Opinion

How Recent Executive Orders Will Affect Your Health Care Costs

In the age of coronavirus, health insurance coverage and medical costs are some of the most pressing concerns for Americans. While health care reform remains embedded in political debate, there’s been a slew of recent executive orders that could put us on the path to more transparent and affordable care.

For starters, anyone eager to see an end to blackbox hospital costs now has reason to celebrate. That’s especially true for those ages 64 and over — more than 60 percent of whom are worried about receiving an unexpected medical bill. Fortunately, a recent court decision held up an executive order that requires hospitals to post list prices to help put an end to surprise billing.

Now, patients will be able to access an itemized list of treatment prices, instead of being hit with an astronomical bill at the end of a hospital visit with little explanation as to where these costs come from. That’s good news for the overwhelming 93 percent of Americans who say prices for medical procedures should be as transparent as prices of food in the supermarket. There’s also hope that when hospitals are required to share the itemized bill, charges for $15 Tylenol pills and $8 boxes of tissues might become a thing of the past.

But increased price transparency isn’t enough to combat the skyrocketing costs of prescription drugs. With over 20 percent of Americans unable to afford a necessary prescription drug over the course of a year, it’s certainly an issue that requires attention. In fact, almost 90 percent of people believe prescription drug prices are too high. When it comes to seniors, almost 40 percent say they pay more than $50 a month on prescriptions.

Fortunately, four recent executive orders are designed to tackle this issue. The first directs federally qualified health centers to provide discounts on insulin and epinephrine to low-income Americans. This would greatly alleviate drug costs, especially for the over 7 million Americans who suffer from diabetes.

The second order would prohibit deals between pharmacy benefit managers and drug manufacturers. This is good news for consumers. PBMs often act as “middlemen” that actually drive up costs for patients, causing them to miss out on discounts for prescription drugs. In a similar vein, another executive order would require that the United States pay the lowest prices possible for Medicare Part B drugs. However, the jury is still out on this mandate; the president gave drug companies until Aug. 24 to come back with a different deal.

The coronavirus pandemic has also exposed America’s reliance on foreign manufacturers, specifically ones in China, for prescription drugs. This realization has pushed our federal government to consider ways in which we can lower medical costs and better prepare our country for a future health crisis.

Now, a recently signed executive order would allow for the importation of prescription drugs from Canada and other counties into the United States. The administration has also suggested putting forth a series of orders that would require pharmaceutical companies to develop drugs in the United States. This could drastically decrease pharmaceutical shortages, giving Americans a reliable supply of medicine and potentially driving down costs.

While Americans certainly want price transparency and reduced drug costs, there’s another crucial piece to the health care puzzle: protection for those with pre-existing conditions. After all, it’s one of the most praised aspects of the Affordable Care Act. It’s also one that has many people nervous now that the administration has asked the Supreme Court to invalidate the ACA. Fortunately, yet another executive order has been signed that will ensure those with pre-existing conditions are still covered, regardless of the court’s decision.

We have a long way to go when it comes to ensuring Americans can access affordable and transparent health coverage, but we’re making progress. As our political leaders continue to tackle health care reform, these executive orders should provide a blueprint for the type of change consumers want to see.

 

Jan Dubauskas is a health care expert, enthusiastic insurance pro, attorney and mom serving as vice president of healthinsurance.com.

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