On December 3, 2018, the U.S. Department of Health and Human Services (“HHS”), in collaboration with the Departments of the Treasury and Labor, the Federal Trade Commission, and several offices within the White House, produced a 119-page report outlining recommendations to reform the healthcare system. This report is in response to Executive Order 13813, in which President Donald Trump directed the Administration, to the extent consistent with law, to facilitate “the development and operation of a healthcare system that provides high-quality healthcare at affordable prices” through the promotion of choice and competition.

The report criticizes state and federal rules that the Administration claims inhibit choice and competition and offers free-market oriented recommendations aimed at producing a more efficient healthcare market. Some of the report’s recommendations, such as weakening Affordable Care Act (“ACA”) protections and network adequacy requirements, are unlikely to be supported by Democrats, who will soon control the U.S. House of Representatives. Other recommendations, however, such as increasing the Federal Trade Commission’s authority over non-profit hospitals, facilitating patient access to telehealth, and improving price transparency, could generate bipartisan support.

Additional report recommendations include:

  • Increased efforts on the part of the Administration in monitoring market competition, especially in relation to provider consolidation;
  • States broadening their scope-of-practice statutes to enable healthcare providers, such as advanced practice registered nurses and physician assistants, to use their full skill set to treat patients;
  • States improving the mobility of healthcare providers across state lines by encouraging interstate reciprocity of licensure and/or expedited processing for multi-state licensure;
  • Streamlining federal funding of medical education; and
  • States scaling back on Certificate of Need statutes.

It remains to be seen what effect, if any, this report will have on the direction of future healthcare policy, but it certainly provides some insight into the Administration’s approach to healthcare policy going forward.