Policy Brief Paper
Executive summary
Healthcare policies have the effect of facilitating or hindering healthcare delivery. On the other hand, legislation directly affects the environment that nurse’s practice on all levels. In that holistic nurses are advised to participate in the legislative process, influence the policy development by advocating and better meet needs of providers and care recipients. The paper evaluates the policy process and also the engagement of political activism that relates in ensuring healthcare policy reduces disparities, improves access and quality, reduced costs and promotes equity. The paper focuses on the student’s ability to evaluate policy process and the decision making whether certain policies achieve patient advocacy goals.
The strengthening Health Care and Lowering Prescription Drug Costs Act which seeks to amend the Patient Protect and Affordable Care ACT in providing for federal exchange outreach and educational activities. The legislation addresses two major concerns to the people; the lowering of prescription drug prices and the defending of the vital protection for people with pre-existing. The legislation packages influence three bills to lower prescription drug costs to help lower generic drugs in get to the market faster and measures that reinforce the protection of people with pre-existing conditions. The end result will be expanded enrolment in quality and affordable coverage for more people. The legislation will have an effect of removing barriers to the lowering of costs of generic drugs. Lowering generic drugs prices in the prescription drug market results to cost savings for tax payers and consumers. Statistically, generic drugs entry in the year 2017, led to market savings to consumers and tax payers amounting to $265 billion. In the same effect, the decrease of the average drug price by 50 percent in the first year of generic entry will translate to an 80 percent reduction in five years.
Background and significance
The Strengthening Health Care and Lowering Prescription Drug Costs Act is a combination of seven bills that affect change across the healthcare. The act focusing on two major section, drug pricing which is related to three bills and health insurance coverage that relates to the other four bills. The main aim of the bill is to lower drug prices through the restructuring of the patent process with the influence of preventing large pharmaceutical companies from developing a monopoly.
The three prescription drug bills involve extensive research and access to generic drugs and increases the speed of getting generic drugs on the market. The part of the legislation focuses on placing limitations that prevent exclusivity claims of large pharmaceutical companies. As a result, it would prevent the large pharmaceutical companies from paying other companies to keep generic drugs off the market. The bill would have the effect of increasing the number of generic drugs in the market and would push down high prescription drug prices.
The legislation has the focus to increase insurance coverage in the U.S through limiting access to short-term, limited duration insurance plans that have been discriminative against and increased funding consumers with pre-existing conditions. Following the loss of ninety percent of funding on the health insurance navigator programs and Affordable Care Act outreach and education programs. The programs were to help businesses and individual find and enroll in appropriate health insurance plans. The need for better programs that define success through emphasis on new communities and focus on application members. The bill arises from the requirement for each state to have no less than two navigator programs that collaborates with a community-based organization.
Policy Option/Position Statement
Bipartisan measures under three bills helped reduce the prescription drug prices which include the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act, the Bringing Low-cost Options and Competition while Keeping Incentives for New Generics (BLOCKING) Act and the Protecting Consumer Access to Generic Drugs Act. The other four bills meant to strengthen the Affordable Care Act are, HR 987 Marketing and Outreach Restoration to Empower, MORE, Health education Act, HR 1010 Prohibiting Short-Term, Limited Duration Insurance, the HR 1385 State Allowance for a Variety of Exchanges, SAVES Act and HR 1386 Expand Navigators Resources for Outreach, Learning and Longevity, ENROLL Act.
Lawmakers, both democratic and republican agree on the need to address direct cost to patients for healthcare especially drugs. Lowering the cost of prescription drugs is seen as a way to increase availability and therefore patient access to generic drugs. The recent actions involve republics seeking to weaken the ACA from the time it was enacted through arguing on its high costs and force people to purchase plans they don’t want. Support of the bill argue it facilitate the development and marketing of generic and biosimilar drugs and therefore help decrease the drug prices while promoting enrollment in ACA health exchanges. Strengthening Health Care and Lowering Prescription Drug Costs Act – H.R.987, would be recommendable to be executed at the state level and the drugs should be affordable to the patients and the generic drugs should be available to the public more quickly in a way that supports the need of the older Americans.
Evidence-Based Strategies
The effectiveness of the Strengthening Health Care and Lowering Prescription Drug Costs would be in lowering drugs prices through the restructure of patent process that would prevent large pharmaceutical companies from developing into monopolies concerning drug production. The bill effectiveness would be contributed by three prescription drug bills that increase research and access to generic drugs and speed the arrival of generic drugs in the market. The effectiveness of the bill would also come in the increase of insurance coverage through the limitation of access to short-term, limited duration insurance plans. The bill would effectively increase the funding for health insurance navigator programs and the Affordable Care Act outreach and education programs.
The efficiency of the bill would to decrease direct spending by $520 million and increase revenues by $93 million in a period of over ten years which would result to a net deficit reduction of $613 million. The provisions are also estimated to reduced the spending on appropriation by $24 million with the assumption that the appropriation actions are consistent with the provision. According to the Congressional Budget Office, the provisions of the legislation would provide $100 million annually to the Affordable Care Act navigator program as well as appropriate $200 million that will allow states to establish their own-based health insurance exchanges.
Representation of each states in the bill addresses the issue of equitability. The bill recommends and works towards the equitable access to prescription generic drugs and insurance programs in all states for all American citizens. A wide range of effects on the human sector by the legislation by increase the number of drugs available on the more market and increase the enrolment in government healthcare plans for CHIP and Medicaid. As a result, it would allow more equitable access to medical services for children, families, people with disabilities and older adults when they need it.
Recommendation for Actions
To reduce bias, the strategy of revoking the administration rule would expand the junk health insurance that must be enforce to protect people from getting the insurance as it will provide little to not coverage when it is needed the most. Research studies have shown that individual that buy insurance that last for up to three years do not know that it does not cover their pre-existing conditions. The effect of the policies would be to siphon off health individuals from the health insurance exchanges as the premiums increase for everyone else.
Preparing for the Opposition
The opposition of the bill provisions seek to support administration rules that make short-term, limited duration insurance plans readily available to people seeking insurance. The argument is based on health insurance under the ACA being unaffordable as it forces the purchase of plans that cover things are not needed. The opposition argue the young and health people should not pay for health care they do not want and need for the sake of subsidizing for the health care of older and sicker people. In response, the bill provision intent to help individuals in finding affordable plan through providing funding for state to establish their own-state-operated health insurance marketplaces. The provisions also expand the access to short-term health plan that don’t comply with consumer protections such as protection for individuals with pre-existing conditions.
References
Bill highlight: Strengthening Health Care and Lowering Prescription Drug Costs Act (H.R. 987). (2019, July 26). National Human Services Assembly. Retrieved from https://www.nationalassembly.org/resources/bill-highlight-strengthening-health-care-and-lowering-prescription-drug-costs-act-h-r-987/
Rep. Johnson votes on Strengthening Health Care and Lowering Prescription Drug Costs Act. (2019, May 16). Congressman Hank Johnson. Retrieved from https://hankjohnson.house.gov/media-center/press-releases/rep-johnson-votes-strengthening-health-care-and-lowering-prescription#:~:text=Johnson%20voted%20to%20pass%20H.R,people%20with%20pre%2Dexisting%20conditions
Strengthening Health Care and Lowering Prescription Drug Costs Act – H.R.987 – NWYC. (n.d.). National Write Your Congressman (NWYC) is an organization that gives small businesses a voice in American government – NWYC. Retrieved from https://www.nwyc.com/article/strengthening_health_care_and_lowering_prescription_drug_costs_act_hr987
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Freed, M., Cubanski, J., & Neuman, T. (2019). A Look at Recent Proposals to Control Drug Spending by Medicare and its Beneficiaries. The Henry J. Kaiser Family Foundation.
