Health Care Legislation Tracking Research Paper
HEALTH CARE LEGISLATION TRACKING
Purpose: This assignment will enhance your skills in legislative bill tracking and analysis.
Directions: Track a piece of health care legislation (current or previous legislative session).
- Describe the legislation. Include, bill number, title, purpose, aim, objectives, goals of the legislation
- Explain the rationale for selecting the legislation. Include research findings that related to the need for the legislation.
- Identify who supported and opposed the legislation and provide detailed rational why they supported or opposed the legislation.
- Describe current status of the bill and the outcome of the legislation
- Discuss the economic impact of the legislation related to cost and quality of care
- Discuss the implications of this bill on professional nursing practice and leadership
** NOTE: Papers should be no longer than 5 double spaced pages in length (excluding Title Page and References and please note faculty will stop reading after 5 pages of content).
Headings are expected please use the grading criteria items for headings
Papers must be typed and in APA format
Student’s Name: Date:
HEALTH CARE LEGISLATION TRACKING
EVALUATION CRITERIA
| Criteria | Possible Points | Points Earned | Comments |
| Legislation Description | 10 | ||
| Legislation Rationale | 15 | ||
| Legislation Support and Opposition. Provide detailed rationale for support and opposition of the bill | 15 | ||
| Legislation Outcome | 15 | ||
| Economic Impact of Legislation | 20 | ||
| Impact of legislation on Professional Practice and Nursing Leadership | 15 | ||
| Clear grammar, spelling, writing style, references, double spaced paper within five page limit (excluding references and title page) and APA style. Headings are expected. Please use the grading criterial items for headings. | 10 | ||
| TOTAL | 100 |
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Solution
Legislation Description
One of the most impactful bills that were introduced in the 116th Congress, which was convened between 2019 and 2020, was the prescription drug pricing reduction act of 2020. S.4199 – Prescription Drug Pricing Reduction Act of 2020 was introduced by Senator Grassley Chuck, who is the Republican Senator for Iowa (Congress.gov, 2020). The main purpose of the prescription drug pricing reduction act of 2020 was to amend different titles of the social security act so as to allow the reduction of prices of prescription drugs among patients utilizing Medicare and Medicaid programs. The bill was also intended to improve transparency related to pharmaceutical transactions and prices and to lower the out-of-pocket costs facing patients while ensuring accountability of pharmaceutical companies to taxpayers (Congress.gov, 2020). Senator Grassley introduced the bill on the 2nd of July 2020. The main objective of the prescription drug pricing reduction act of 2020 was to implement changes in different government-funded insurance programs such as Medicare and Medicaid so as to reduce the prices of prescription drugs. The bill sought to address different things, including requiring pharmaceutical companies to provide rebates to the centers for Medicare and Medicaid services for various drugs that were covered under Medicare in instances where such pharmaceutical companies increased prices faster than inflation (Congress.gov, 2020). The bill also requires drug manufacturers to provide rebates to CMS for any single doses of drugs that were discarded under the Medicare program based on the information that was reported by providers. The bill also sought to reduce out-of-pocket spending by eliminating a beneficiary cost-sharing approach under the Medicare prescription drug benefit (Congress.gov, 2020). The bill also required the adoption of pricing models for prescription drugs that prohibited any form of spread pricing and also increased the number of rebates payable to pharmaceutical companies under the Medicaid drug rebate program. The bill also required the CMS to provide the necessary information related to rebates, drug discounts, and payments between pharmacy benefits, managers, pharmacies, and health plans publicly (Congress.gov, 2020).
Legislation Rationale
One of the most concerning issues in the healthcare sector in the US currently is health care costs. Over the past several decades, health care costs have risen significantly and raised the concern of numerous stakeholders, including patients at care providers and regulators such as the government. According to Crowley et al. (2020), healthcare spending rose by nearly a trillion dollars between 2009 and 2019, even when considering inflation. By 2019 healthcare spending in the US was nearly 3.8 trillion, which represented $11582 per person annually (Papanicolas et al., 2018). The cost of healthcare in the US represents the highest cost in the world, even considering developed countries. By 2028 it is expected that the cost of healthcare in the US will rise to nearly $6.2 trillion, representing an average of $18,000 per person annually (Shrank et al., 2021). The skyrocketing costs of healthcare in the US have therefore remained an issue of great concern among various stakeholders, including patients and political leaders. As the costs of healthcare in the US have continued to rise significantly every year, the income for individuals and families has stagnated for many decades resulting in a significant proportion of the population not being able to afford healthcare services. A record number of the population in the US can also not be able to afford insurance coverage. A combination of lack of health insurance cover and skyrocketing costs of healthcare contributes significantly to the lack of access to healthcare services among low-income and marginalized populations (Shrank et al., 2019). It has therefore become important for regulators such as Congress and the Federal Government to adopt various interventions to try and control the cost of healthcare in the US. Over the years, various legislations have been introduced in Congress in a bid to control healthcare costs. The prescription drug pricing reduction act of 2020 is one of the most recent regulations that has been introduced in Congress to try and deal with the challenge of skyrocketing healthcare costs.
Legislation Support and Opposition
There are various groups that were in support of the Prescription Drug Pricing Reduction Act of 2020, which include Republican senators and representatives of professional nursing organizations and different non-governmental organizations. The main rationale that Republican senators and representatives provided in support of the Prescription Drug Pricing Reduction Act of 2020 was that there was a need to control the prices of healthcare services in the US, which would be a more effective solution than providing universal health care coverage (Congress.gov, 2020). Republicans believe that instead of introducing a universal health care coverage that could cost the country more, the Federal Government should help to regulate the healthcare systems in a way that will control healthcare costs. Professional nursing organizations have also been supporters of the act to reduce the price of prescription drugs. Professional nursing organizations’ support of the act is based on their concern that the escalating costs of healthcare are resulting in significant disparity inaccessibility of healthcare services. Numerous non-governmental organizations whose main purpose is to regulate the cost of healthcare have also been supporting the art to reduce the prices of prescription drugs. The NGOs support the act because it aligns with their main goals and objectives of advocating for controlled prices of various health care procedures in the US (Congress.gov, 2020).
In contrast, Democrat senators, house representatives, and associations of pharmaceutical companies have been in opposition to the Prescription Drug Pricing Reduction Act of 2020. The main reason that Democrats have provided in opposition to the bill to regulate the prices of prescription drugs is that such a move is not adequate in addressing the high prices of healthcare in the US. The Democrats favor a more radical approach in regulating the Healthcare cost, which includes providing universal health coverage to all Americans. On the other hand, the Association of Pharmaceutical companies has been opposing the bill that seeks to reduce and regulate the prices of prescription drugs, arguing that such a move is interfering with a free-market model, which is the central business model in the US. Pharmaceutical associations argue that just as Congress cannot intervene to regulate the prices of other consumer goods, they should not intervene and regulate the prices of pharmaceutical products, including prescription drugs (Congress.gov, 2020).
Legislation Outcome
The S.4199 – Prescription Drug Pricing Reduction Act of 2020 is currently pending in Congress after only two readings. The bill was therefore referred to the committee on finance and has not been reintroduced or debated in Congress since 2020. Once the bill has been reviewed by the committee on finance and approved, it will then be reintroduced on the floor of Congress and debated. This will then be followed by voting, beginning with the House of Representatives and then Congress. If Congress approves a bill, it will then be forwarded to the president to be signed into law.
Economic Impact of Legislation
The economic impact of the bill to restrict the prices of prescription drugs would be significant. According to Crowley et al. (2020), price controls can help to reduce the cost of health care in the US by at least 25%. This is because numerous pharmaceutical companies in the US take advantage of the free market to overcharge consumers. Controlling prices of drugs and other healthcare equipment can therefore go a long way in helping to control the skyrocketing cost of healthcare in the US. It is estimated that price controls can help save the US healthcare system at least$250 Million annually. This money can be relocated to other areas in health care, such as hiring more health caregivers, as the demand for healthcare services is expected to continue increasing significantly as the population ages (Papanicolas et al., 2018).
Impact of legislation on Professional Practice and Nursing Leadership
The bill to control the prices of prescription drugs can have a significant impact on nursing leadership and practice. The enactment of the bill into law will therefore increase the prominence of nurse practitioners who would act as supervisors to ensure that pharmaceutical companies adhere to the price guidelines. Nurse practitioners would then report any lack of adherence to price control by the authorities such as the Centers for Medicare so as to provide funds to the necessary pharmaceutical companies. Nurse practitioners would therefore play a significant role in ensuring that the law controlling the prices of prescription drugs is followed.
References
Congress.gov. (2020). S.4199 – 116th Congress (2019–2020): Prescription Drug Pricing Reduction Act of 2020. Congress.Gov | Library of Congress. Retrieved the 1st of December, 2021, from https://www.congress.gov/bill/116th-congress/senate-bill/4199
Crowley, R., Daniel, H., Cooney, T. G., & Engel, L. S. (2020). Envisioning a Better US. Health Care System for All: Coverage and Cost of Care. Annals of Internal Medicine, 172(2_Supplement), S7. https://doi.org/10.7326/m19-2415
Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health Care Spending in the United States and Other High-Income Countries. JAMA, 319(10), 1024. https://doi.org/10.1001/jama.2018.1150
Shrank, W. H., DeParle, N. A., Gottlieb, S., Jain, S. H., Orszag, P., Powers, B. W., & Wilensky, G. R. (2021). Health Costs And Financing: Challenges And Strategies For A New Administration. Health Affairs, 40(2), 235–242. https://doi.org/10.1377/hlthaff.2020.01560
Shrank, W. H., Rogstad, T. L., & Parekh, N. (2019). Waste in the US Health Care System. JAMA, 322(15), 1501. https://doi.org/10.1001/jama.2019.13978