In 1 Illinois District, Residents' Main Concern: Healthcare, Drug Costs, Legislator Says

Each year the Academy Health National Health Policy Conference features an appearance by at least 1 legislator as well as a subsequent panel with congressional staffers.

The congressional panel is Tuesday. On Monday, Atul Grover, MD, PhD, the executive vice president for the Association of American Medical Colleges, sat down with Representative Lauren Underwood, D-Illinois, for a conversation about her healthcare-related efforts during her first year in Congress representing people from a suburban rural district 2 hours from Chicago.

Before joining Congress, Underwood, who has a nursing degree but has spent most of her career in the policy arena, worked for HHS and also for a Medicaid plan. She currently serves on the the House Committee on Veterans Affairs, among others. She is also cofounder and cochair of the Black Maternal Health Caucus and is the youngest-ever African American woman to serve in Congress.

During her first year in office, she cosponsored bipartisan legislation called the Lower Insulin Costs Now Act, which President Donald Trump signed into law in December. The law will allow the FDA to continue to review applications for generic insulin beyond March 2020, when insulin will transfer to a biologics approval pathway.

Given the challenges discussed during the first day of the meeting, such as chronic disease and mortality from drugs and alcohol, Grover asked how society should set priorities about which issues to tackle.

“I think the first thing you have to do is play a little defense,” she said, referring to administration efforts to overturn the Affordable Care Act. She also noted that budget proposed by President Trump Monday includes deep cuts to Medicaid and other health programs.

Medicaid is used to help pay for substance abuse treatment, for example, as well as mental health services. “Those things are essential when we think about extending life expectancy, combatting suicide and addiction across the country.”

When discussing the healthcare system with residents in her district, Underwood said, their 4 main concerns involve premiums, deductibles, drug costs, and surprise medical bills, and the biggest barrier to care comes in the form of premium costs, she said.

Her district is relatively high income, with the average income at $105,000. But marketplace premiums average $20,000 to $25,000 a year.

Referring to maternal mortality, Underwood pointed out the statistic has been unchanged her entire life—black women are 3 to 4 times more likely to die as a result of pregnancy. “It is unacceptable,” she said.

Last November, the House Energy and Commerce Committee passed bipartisan legislation cosponsored by Underwood to extend the time that women are covered by Medicaid postpartum from 60 days to 1 year. The law, called the Helping Medicaid Offer Maternity Services (MOMS) Act (HR 4996), is optional for states, but Underwood said there are incentives.

Other legislation is expected to be introduced to fight the problem this year, she said.