, explaining that Joe Manchin’s office—which represents the state of West Virginia—made plans at the beginning of the year to further address substance use disorder and overdose deaths throughout the state. However, these plans lost priority due to COVID-19. Like many across the country, she was taken aback by the emergence of the pandemic and the drastic changes that came with it. “What we do a lot of is responding to constituents.”
Smith responded to calls from concerned doctors, patients and other health care providers in West Virginia on the impact of the pandemic. One particular issue doctors had was implementing telehealth services. She explained that the state does not have great cellphone coverage in addition to very little broadband access.
Another major issue that West Virginia began to experience was the loss of revenue on elective procedures in hospitals and health care providers. As a result, the state has seen three hospitals close since the start of the public health emergency.
“From our view, providing support to our rural health providers has been a major initiative,” says Smith. Her office has been working hard to ensure that funding gets to the providers that need it most.
Recently, West Virginia has been relatively well and is on the path toward reopening. However, Smith noted that the health disparities for African Americans in the state are significant and concerning in the midst of the pandemic.
To learn more about how Congress is working to help states like West Virginia, Stuart Portman spoke about his role on the Senate Finance Committee. He oversees all policies that relate to Medicaid, the Children’s Health Insurance Program, the Affordable Care Act and health taxes. Portman mentioned that there are many different issues they are juggling that are related to the COVID-19 response and beyond the virus. One particular issue the committee has been focusing on is prescription drug pricing.
“In America’s healthcare system, we talk a lot about symptoms and not a lot about the underlying issues,” noted Portman. “That also plays a role in our policy decisions as well.”
Additionally, they’ve focused on maternal health. Portman explained that a great deal of work is needed to improve maternal health outcomes in the United States.
The majority of Congress’ time Portman notes, is still being spent on the COVID-19 response. Since his role is focused on Medicaid, he’s spoken with providers, Medicaid directors, and governors’ offices on budget shortfalls.
One particular sector of the healthcare industry that’s been facing issues are small primary care practices in the midst of the pandemic. To speak on this matter, Executive Vice President of the American Academy of Family Physicians, Shawn Martin, discussed the future of primary care and its current state. “The healthcare system was under great stress prior to the pandemic,” says Martin—the outbreak of COVID-19 was an added layer of stress that he notes the system was not well prepared for.
After about three weeks of the pandemic, the American Academy of Family Physicians released surveys into the field. They found that primary care practices experienced a significant reduction in staff. Martin notes that practices of all sizes and locations underwent operational stress due to the rapid changes caused by COVID-19.
Martin also expressed concern over the future of small, independent practices. He emphasized their importance in the healthcare systems of suburban and rural communities, “When you think about those practices not being existent moving forward, that’s an alarming trend that we’re very concerned about.” Due to the aging population, the need for primary care has increased in the United States. Investing in primary care practices is pertinent more than ever.
Investing in primary care practices will take the support of both the federal and state government. Hemi Tewarson, who leads the Health Division of the National Governor’s Association’s Center for Best Practices, spoke on the role of governors during this unprecedented time. She describes her division as a think tank support network. She spoke about the priorities of governors across the country in the context of the pandemic and the short- and long-term impacts of their budgets.
“They are facing significant budget shortfalls,” she says, citing that states experienced a revenue cuts that ranged from ten percent to seventy percent. “State revenue is a hard thing to address. Unlike the federal government they have to balance the budget.”
A major issue concerning state budgets is preventing the elimination of public programs that are needed during the pandemic. Because of this, there has been incredible pressure to open back up across states due to the economic impact of closures. Tewarson notes how loosening restrictions is going to be a long process, and how the flu season may have an impact on identifying the virus in the future.
“Already some states have seen some uptick like Arizona and Florida,” says Tewarson on the possibility of a second wave in the wake of reopening’s.
Another health policy issue her association has been working on is insurance plans and what insurers will pay for when arrangements with the federal government end on COVID-19 testing. “We’ve been having multiple calls on this topic with state officials,” she mentions.
Tewarson noted that governors on both side of the aisle are asking for more federal dollars during this unprecedented time. As mentioned before, a major concern for states will be balancing budgets as the pandemic carries on for the foreseeable future.
Significant work is being done in all levels of the government and the healthcare industry to address the unique problems posed by the current pandemic. Experts like the panelists in the webinar are aiming towards what works best for health care providers, workers, and their patients across the country.
Details for upcoming webinars can be found on the CHPRE Health Policy Series page.