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 policy. The Roundtable does this by providing in-depth policy analysis and a forum to collectively engage with key decision-makers in Washington, D.C. Benefits provided by Roundtable members have a far-reaching positive impact on the economies of our states and help to fuel a robust provider network and health care delivery system that benefits all citizens.

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 benefits 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 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.
  • We support policies that promote quality, affordable health coverage for all Americans.
  • We support policies that build on the passage of the Medicare Access and CHIP Reauthorization Act (MACRA), including the rapid shift to value-based clinical and payment models that apply to providers and purchasers alike, as well as policies that increase pricing transparency.
  • 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 show the most promise to improve care at a sustainable cost, such as Independence at Home.
  • We support the continued implementation of federal incentives to expand the adoption of HIT platforms across providers, thereby improving quality, 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 Cost Containment

  • We support congressional and the regulatory efforts to establish and sustain greater competition in the pharmaceutical – and especially the biopharmaceutical — marketplace. As such, we support the implementation of a clear, efficient regulatory pathway to rapidly bring lower-cost biosimilars to market.
  • We support ongoing efforts that seek to align the pace of approval with the pace of discovery of safe, innovative, and cost effective pharmaceutical and device products in the U.S. Equally important, we support efforts to ensure that public sector workers, retirees, and their families have robust access to these innovative therapies.
  • We support efforts to end anti-competitive arrangements between brand and generic pharmaceutical companies.
  • We support policies that establish a reasonable base for pricing of pharmaceutical products, including allowing for the reimportation of safe, effective drugs from Canada and other OECD nations and allowing Medicare to enter into direct negotiations with pharmaceutical manufacturers.

Health Care Quality and Improved Outcomes

  • We support the continued implementation of the National Quality Strategy which will set benchmarks and targets to improve health care delivery services and patient outcomes.
  • We support the further development of 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.
  • 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 long-term 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. In addition, if the “Cadillac tax” were repealed, the Roundtable oppose an alternative to the excise tax, such as a cap on the tax exclusion of employer-based health benefits.
  • 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.