United States of Care Letter to Congressional Leadership Encouraging Passage of People-Centered Health Care Priorities for End of Year Legislation

Dear Majority Leader Schumer, Minority Leader McConnell, Speaker Johnson, and Minority Leader Jeffries:

United States of Care (USofCare) is a nonpartisan, nonprofit organization working to ensure that everyone has access to quality, affordable health care regardless of health status, social need, or income. Through our work driving people-centered health care transformation at the state level, we know that people want high-quality, personalized health care that continuously meets their unique needs at a price they can afford.

From our research, we know that 84% of voters across party lines and demographics believe that health care is a high priority issue for Congress to address this year. As the 118th Congress draws to a close, we urge lawmakers to center the cost concerns weighing down everyday people who continue to be frustrated by the skyrocketing cost of health care. Congress has a strong mandate from the American people to provide them with the certainty that they can afford the high-quality, dependable health coverage they need while preserving the high quality of care and choices people value in the current system. 

USofCare encourages Congress to include the following health care priorities in end-of-year legislation. Our work listening to communities’ needs for the health care system and state-based advocacy tells us that these highly popular policies will make health care more affordable and accessible for people across the country:

• Give people flexibility and choice: Make permanent the expanded Medicare telehealth flexibilities first established during the COVID-19 Public Health Emergency 

Our research into the telehealth experiences of Americans over 50 years old during the COVID-19 public health emergency demonstrates that the expansion of virtual care has helped people – particularly older adults – gain access to life-saving services. Support for virtual care extends across demographics, and older adults like an approach that combines virtual and in-person visits that meet their unique needs. Current telehealth flexibilities are set to expire on December 31, 2024. In addition to making existing Medicare telehealth flexibilities permanent, USofCare encourages lawmakers to enact additional reforms, including permitting audio-only care to equitably address health needs in areas without broadband, removing geographic and originating site restrictions, and removing in-person requirements for accessing telehealth. Although lawmakers are considering temporary extensions of Medicare telehealth flexibility, USofCare encourages lawmakers to make these changes permanent in order to give people the personalized, convenient, and accessible care they want. Lawmakers must also reauthorize the Affordable Connectivity Program (ACP), which expired on May 21, 2024. The ACP helped ensure that people are able to benefit from expanded telehealth services and are able to access broadband affordably. Lawmakers should ensure that all communities who need access to telehealth services are able to do so affordably and conveniently. 

• Address voters’s #1 concern about affordability: Make permanent the enhanced Affordable Care Act Premium Tax Credits (ePTCs) 

Our listening work is clear: people’s top concern with the health care system is that it is not affordable. People in all 50 states lack access to quality, affordable health insurance, and we know that cost is one of the biggest barriers for people seeking care.  Millions of people have benefited from Congress making more people eligible for the Affordable Care Act’s Enhanced Premium Tax Credits (ePTCs). If ePTCs expire, over 3.8 million people are expected to lose coverage, and premiums are expected to increase sharply. Extending ePTCs has bolstered enrollment in health care coverage in communities of color and has proven instrumental in increasing coverage in states where Medicaid has not been expanded and if ePTCs are allowed to expire, the uninsured rate is expected to drastically increase particularly in nonexpansion states who already have higher uninsured populations. Health care affordability solutions like making ePTCs  permanent are exactly what people want to have peace of mind that they can afford and maintain coverage of the health care they need into the future. Should Congress fail to extend or make permanent the ePTCs, access and affordability of care may vary drastically state-by-state. 

• Address voters’s #1 concern about high prices: Enact Site-Neutral Payment Reforms and Hospital Billing Transparency under H.R. 5378, the Lower Costs, More Transparency Act 

Voters across party lines and demographics overwhelmingly support policies to curb high hospital prices and implement transparency in health care billing. As you know, in December 2023, the U.S. House of Representatives passed the Lower Costs, More Transparency Act (H.R. 5378) with a strong bipartisan majority. The bill allows policymakers greater visibility into the types of charges and billing practices occurring at hospital campuses and off-site facilities affiliated with larger health systems and hospitals. The bill is stalled in the Senate, and we urge the chamber to pass it and bring about needed reforms that address runaway hospital prices and finally introduce transparency so people can make informed decisions about their care. 

H.R. 5378 is a modest step towards implementing comprehensive site-neutral payment reform and realizing broader affordability and transparency policy solutions across the health care system, and follows the footsteps of the 13 states that have already moved to address hospital prices in this way. USofCare looks forward to building on these state-level successes and working with lawmakers in the 119th Congress to pass comprehensive site-neutral payment and hospital transparency billing reform. 

• Make people healthy and strengthen primary care: Reauthorize Long-Term Funding for Public Health Programs and Health Care Extenders

As we are facing a health care provider workforce shortage and people express wanting health care that works better for them, USofCare has been listening to people across the country about their experiences and perspectives accessing primary care. We have heard that while the majority of adults report receiving primary care services, gaps in primary care still exist— and the main barrier to care is cost. People have a clear vision of how primary care in the U.S. should be: accessible, affordable, and convenient. As the U.S. continues to face a primary care and broader health care provider workforce shortage, people struggle with both accessibility and affordability of health care. There are currently over 8,000 designated primary care Health Professional Shortage Areas in the United States, and the Health Resources and Services Administration projects a national shortage of 68,020 full-time equivalent primary care physicians by the year 2036. Reauthorizing and increasing funding for public health and health care programs – including the Teaching Health Center Graduate Medical Education Program, the National Health Service Corps, and the Community Health Center Fund – will help to decrease the primary care provider shortage allowing people to access the primary care providers they need. 

USofCare looks forward to working with lawmakers to pass these health care priorities before the end of the year and stands ready to support lawmakers in building on these reforms throughout the 119th Congress. If you have any questions about USofCare’s policy priorities, national polling and listening work, or our state advocacy, please reach out to Lezah Calvin, Senior Manager of Federal Affairs, at [email protected]

Sincerely,

Natalie Davis 
Co-Founder & CEO
United States of Care