ACTION AGENDA

The Public Sector HealthCare Roundtable is a non‐profit, non‐partisan coalition of public sector purchasers from across the U.S. including states, counties, and municipalities that collectively spend tens of billions of dollars annually on health care benefits to provide coverage for millions of employees, retirees, and their dependents.

The Roundtable is committed to ensuring that all public sector employees, retirees, and their dependents have access to affordable, quality health care coverage. The members of the Public Sector HealthCare Roundtable have a long-term commitment to maintaining programs that enable public workers, retirees, and their families to obtain high-quality health coverage at a cost that is affordable and sustainable for the workers, their families, and their employers..

As such, the Roundtable is committed to the following policy priorities in 2019 to ensure a more sustainable, rational health care system for all Americans:

• Quality, Affordable Health Care Coverage:  We support efforts to ensure that all Americans
  have access to quality, affordable health care coverage.
  • Action Items:  Support policies that provide incentives to purchase coverage and sustain
    federal and state marketplaces; support efforts to stabilize insurance markets and oppose
    those that undermine them.
  • Relevant Legislation & Regulation:  ‘Bipartisan Health Care Stabilization Act of 2017 (H.R.
    4695)
  • Tools:  Letters to Congress, meetings with congressional staff, signing stakeholder letters with
    allies, Public Sector Health Care Roundtable member outreach and education.
• Health System Innovation and Sustainability:  We support policies that constrain health care
  cost growth and ensure the sustainability of public programs, including the movement to
  innovative payment models based on value and quality, rather than volume.
  • Action Items:  Support efforts to develop innovative models via CMMI; identify and consider
    support of bipartisan legislative proposals that move to value-based payment models; support
    CMS efforts to revise and improve value-based payment models.
  • Relevant Legislation & Regulation:  Implementation of the Creating High-Quality Results and
    Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 (S. 870);
    implementation of multiple CMMI demonstration programs, including those related to
    accountable care (e.g., Next Generation ACO), episode-based payment (e.g., Bundled Care
    Payment Initiative), primary care transformation (e.g., Independence at Home) and others,
    Patient Choice and Quality Care Act of 2017 (S. 1334)
  • Tools: Letters to CMS, meetings with CMS officials, meetings with congressional staff, signing
    stakeholder letters with allies, Public Sector Health Care Roundtable member outreach and
    education, white papers with key allies.
• Pharmaceutical Cost Containment:  We support congressional and regulatory efforts to
  establish and sustain greater competition in the pharmaceutical – and especially the
  biopharmaceutical – marketplace. We also support ongoing efforts that seek to increase the
  pace of approval with the pace of discovery of safe, innovative, and cost-effective
  pharmaceutical and device products in the U.S.
  • Action Items:  Enthusiastically support legislation to shorten market exclusivity for biologic
    drugs, to allow Medicare to negotiate with manufacturers, to speed FDA approval of generics
    while maintaining appropriate levels of review, to create incentives for value-based
    purchasing, and to target abusive delay tactics that are being used to block entry of affordable
    generic drugs; support efforts to increase transparency to address the opioid epidemic.
  • Relevant Legislation and Regulation:  The Creating and Restoring Equal Access to Equivalent
    Samples Act (CREATES Act) (S. 974); the Price Relief, Innovation, and Competition for
    Essential Drugs Act (S. 3094 and H.R. 5573); the Improving Access to Affordable Prescription
    Drugs Act (S. 771); implementation of the Opioid Crisis Response Act of 2018 (S. 2680);
    support Administration OECD reference pricing efforts.
  • Tools:  Meetings with FDA officials, letters to Congress, meetings with congressional staff,
    signing stakeholder letters with allies, Public Sector Health Care Roundtable member
    outreach and education, white papers with key allies.
• Health Care Quality and Improved Outcomes:  We support the further development and use
  of quality measures, and particularly those in high-impact areas such as the complex chronically
  ill, as well as policies that establish and disseminate comparative effectiveness research in order
  to identify the most appropriate treatments at the lowest cost that will achieve the highest-quality
  outcomes for patients.
  • Action Items:  Support efforts to fund public-private entities such as the National Quality
    Forum; Support the continued funding of the Patient Centered Outcomes Research Institute
    (PCORI) and efforts to compare cost data;
  • Relevant Legislation and Regulation:  Support efforts of the Agency for Healthcare Research
    and Quality in implementation the National Quality Strategy; support 2019 legislative efforts to
    reauthorize PCORI (bill forthcoming); establishment of evidence-based quality measures in
    CMMI demonstrations.
  • Tools:  Letters to Congress, meetings with congressional staff, signing stakeholder letters with
    allies, Public Sector Health Care Roundtable member outreach and education, white papers
    with key allies.
• Health Care Tax Policy:  We strongly oppose approaches such as the so-called “Cadillac tax”
  and “health insurance tax” on health insurance premiums which would impose enormous
  financial burdens on public workers, retirees, and their families while also creating significant,
  longer-term disincentives for public sector purchasers to develop and implement innovative
  benefit designs that encourage the utilization of high-value health care services.
  • Action Items:  Support efforts to repeal and/or delay the “Cadillac Tax”; support efforts to
    repeal the health insurance premium tax.
  • Relevant Legislation & Regulation:  Healthcare Tax Relief Act (S.172, S.80); Middle Class
    Health Benefits Tax Repeal Act of 2019, (H.R.748)
  • Tools:Letters to Congress, meetings with congressional staff, signing stakeholder letters with
    allies, Public Sector Health Care Roundtable member outreach and education, white papers
    with key allies, white papers with key allies.