What we are watching in 2020

While the federal health policy space is unlikely to see any major upheavals in an election year, there are still some key issues we will be watching in 2020.

1. Release of the final rules from the U.S. Department of Health and Human Services (HHS). Specifically, we are watching for:
   1. • The Centers for Medicare and Medicaid Services (CMS) and HHS Office of the National Coordinator (ONC) for Health IT interoperability rules. In conjunction with these final rules, CMS could also propose or finalize additional reimbursement policies that nudge providers toward interoperability.
      • The Substance Abuse and Mental Health Services Administration (SAMHSA) is also expected to finalize the new patient privacy rules for substance use treatment under 42 CFR Part 2 to align with HIPAA and the CMS interoperability efforts to give patients more control over their data.
2.  Scalability of opioid use disorder (OUD) funding and infrastructure to other substances. Last year, we wrote about the issue of states using OUD funding opportunities in order to address OUD, but also other substance use disorders (SUD) when there are opportunities to create long-term infrastructure and treatment. Many states are again seeing a resurgence in the use and deaths associated with methamphetamines and cocaine.
3. Efforts to establish a national patient identity system. In 2019, there was some rhetorical progress on the idea of creating a national system to correctly identify patients across medical settings, which would improve the quality of patients’ health data and better enable some sophisticated outcomes-based reimbursement models. By the end of the year, the only progress was in the budget law, where ONC will be required to draft a report regarding strategies that would enable better patient identification across systems. Last year, we covered a Senate committee hearing on this topic, so there continues to be an interested audience.
4. The fate of the Affordable Care Act (ACA) through court decisions. While the final ACA decision is expected to eventually end up at the Supreme Court, it could be heard there as early as this term, or as late as sometime after the 2020 election. Since the ACA policies impact the entire healthcare system and state economies, we are monitoring this closely.
5. Federal elections and policies. The results of the federal elections later this year could influence health policy and government funding for safety net programs for years to come. After the election, we are hopeful to see some movement on some of the bipartisan healthcare issues mentioned here.