Bipartisan Recommendations to Reduce Health Spending from Brookings and AEI

Experts from the Brookings Institution and the American Enterprise Institute have released a joint list of recommendations to reduce health care costs in response to a request by the Senate Health, Education, Labor, and Pensions (HELP) Committee. Henry Aaron, former CRFB staff member Loren Adler, Joseph Antos, James Capretta, Matthew Fiedler, Paul Ginsburg, Benedic Ippolito, and CRFB board member Alice Rivlin authored the list, which includes policies that are aimed at "improving incentives in private insurance, removing state regulatory barriers to provider market competition, improving incentives in the Medicare program, and promoting competition in the pharmaceutical market."

The recommendations include policies that would:

  • Limit the exclusion for employer-provided insurance
  • Increase resources for antitrust enforcement
  • Allow states to create claims databases
  • Encourage repeal of state laws prohibiting insurance networks
  • Encourage repeal of state laws regulating hospital expansions
  • Protect patients from surprise physician billing
  • Expand site-neutral outpatient payments
  • Re-balance Medicare physician fees toward patient visits
  • Reform Medicare cost-sharing and Medigap policies
  • Increase flexibility for Part D "protected classes"
  • Reduce Part D reinsurance payments to insurers
  • Reform Part B drug payments
  • Encourage the use of generic drugs in Part D
  • Mandate bundled payments where they've been tested
  • Provide a comprehensive Medicare plan comparison tool
  • Enact the CREATES Act to boost generic drugs
  • Restrict the orphan drug designation
  • Tie the 340B program to patients rather than facilities

These policies have the potential to both reduce health care spending and garner bipartisan support. There are also many other options to reduce health spending at the federal level or system-wide that the Senate HELP Committee and other lawmakers could adopt.