The impact of the election on healthcare is the focus of the STAT Summit

BOSTON – Healthcare is at stake in the upcoming US election – and leaders from across the political spectrum weighed in on the policy priorities for the next US president at STAT’s flagship summit.

Speakers included former officials from the Biden, Trump and Obama administrations as well as top industry executives, covering healthcare topics from Medicare to drug prices to artificial intelligence. We have compiled the highlights of our reporting below.

Joe Grogan’s Medicare Part D Prediction: It’s a ‘Time Bomb’

If former President Donald Trump returns to office, Republicans will have to repeal or reconsider President Joe Biden’s signature drug pricing reform and expansion of premium subsidies under the Affordable Care Act, according to Joe Grogan, a former Trump White House official .

Grogan argued that Biden’s Inflation Reduction Act destabilized Medicare Part D, the prescription drug program’s price advantage. He predicted higher premiums would push the Part D program into an inevitable “death spiral” and said lawmakers should consider repeal.

“Congress needs to ask: Do we still want a standalone Part D program?”

To replace Medicare Part D, Grogan proposed moving all beneficiaries into the privately run Medicare Advantage program or offering a combination of MA and health savings accounts.

Grogan also argued that the GOP should not extend increased ACA subsidies in exchange for lower health care premiums. The subsidies that the Biden administration passed in its Covid relief bill and extended through the IRA are scheduled to expire in 2025. He dismissed concerns that many of the people benefiting from the subsidies live in Republican-run states, saying that there is an “unbearable” level of fraud in the program.

Read more from Sarah Owermohle, including Grogan’s assessment of Republicans’ potential chance to reform public health agencies.

“We need to completely regulate Medicare Advantage,” advises Don Berwick

“Medicare Advantage is dragging down the Medicare program,” said Donald Berwick, who led Medicare during the Obama administration. His policy recommendations are in direct contradiction to Republican leaders, including Joe Grogan, who proposed moving everyone into the MA program at the STAT summit.

Medicare pays private insurers a set annual rate for each MA enrollee, based on “risk scores” that describe how sick a beneficiary is. This regulation is intended to enable insurers to receive appropriate compensation for the care of sick patients. However, the complicated system for calculating MA pay rates, which incentivizes insurance companies to make patients appear truly sick on paper, results in taxpayers paying over $80 billion more annually for people in MA than for people with traditional Medicare -Insurance.

“There’s a bleeding going on,” Berwick said.

More than half of Medicare recipients are already enrolled in private MA plans, which often have lower premiums, and that number is growing quickly. Private insurers don’t necessarily need to be excluded from Medicare, but “we need to regulate them thoroughly,” Berwick said.

Berwick also isn’t convinced that Medicare’s traditional fee-for-service reimbursement model is the way to go. Instead, he suggested that a system that adjusts payment based on patients’ social and demographic characteristics, such as age, gender and income, would be better.

Read more from John Wilkerson about Berwick’s policy guidance for the Medicare program.

The left is proving to be more pro-business, says Tony Coles

According to veteran biotech executive Tony Coles, the Republican Party no longer appears to be best for business. Coles, which has completed two multibillion-dollar acquisitions, sends most of its public gifts to Democratic candidates.

“As a capital risk and capital-based industry, where can we actually find the kind of support and funding we need to continue to deliver innovation? At the moment, I would argue – regardless of the pricing – that this is on the left side of the aisle.”

As the election draws closer, negative portrayals of the biotech and pharmaceutical industries are coming from both sides of the campaign, and Coles urged industry leaders not to fret over debates over drug prices and reimbursements. His North Star continues to focus on the good they do.

“As an industry, we have a responsibility to step up and be responsible corporate citizens and remember what George Merck taught us in the mid-19th century – that when we focus on patients first, profits follow.” he said.

Read more from Allison DeAngelis about Coles’ advocacy for corporate responsibility and the political parties’ response to his action on behalf of the bipartisan Black Economic Alliance.

Bristol Myers Squibb’s DC trip

When Bristol-Myers Squibb CEO Christopher Boerner was asked about the most difficult moment of his first year as CEO, he said it was the “unexpected opportunity” in front of Sen. Bernie Sanders (I-Vt.) on Health, Education, Labor and Pensions Committee to testify on the company’s drug pricing strategy.

Bristol also faced one of the industry’s biggest challenges: price negotiations surrounding Eliquis, the blood thinner that Bristol sells with Pfizer. It generates $12.6 billion in annual sales and was one of the first products negotiated under the IRA.

On stage, Boerner said he was “proud of the way the team has committed themselves [the Centers for Medicare and Medicaid Services]“And that Eliquis was actually the type of drug the system was designed to boost: relatively inexpensive, widely available and could help prevent hospitalizations in the future.

Boerner emphasized that BMS is a global company that operates on both sides of the aisle, and he stuck to that point when repeatedly asked which presidential candidate would be better for his company. “Our focus as a company doesn’t really change depending on who is in the White House or controls Congress,” Boerner said.

But the company has political goals. Boerner said BMS will be “at the forefront” of encouraging pharmaceutical companies to offer patient support under the Medicare program, which is currently prohibited by law

Backstage, he expressed his love for the company, saying: “I feel like we’re at a really crucial stage where we’re having to deal with some things and it’s important to have someone who can “This place is very close to my heart.”

Micky Tripathi believes the election will have no impact on federal AI rules

The top federal government official responsible for regulating artificial intelligence in health care said the upcoming presidential election would not impact regulations, despite concerns that a Donald Trump administration could lead to less technical oversight.

Micky Tripathi, assistant secretary for technology policy at the Department of Health and Human Services, said he would expect continuity in health technology policy if Vice President Kamala Harris wins the election. Should former President Donald Trump take office again, Tripathi said, “We had relative agreement across the parties on the focus on AI and the focus on interoperability.”

Over the past four years, the Biden administration has taken several steps to minimize the dangers of AI in healthcare, including biased algorithms, diagnostic errors and medical discrimination. Prominent Silicon Valley leaders with interests in AI, such as venture investor Marc Andreessen, have backed Trump because they say he would be less likely to over-regulate the technology.

Regardless of who takes over the White House, Tripathi faces significant constraints on regulatory powers and budget. Given these limitations, Tripathi has touted public-private partnerships and suggested that groups of healthcare providers will ultimately be responsible for using AI.

Read more from Mohana Ravindranath on Tripathi’s vision for the future of AI regulation.

Matt Herper contributed to this story.