Federal Health Care Policy Priorities for Public Sector Purchasers

Who We Are

The Public Sector HealthCare Roundtable is a non-partisan, member-directed coalition that exists to give
public sector health care purchasers and State and local health plan administrators a voice in the design,
development, and implementation of national health care policies. The Roundtable does this by providing
in-depth policy analysis and monitoring, education on issues relevant to public sector purchasers, and a
forum to collectively engage with key decision-makers in Washington, D.C.

What We Believe

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. It is our
belief that national health care policies should advance innovative proposals to constrain costs, increase
value, and improve quality and efficiency in the health care delivery system.

Our Federal Policy Priorities

Health Care Coverage, Innovation, and System Sustainability

  • We support policies that promote quality, affordable health coverage for all Americans.
  • 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.
  • We support public programs that facilitate the shift to value-based care, such as the sustainability of the Centers for Medicare and Medicaid Innovation (CMMI) that continues to test and evaluate innovative delivery system models (including accountable care organizations, bundling arrangements, competitive bidding, etc.). We support the rapid expansion of such models that demonstrate value.
  • We support the continued implementation of federal incentives to expand the adoption of health
    information technology platforms across providers, thereby improving quality, reducing waste,
    ensuring efficiency in health care delivery, and reducing medical error.
  • We support federal health policies that aggressively target waste, fraud, and abuse, recognizing
    that up to one-third of care provided in the U.S. is unnecessary or inappropriate.

Pharmaceutical Access, Cost, and Treatment

  • We support legislative and regulatory efforts to establish and sustain greater competition in the
    pharmaceutical – and especially the biopharmaceutical – marketplace, and the movement to valuebased
    payment for prescriptions to address exorbitant original list prices set by brand
    manufacturers.
  • We support ongoing efforts that seek to align the pace of approval with the pace of discovery of
    safe, innovative, and cost-effective pharmaceutical products; equally important, we support efforts
    to ensure that public sector workers, retirees, and their families have robust access to these
    innovative therapies.
  • We support providing FDA with the resources necessary to quickly bring safe and effective generic
    drugs to market and to end the backlog of generic applications, particularly as it relates to classes
    of drugs with limited or no generic competition.
  • We support policies that would allow for the reimportation of safe, effective drugs from Canada and
    other OECD nations and allow Medicare to enter into direct negotiations with pharmaceutical
    manufacturers. We support efforts to end anti-competitive arrangements between brand and
    generic pharmaceutical companies.
  • We support policies that require drug makers to reveal indirect and direct research and
    development costs, as well as evaluate the impact of direct-to-consumer television advertising.
  • We support policies that addressing the burgeoning opioid abuse epidemic in the U.S., including
    increased NIH funding and flexibility, increased access to behavioral health and recovery centers
    via SAMHSA, greater data sharing capabilities between states and federal agencies such as the
    CDC, and enhanced training for first responders.

Health Care Quality and Improved Outcomes

  • We support the further development of evidence-based quality measures, and particularly those in
    high-impact areas such as the complex chronically ill and those individuals that are functionally
    limited.
  • We support 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, including the reauthorization of the Patient Centered Outcome Research
    Institute (PCORI) to allow for comparison of cost data.
  • We support the continued implementation of the Prevention and Public Health Fund which will
    focus on prevention research and health screenings, educational outreach and immunization
    programs.

Innovation in Care Delivery

  • We support innovative care delivery models, such as Independence at Home, that allow those with
    complex needs and those individuals nearing the end of life to receive care in the home setting.
  • We support federal policies that seek to provide financial and caregiver support for those with longterm
    care needs, such as those in need of assistance with activities of daily living.
  • We support the development and implementation of innovative value-based benefit designs that
    incentivize the use of high-value health care services and medications.

Health Care Tax Policy

  • We strongly oppose policies such as the so-called “Cadillac tax”, which would impose enormous
    financial burdens on public workers, retirees, and their families. We support the full repeal of the
    Sec. 49801 of the Affordable Care Act that creates an across-the-board 40 percent tax on
    important health insurance benefits offered to millions of Americans, including public sector
    employees.
  • We strongly oppose policies that increase insurance premiums for retired public sector employees
    and their families, including the health insurance premiums tax. We support the full repeal of the
    “Health Insurance Tax”.