Every time we turn on the television, we see politics. Not just campaign commercials, but also nearly every news event – from devastating weather events to wars across the globe – is being put through the filter of American politics.
Be that as it may, ironically, we are entering the doldrums of lawmakers actually getting anything done. Finding itself on the precipice of yet another threat of a federal government shutdown, last week Congress passed a let’s-try-this-again-in-12-weeks extension to the budget, and then they went home to campaign.
But the lack of activity in Washington is just the quiet before the storm.
Traditionally, the first few months of a two-year congressional session is its most active period. On average, 50 percent of a congressional session’s bills are introduced in the first six months. This makes sense if you think about all those new lawmakers, eager to make a mark for themselves, full of energy and hope, pushing out the ideas that they campaigned on in the form of bills.
So, 2025 promises to be a very active year in terms of healthcare policy, at both the state and federal levels.
Let’s tick through a few healthcare policy issues coming at us in the next 12 months:
First, look to the lame-duck session immediately after the elections, but before the new Congress takes their seats, for a healthcare package to attach to the government budget that needs to be passed. That healthcare package may include telehealth extensions, as well as a discussion about provider reimbursement from Medicare.
Starting in January, bills will start circulating again that would fortify the transparency rules and the No Surprises Act. One part of the No Surprises Act that will likely not be acted on will be what to do with balance billing for ground ambulances. That’s okay; the states have been hard at work on that, and legislation on ground ambulances will continue to be passed at the state level in 2025. Five states passed ground ambulance laws in 2023, and another five states passed laws this year.
A relatively new category of healthcare policy we can expect to explode over the coming year is healthcare legislation related to data. Included in this category would be legislation regarding artificial intelligence (AI), consumer data privacy, cybersecurity in healthcare, and continuing regulations on data interoperability and administrative transactions.
With regard to AI and consumer data privacy, again, while we’ve seen ideas swirling in D.C, we’re seeing a lot more legislation actually pass at the state level. Twenty-two states have passed laws on consumer data privacy, and we can expect more in 2025. In general, these state laws exempt Health Insurance Portability and Accountability Act (HIPAA)-covered entities and data; however, as we know, not all of the data collected by healthcare entities regarding patients falls under HIPAA.
The states are also actively passing AI legislation. To date, the state AI laws have not centered on healthcare, but we can expect that they soon will.
In contrast, the new Congress in D.C. will likely be more active on healthcare cybersecurity than the states. A number of proposals are circulating now that would do one of two things: they either a) provide resources for healthcare entities, providers in general, after they are impacted by cyber attacks, or b) they add more requirements for healthcare entities to prevent cyberattacks.
You may recall, too, that the U.S. Department of Health and Human Services (HHS) plans to modify the HIPAA security rule through regulations sometime over the next six months. Those modifications are expected to be specifically focused on cybersecurity.
We can also expect more congressional work on pharmacy benefit managers (PBMs) and private equity’s role in healthcare.
One area of healthcare policy where we will likely not see any change in the new Congress is the Affordable Care Act, even though the Republican vice presidential nominee, J.D. Vance, appeared to reference it a number of times last week.
While the ACA is still mentioned in speeches and campaign commercials for the presidential election, the publication The Hill reported last week that there is no appetite for re-litigating the law within Congress.
This echoes what we heard earlier this year, when Senate Republican Leader Mitch McConnell said that the battle over the Affordable Care Act is “largely over.” The focus next year will be on tax reform, according to Republican lawmakers who were interviewed by The Hill.
In sum, it’s quiet now, but we should buckle up for a big year ahead of us in healthcare policy.
