Opening Remarks by Matt Eyles, AHIP President and CEO
AHIP Virtual National Conference on Health Policy and Government Programs 2022
March 14, 2022
Good morning, everyone, and welcome to AHIP’s National Conference on Health Policy and Government Health Programs. I’m Matt Eyles, President and CEO of AHIP.
We’ve put together an amazing virtual program…. One that explores the policies that will shape the future of health care affordability and access for all Americans.
It’s a great opportunity to engage with leading experts who are working to make health care better, more equitable, and more affordable.
We’ll focus on policy issues and emerging trends in Medicare, Medicaid, and programs serving those who are dually eligible.
We’ll also explore the future of employer-provided coverage as well as the individual market.
In all these markets, health insurance providers have gone above and beyond throughout the COVID-19 pandemic to ensure Americans get the affordable, high-quality, and equitable health care coverage they need and deserve.
Now it’s time to ensure that coverage remains strong for every American. Coverage based on strong public-private partnerships delivered through the private sector and committed to ensuring high-quality service and care for everyone.
COVID-19 and Beyond
As we enter the third year of the public health emergency, health insurance providers continue to take the lead to ensure that people have access to COVID-19 testing, treatment, and vaccines. They have also taken decisive action to provide improved access to preventive care, as well as treatment for chronic conditions and other illnesses.
Working together with doctors and hospitals to set up alternative pathways to engage patients through telehealth services … increasing access to behavioral health care through virtual technologies … and providing food and other non-medical services for their vulnerable enrollees and underserved communities.
Last year, our Vaccine Community Connectors program helped vaccinate more than 2 million seniors from at-risk communities against COVID-19 in less than 100 days.
We worked hard to ensure the rules around surprise medical bills protect Americans from crippling surprise expenses while improving affordability. And even today amid numerous legal challenges, we continue to back the Administration’s rulemaking to end this practice, which has bankrupted too many hardworking American families.
We advocated for solutions to expand coverage to more Americans, including the improved subsidies included in the American Rescue Plan Act – or ARPA – which today are helping millions of more hardworking families buy coverage in the individual market.
We expanded initiatives to provide health and financial education to underserved communities, and we remain committed to ensuring health equity.
And today, as Americans are more focused on their health than ever – as they prioritize both their physical and mental well-being – as they fight to finally emerge from the pandemic – health insurance providers continue to work to ensure they have access to affordable, high-quality coverage and care.
It’s a central policy issue. Because it’s critical for the future of our country.
Keeping the nation healthy enables all of us to thrive physically, emotionally, socially, and financially. And that translates directly into a stronger America.
It is those goals – those values – that inspire America’s health insurance providers.
It’s a commitment we make to families and communities.
It’s a trust put in us by our state and federal policymakers along with leaders across our health system.
And it is why our focus for 2022 – our vision for this year and beyond – is leading solutions and advocating for policies that will result in healthier people. Healthier families. Healthier communities. And a healthier nation.
Looking Ahead: Health Insurance Provider Priorities for 2022
As we move through 2022, our industry will continue to support solutions to ensure that all Americans have access to affordable, high-quality health insurance coverage.
We’ll continue to hold Big Pharma accountable for the out-of-control prices that they – and they alone – set and increase year after year.
And we’ll call on lawmakers to resist giving Big Pharma a free pass to continue business as usual for price hikes that put medicines out of reach for too many American families.
For example - take insulin, which is lifesaving for millions of Americans.
On average, insulin prices increased 11% every year from 2001 to 2018. Why? Because there’s nothing to stop Big Pharma from raising them.
This drive to maintain the highest profit margins have resulted in drug manufacturers earning, on average, $18.6 billion in total global revenues for a new drug – 10 times more than the average $1.8 billion cost of new drug development, according to a recent AHIP study.
And while the U.S. accounts for just 4% of the world’s population, it accounts for more than half (56%) of total drug revenues for a typical branded drug.
Big Pharma’s campaigns are based on distraction, a sleight of hand, saying….“look over there” in an attempt to blame on every other part of the supply chain.
Let’s keep it real: The problem is the price – the underlying price of a drug – and we need solutions that create greater accountability for Big Pharma.
Solutions that stop drug manufacturers from engaging in patent games that distort the patent system for their own gain.
Solutions that speed the availability of biosimilars as much needed competitors to high priced biologics….
That support the use of specialty pharmacies for safe, more affordable access to physician-administered drugs….
And that stop drug manufacturers from abusing copay cards and charitable organization structures ultimately for their own financial benefit.
It’s easy to offer copay assistance or donate millions when your model tells you the result and return on that investment is tens or even hundreds of millions per year.
We’ll also work to ensure that every American has access to mental health services and substance abuse disorder treatment.
Improving access to quality behavioral health care for all Americans--when and where they need it--is a multifaceted challenge, particularly among under-represented and underserved communities.
Use of mental health services increased more than 100% over the past decade, and the pandemic increased the need.
More has to be done to respond to this need. Increase the number of behavioral health providers. Eliminate barriers on access to telehealth. Fully integrate behavioral health into value-based care.
We’ll continue to engage with Congress and the Administration on new solutions that Americans need now to improve behavioral health care for children, adolescents, and adults.
We’ll also work to deliver more competition to the nation’s health care system.
We’ll engage with government and other stakeholders to advocate for the laws, regulations, and enforcement actions that remove anti-competitive behavior that’s raising health care costs for Americans….
That reduce monopoly behavior from dominant health care systems and private equity firms, which raise health care costs without adding value for patients….
That encourage effective – and affordable – ways to deliver care, such as telehealth and home-based care that reward for better patient outcomes.
Making Coverage Affordable and Accessible for More Americans
We’ll continue to advocate for policies that will allow more low-income people and families to get covered.
A record 14.5 million people now have coverage through the individual market—both because of the quality choices available in the individual market, and the expanded subsidies provided through ARPA.
We should continue to build on that achievement – extending or making those subsidies permanent and allowing this market to thrive as a competitive market that works.
We’ll also keep working to improve employer-provided coverage.
Employer-provided coverage showed extraordinary resilience throughout COVID-19, delivering affordable access to care, effective ways to improve health, and financial security for nearly 180 million Americans.
Now is the time for new solutions that make it even more flexible and valuable for families.
For example, we strongly support continued flexibility for Consumer-Directed Health Plans to cover telehealth before a patient touches their deductible.
This has been a highly popular and successful benefit. It should be permitted to continue.
Strengthening and Improving Medicare Advantage
Our commitment to protecting the most vulnerable Americans has also made programs like Medicare Advantage such a popular choice among seniors and people with disabilities.
Medicare Advantage is the leading example of the public and private sectors working well together to provide affordable, high-quality health care to Americans.
MA plans continue to expand the important services they offer, delivering more value to the seniors and Americans with disabilities that rely on the program every day.
From integrated dental, vision and hearing benefits, to meal and transportation benefits, to wellness programs.
Over 90% of seniors enrolled in MA are satisfied with their coverage, and the benefits they receive, especially coverage for preventive care.
Study after study shows that MA plans improve health.
MA plans also provide financial security, with premiums becoming more affordable and caps on annual out-of-pocket costs not available to those in Original Medicare.
The result? More than 28 million Americans choose Medicare Advantage because it delivers better services, better access to care, and better value than original Medicare.
And, because their constituents value MA so highly, MA has strong bipartisan support in both sides of Congress.
Over 340 bipartisan House members and 60 Senators recently signed onto letters to CMS urging the agency to keep MA strong and stable.
Enrollees in MA are also more racially and ethnically diverse than those in the Original Medicare program. And Medicare Advantage has also been a tremendous benefit for dual eligible Americans, who are often the most vulnerable patients.
Dual eligibles enrolled in Medicare Advantage were less likely to experience any COVID-19-related disruptions to their health care compared to duals enrolled in original Medicare.
They were also less likely to report that they were unable to get diagnostic or medical screening tests, treatment for ongoing conditions, and urgent care for accidents or illnesses during the pandemic.
Protecting Medicaid Managed Care
Medicaid managed care has been just as essential.
A public-private partnership between state governments and health insurance providers, Medicaid managed care ensures affordable, high-quality care for Americans who need it most.
Medicaid and CHIP programs provide coverage and a pathway to care for 1 out of every 4 Americans, and Medicaid managed care plans serve over two-thirds of them.
The programs cover eligible low-income adults, pregnant women, children, older adults, and people with disabilities, and include 2 million of our veterans.
Medicaid managed care plans deliver real savings through patient-centered care coordination programs, high-quality and accessible provider networks, increased prescribing of generic prescription drugs, and other effective solutions.
They create customized programs for healthier moms and babies, encourage vaccinations, and help their members overcome substance use disorders.
We’re seeing new programs and community partnerships that are providing nutritious meals and exercise programs, improving individual health, and reducing social barriers to better health.
And Medicaid managed care offers Americans access to home and community-based services, giving them the freedom to receive care in their home.
When the public health emergency ends, we need to make sure the efforts to restart eligibility determinations in Medicaid don’t inadvertently lead to millions of Americans falling off of coverage.
Taking Action: Addressing Health Equities and Social Determinants of Health
Health insurance providers have long been, and today remain, strongly committed to health equity and removing social barriers to health.
Everyone deserves health care access, regardless of the individual qualities that make us each who we are, from our race and zip code to gender, age, and how much we earn.
And we’re working together to improve our outreach to underserved communities, and to combat social factors that can lead to poorer health conditions.
Through the pandemic, health insurance providers put their community relationships and partnerships to use, with new efforts that build on our long-standing commitment to improve health equity.
And that work continues today, as we advocate for new health equity policies.
We support solutions to broaden the diversity of the health care workforce, including loan repayment and scholarship programs like the National Health Service Corps and Nurse Corps.
Improved race and ethnicity data standards and data collection that better allow people to select how they identify.
Better data to identify and act on disparities based on race, ethnicity, disability status, sexual orientation, and gender identity.
Investments in communities and community resources that help to address health-related social needs.
Greater flexibilities for health insurance providers to mitigate social barriers to health to promote more equitable access to care.
Health Insurance Providers: Guiding Greater Health
Health insurance providers are champions of care in 2022 and beyond, and we are driven every day to improve the health, well-being, and financial security of every American.
We won’t shrink from the challenges that may face us – the stakes are too high.
As you participate in this conference over the next week, you will hear many stories and best practices from presenters, panelists, sponsors, and exhibitors who are leading the way.
I am grateful for their leadership, and their willingness to share their insights.
Please be sure to review the agenda. Participate in all of the great sessions you can. Visit the Exhibit Hall to explore solutions to better serve your members. And take what you learn back into your organizations.
As health insurance providers and champions of care, we are all working every day to provide Americans with the affordable, high-quality health care they need, and as much certainty and stability as possible.
Together, we are Guiding Greater Health.