priorities for the next congress. >> thank you, everybody. i'm very excited to be the last person hosting a panel between you and your weekend. here to talk about the policy that is possible in congress and the federal government over the next couple of years. first i want you to picture this , you are a patient sitting in a doctor's office nervously waiting for test results thinking about your health and treatment options and what results could mean for you, your family, your body, your life and definitely about -- and what you don't want to be thinking about is what the indications of the policies might be for your health. you want the peace of mind you get the care you need when you

need it in a way you can understand and you can afford it. this in a shared experience in the u.s. regardless of political affiliation, where you live, what you make, we all have similar experiences and needs. this is more than a gas but backed by research. the advocacy organization i am so lucky to lead has gone across the country to talk to everyday people about what they need from the health care system. driving policy change at the state and federal level.

>> we have gone back and found the 12 issues that matter the most to people and what they expect leaders and health care leaders to fix. so here we are. we approach the 2024 election and we are not naive. we know it will be one of the most divisive elections in history as has been the case for many elections. there are clear divisions on issues people have. we know change is hard and it hard -- it is hard to measure change and on some issues when you turned on the politics and noise you hear people have shared needs and emotions and shared values and language. what does that mean for the work ahead of us?

translating that means also looking at the different options of what the political election outcomes may bring forward because we still have to pass legislation and improve the health care system no matter who is in charge. improving maternal health, lowering the cost of insurance, stopping surprise billing and building a more fair health care system. this is what people tell us they need. where did we see change possible ? that is what we talk about today. progress is happening with political leaders and cooperation and agreement is occurring. we know affordability is the number one issue in both parties realize that. in 2023 and 2024 we saw site neutral payments and addressing facility fees and acts in senate

that both received bipartisan support. even now in lame duck, we see transparency and fairness of hospital pricing has strong bipartisan momentum. another example, we hear from people all the time that they want more time with their doctors and less time waiting in more accountability for their providers and want to focus on their whole body care. we know that is impossible in the move toward outcome-based or value-based care arrangement has been and continues to be a bipartisan place of agreement. we call this patient first care because in this research we found out that people hate the word value and they don't want a value health care system. x■2there is a lot of opportunity and potential for reforms this year to streamline payments and insure medicare beneficiaries receive higher quality care and

members of gop doctors caucus, some of who are retiring are pushing a in working on this. let's look ahead to 2025, we see more time for bipartisan collaboration. we will have affordability issues still and with the trump era tax cuts set to expire in 2020 five, this opens new tax legislation which can include significant health care affordability -- 2025, this opens new tax legislation which can include significant health care affordability. to cover drugs and ensure lower prices for everyone and even those without insurance. republicans want to build on the reforms the trump administration which led to fair pricing and requires hospitals to provide clear pricing information. democrats have a strong desire to make advance premium tax credits which help people afford

coverage through the marketplace. the passage for this is tenuous but under the current divided congress we need to keep the congregation -- conversation up. outside of health care we know that ai is an issue that leaders are going to have to tackle and the potential to revolutionize health care delivery has done well. there is no clear legislation for that yet but we see leads in ai and seeking expert input. we know that ai and health care technology can be effective with trust and make sure all benefit from them. we know maternal and child health is another critical area that we hear from people that needs to be fixed. people ranked this high issue, especially those lonely and

possibly deadly years after a child is born, improving postpartum care is a priority for both parties. the democratic platform includes comprehensive measures like acts . and republicans say it larger reform isn't necessary but places were targeted bipartisan support like supporting health care support wor are here to focus on what change is possible. this panel you here before your weekend isn't about who is going to win but how do we ma who doen good policy is the most important lever to change the status quo and dictates everything about health care, who gets it, where, how much it costs and who is left out. it is a powerful reminder that we can't stop. we are committed to fostering cooperation in the much needed change forward.

i am really excited to bring up to people who are in the everyday business of changing our health care system. lisa at united states care and connor, please come up. we are looking at two perspective in health care, one in congress helping to legislate wish and -- within the halls of power and another who is interfacing with members of congress on a daily basis. thank you both for being here. connor's health policy advisor for the minority staff of the senate committee on finance. he is under the ranking member of idaho where he handles a range of issues. prior to that he served as deputy legislative director for tim scott of south carolina. lisa is in the federal pairs of

united states when she leads efforts in policymakers and stakeholders to expand access for affordable care through bipartisan center for reform. prior to that she worked for a congresswoman in and congressman in michigan. we have to keep people on their toes. they are excited to hear from you. what do you have for breakfast on a morning like this? connor: i honestly had some chips and hummus because some of us are not super proactive are responsible about stocking our refrigerator and pantry. >> lisa? lisa: i mostly had coffee this morning. >> let's take a quick review of

what we see happening in congress. where have you seen bright spots in health care priorities on a bipartisan basis. is it possible and do you see any surprises? connor: thank you to the united states of care and thank you to natalie and lisa for having me. the work you all are prioritizing is so important in that it does cut through a lot of the partisan noise. health care is one of those issues where we have had in years that have been hyper-partisan. we have had agreements around the drug pricing program under medicare part d and i was involved in that exercise and was the lead republican. with respect to reconciliation, turnabout is fair play but we turned around at the end of 2022

and put aside disagreements and were able to advance some incredibly important behavioral health care policies and able to continue extending telehealth access. while we have gotten into this pattern that we all agrees -- degree -- agree that some are nostalgic about the days when congress would come in every single year and keep people on their toes around whether they could keep their practices open. i was not nostalgic for that era to be totally frank. i think the work we did in 2020 to set the table for a lot of the bright spots we have seen subsequently. with respect to drug pricing, we put ase are democrat pals were on that and frankly, thanks to an incredible partnership between senators, but also thanks to a terrific

counterpart, polly webster, that i had on the finance committee on the democrat side, we were able to come■ together at last summer and again last november to advance pbm reforms that saved taxpayer dollars in saved money for seniors at the pharmacy counter. we had conversations about topline spending but part of why i respect the united states of care's approach is affordability isn't viewed by a patient as what is medicare paying or what is this budget spreadsheet saying, it is what are they paying out of pocket. there has been an abject failure with respect to how we can get access to the newest, best drugs at an affordable price for seniors, even when they would have 80% or 90% rebates like we saw insulin. as we advance to the committee on a near unanimous and

unanimous vote last year set the table fo think policies that are likely to move at the end of this year. we have seen the ways and means committee and members of congress advance some key policies with bipartisan support. even though through the committees are not the same is like getting something enacted and signed into law, and i should say i am speaking only on my own behalf and not for the senators or the finance committee, when i look at the cluster that is happening on the house side and i have never been happier to work for the senate, i think the reality is table setting is about as good as it gets right now. through november and we have a lame-duck period, we are optimistic or cautiously optimistic that we can finally move the needle on the pbm reforms and expand and extend

telehealth and virtual health protections for folks on medicare, recognizing that medicare is not just the biggest payer but the arbiter of what most commercial plans will do. we are seeing that with obesity drugs where it is so hard to access one of the products even if you have the dollars because of the sw[upply chain issues, bt you will be a sponsored insurance and a lot of plans had pulled back coverage. medicare can't cover this product statutorily and my inclination is if we advance policies on that front, there is bipartisan support for doing so and we have a lot of issues to work through. you will see commercial payers will follow suit. all that is to say, a lot of great spots on the horizon, the transparency measures natalie mentioned. i am incredibly optimistic about

health care. i don't think it has looked this bipartisan on capitol hill with respect to health care since i can remember, even as the hill itself looks more like a partisan nightmare that i can ever remember. lisa: more specifically it you are seeing a lot of efforts in the house and senate to address consolidation and affordability of the health care system overall. you are seeing a lot of hearings, bipartisan hearings in the energy, ways and means and house budget and senate finance committees. there is bipartisan interest and activity and energy around understanding what is driving up the cost of care in making health care affordable. you saw the lower cost and more transparency act passed last september in the house of representatives. more importantly that was a lot of bipartisan collaboration, three committees with the

democratic and republican chairs and ranking members working to create that in working toward a collaborative solution. you are seeing the climate been tough you are seeing and understanding that we cannot have partisan in a bipartisan and many members are leading into that. natalie: is there anything else you'd like to see get done. lezah: the united states of care is thinking about opportunities to help support the workforce, especially with a lot of workforce shortages around the country and being able to understand how congress can support teaching hospitals and extend medicare and medicaid programs that help support opportunities. a lot of them are extending at the end of the year which was an

intentional by the appropriations bill. that would be an opportunity for advancing health care opportunity and appropriations opportunities at the end of this year. connor: you is said it better more concisely than i could have. natalie: with the 119 congress we don't know what the makeup will be, but what are you hearing about conversations on the hill about health priorities emerging in the 119th congress? connor: i would start with clinician payment reform. we recently released a bipartisan white paper, which is a little long which i apologize for. but my counterpart and i were able to collaborate in line with our boss's priorities and as we were developing this white paper with the goal of starting the conversation around how to fix

the problems and fix problems with the broken fee schedule and fulfill the promise of what we could call value-based care. i think care that is alone -- aligned with higher quality for patients and rewarding clinicians who are generating savings for the system but also saving and sustaining lives, that was the promise in they approached it with the best of intentions. we are clearly overdue for reform on this front. we have our white paper in the colleagues in the house have done terrific work on this front. i think we will start generating structural policy ideas and i think that will be a multiyear process8i, just given how massie the problem is. i think similarly, telehealth, we can't make into a new

extender. we want folks to make the types of long-term patient driven care driven investments to try to actually drive innovation with respect to virtual health and digital health. i know it is great for consultants who have aients whot we keep moving it by a year or two years because it gives them something to successfully lobby on. i think from a patient standpoint and clinician standpoint, and for providers more broadly, we have to get a minute reform in place that gives a promise of access long term as opposed to making medicare seniors who arguably have the highest need for telehealth services saying, there is at the end of the year if the congress can't get their act together, then you are going to fall off of the cliff. it is unethical and unkind and i

think the bipartisan folks we join in. lezah: we have done a lot of research talking to seniors on telehealth care and is something people don't want to go away and they wanted between in-person and virtual. it is true that something can be given and taken away is something they expect from the health system and we can prove them wrong. natalie: any thing else on 19th congress should? lezah: how about advanced premium tax cuts in the affordable care act in the inflation reduction act has enhanced the savings that families get from the tax credits and made them more generous and extended them and hopefully making them permanent is the goal of the next congress and that is something we will

see in 2025 with the tax cuts and jobs acts expiring we will see a lot of activity to increase affordable programs for people next year in congress. natalie: moving to ai, there are a lot of unknowns. we are putting in to understand how do people feel about ai enter their trusted relationships with the health care system. we feel there is enough to the legislative and other means of thinking about how do we shape the future of ai in health care and we are excited to bring that to everyone when we get the results. how do you see it happening inside congress? what conversations are you having and what energy is there? i know to bounce the idea of innovation will need that and many protections in the right way.

what are you going and working on? conor: this is one of those issues that is not only top of mind but one of two or three topics that my family and friends who don't work in health policy will actually ask questions about my job and not tell me just to shut up. with respect to ai, you have seen a lot of hearing activity and i tend to think the signal folks should take is members want to get in on what this looks like and we are eager and welcoming perspectives from across the spectrum. you are totally right to point to the fact that any policy we are advancing needs to be aligned with building patient trust that is earned, not just saying any ai technology is always going to work for you and work extremely well. we need to ensuret we have appropriate protections and we

need folks at the agencies who also understand this tack. my learning curve on this has been out of shape. i find it fascinating but there is a lot of jargon that i don't understand and i know we are making good faith efforts to understand. also clinicians don't understand it. when i talk to doctors, what i am hearing is tremendous respect to some of the admin applications, triage, scheduling. i think that stuff is terrific and there are also cases where we have seen studies in some context having a doctorate gather notes to the use of an aia type tool and if they see it work and if the doctor is transparent with them. we also see context where ai is in good faith applied to a new

setting or context in all sorts of issues. that is creating trust issues and concerns. i think we will see legislation in the next couple of years emerge and potentially start moving with respect to ai health care. what it will have to balance is how do we update medicare coverage and payment policies to account for some of these incredibly exciting breakthrough technologies that really can, especially with medical imaging, revolutionize imaging and with certain aspects of the service, ai can't perform better than the clinician, but the condition still needs to be in the room and verifying it. so coverage and payment, we want to ensure we are promoting innovation that helps patients while at the same time i think

the biggest challenge is going to be how do we create appropriate transparency and protect proprietary information because they are the lifeblood of any technology. how do we make transparency work and how do we -- what is the doctor need to tell the patient. what is a developer need to tell the doctor and frankly what type of literacy, education, ai training needs to be put in place, particularly for small practices, hospitals in rural areas and not large academic centers but the ones of us in baltimore are proud to have back home. i see this as a beautiful bipartisan opportunity but i will be the first to admit it is when we are approaching and we

natalie: so you want to hear from these in the audience? conor: yes, i think we need to. lezah: senators have insight forms they released ande saw a lack of health care understanding and what the implications for ar -- ai in health care. a lot of groups are pushing back on with the implications are for patients understanding how these models that are building into the systems, are they perpetuating the same biases we see in the health care system? we have been interested in the momentum around ai at the state level and trying to get the federal government to meet the opportunity but also not dismiss the needs and concerns of patients in order to ensure industry is supported. that is an important moment where i think folks in this room

remember the facebook and social media hearings in the senate and there is a big gap in understanding the technology and it is important that it is not only lead with ethical considerations in mind but not just letting the companies and vendors creating technology and regulation and understanding what patients need and what we are thinking about is what of the liability concerns here? if the ai you are using with your provider makes the mistake, who is liable for that and how do we understand what is going into the technology and letter patients understanding. there is a big gap in understanding how often this technology is being used and having health care providers be transparent about what it is they are doing and why they are doing it and how they feel it will benefit yr e important par, making sure it is benefiting patients overall and the health care system.

a lot of work to be done. natalie: and that we are focusing on the right issues. if you have any questions, please send them in. i want to talk a little bit about maternal health and mortality rates we are facing. i know we are focused on 100 weeks because 40 weeks is to restrictive. there is a world of need that families have after the child is born. i would love to know how you are thinking about the bipartisan action you are seeing on maternal health, whether at the state or federal level. lezah: we are seeing a lot of action at the state and federal

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