By: Allen Pinn, Coordinator, Policy 

The National Health Council (NHC) prides itself in providing a voice for the over 160 million people living with a chronic disease or disability and their caregivers. In coordination with members across the patient, caregiver, and provider communities, the NHC creates a policy matrix to prioritize policy issues and signify our mission of Putting Patients First. 

In 2023, the NHC continued its leadership in the health care space. The year was heavily marked by political uncertainty and the broad implications of the implementation of the Inflation Reduction Act. In a step towards more affordability for patients, CMS issued their first guidance on the Medicare Prescription Payment Plan program aimed at reducing the burden of out-of-pocket costs for Part D prescriptions. In submitted comments, the NHC commended CMS for its initiatives to reduce patient burdens, while also emphasizing the importance of continued monitoring and oversight to strengthen the program. The NHC also held multiple webinars/briefings on the Drug Price Negotiation Program (DPNP), informing patient organizations of the law’s parameters and how to best inform their patients on new developments; NHC staff also listened to all ten DPNP Patient-Focused Listening Sessions and was able to provide valuable insight on the process to its membership. This will also be an input into a significant initiative the NHC will undertake to improve the listening sessions and other patient engagement activities at CMS. 

Another area the NHC was deeply engaged with this year was the protection of Medicaid. Earlier this year, when Congress and the Biden administration was enamored in a debt ceiling battle, the NHC along with its cohort of dozens of its membership organizations coordinated with one another to express the importance of Medicaid in patients’ lives and how burdensome work requirements would have sweeping impacts on vulnerable communities. In response, a debt ceiling package was signed without Medicaid work requirements, symbolizing the power of patient advocates’ voices. 

Other areas where the NHC continued to make strides in its advocacy included telehealth expansion, health care transparency, and pharmacy benefit manager reforms. All these issue areas have garnered bipartisan interest and will remain top of mind for the NHC. 

2024 Policy Matrix 
The 2024 Policy Matrix outlines an assortment of policy priorities deemed pertinent by the NHC’s membership.  

Designed by the NHC’s Board Policy Committee, the Policy Matrix is informed by an annual survey of our members and input from multiple NHC-affiliated groups including the Health Care Reform and Medical Innovation Action Teams and attendees of the Washington Representatives Retreat. 

The NHC Policy Matrix is composed of four quadrants: Lead, Partner, Engage as Needed, and Monitor. The Matrix is organized by scales that place issues based on the NHC’s ability to influence change (either due to political feasibility or based on other organizations or coalitions leading on the issue) and the importance to the patient community. Below is a summary of the health care priorities outlined in this year’s Matrix. 

Equity 
Equity remains at the center of NHC’s Policy Matrix, symbolizing our continued commitment to promoting a more equitable health care ecosystem. 

In 2024, the NHC will continue focusing on:  

• Promoting an inclusive, equitable, accessible, and high-quality care delivery system; 
• Advocating for equitable access to affordable and comprehensive health insurance coverage; 
• Partnering with organizations that have a record of accomplishment in addressing social drivers of health to reduce health disparities; and 
• Collaborating with the biomedical and health-services research and the health economics ecosystem to support equity in development and valuation of new and innovative treatments and services, including the collection and reporting of demographic factors in research to include race, disability status, ethnicity, age, sexual orientation and gender identity, and other factors to help identify and eliminate biases. 

Additionally, we will ensure equity is an integral component of all the policy work related to other topics in our Matrix.  

Lead Quadrant 

The Lead Quadrant represents issue areas the NHC will actively lead in addressing. For each of these, the NHC develops principles, specific recommendations, and directly engages with policymakers. Below are the three primary areas regarded as urgent issues among the NHC and our Board Policy Committee: 

• Patient Access: The NHC will lead efforts to reform utilization management, Centers for Medicare and Medicaid Services’ patient engagement, and telehealth expansion/access. 
• Health Care Costs: The NHC will continue to address system–wide transparency, a redesign of Medicare Part D (including an out-of-pocket cap and monthly payment plan), and more inclusion of patients’ perspectives in value assessment and price negotiation. 
• Medical Innovation: Bringing new treatments and cures to patients is at the core of the NHC’s work regarding medical research. Following the enactment of PDUFA VII, the NHC will continue to engage in its implementation as we enter 2024. In addition, the NHC will also continue to advocate for more patient/caregiver engagement and the use of real-world evidence and real-world data in medical innovation. 

Partner Quadrant 
The Partner Quadrant displays issues the NHC will work in partnership with member organizations in addressing. Across the NHC’s membership and networks, organizations work towards making patients’ voices better heard. For each issue, the NHC has identified leading organizations or coalitions and actively works with them, often in leadership roles of coalitions. 

The issues NHC plans to work in tandem with our partners include: 

• Mental/Behavioral Health 
• Quality Measurement 
• Copay Accumulators 
• Increasing and Improving Insurance Coverage including:  
• Affordable Care Act (ACA) Market Improvement  
• Medicaid Unwinding 
• Protecting Medicaid 
• Medicare Advantage  
• Health Appropriations  

Engage as Needed Quadrant 
The Engage as Needed Quadrant highlights priorities that the NHC will continue to track and actively engage in if deemed appropriate. Included in this quadrant are the continued focus on the following: 

• Health Care Workforce  
• Surprise Medical Billing 
• Outcomes/Value-Based Arrangements 

Artificial intelligence (AI) in health care has been added to the matrix as an issue to address specifically. As AI grows more rampant in health care, the NHC is committed to prioritizing policy solutions centered on patients.  

Monitor Quadrant  
The Monitor Quadrant comprises of issues that the NHC will watch closely but not actively engage. The NHC will monitor the implementation of the following:  

• Opioids and Pain Management 
• Pandemic Preparedness and Responses 
• Public health infrastructure 
• Disease Prevention 

As the globe enters a new phase of the COVID-19 pandemic, the NHC has updated how it engages with policies centered around COVID-19, notably the 2024 Matrix includes monitoring Long COVID support, an area which has had a significant effect on the chronic conditions community. 

Conclusion 
As 2023 concludes, the NHC will continue to prioritize the most urgent health care issues in 2024.  

For any comments and/or questions about the NHC’s 2024 Policy Matrix and policy priorities, please contact Eric Gascho, Senior Vice President, Policy and Government Affairs.