On Tuesday, Feb. 3, IWU alum Amy Tenhouse ‘97, gave a presentation titled “U.S. Healthcare: Where Are We, Where Are We Going, and How to Advocate for Change.”
The presentation was a part of the fifth Gerbhardt Family Endowed Speaker Series for Political Science. The series brings in professionals who can “address issues in current affairs and public service,” according to Greg Shaw.
Held in Beckman Auditorium, there were nearly 50 attendees across all disciplines.
Tenhouse’s career in politics includes working as a member of Congress, a staffer on the House side, and working as a Senate committee member. The alum currently serves as the Vice President of Government Affairs for Molina Healthcare, where she has been for 17 years.
Molina Healthcare focuses on providing insurance to people in government programs such as Medicare and the marketplace, with a focus on lower-income individuals in Medicaid.
Tenhouse’s presentation addressed where we are in the U.S. in terms of our healthcare system. “It’s a hybrid system. There is no one program that covers everyone,” Tenhouse said,
“In private insurance, two-thirds of people are covered under employer-sponsored coverage. Public programs like Medicare target seniors and disabled persons, while Medicaid and SHIP cover low-income individuals,” Tenhouse said,
The alum also compared the healthcare system in the United States to those of other leading countries.
“Most of our peer countries offer some form of universal healthcare,” Tenhouse said,
“We are a leader in global innovation with technologies, pharmaceuticals and high-end specialty care, including shorter wait times and a wide market,” she said.
“On the flip side, we spend more on healthcare than any other country, and we don’t always have the outcomes we should,” Tenhouse said.
The alum listed examples, include high maternal mortality rates as well as high premiums, deductibles and out-of-pocket expenses.
Regarding the future of healthcare in the U.S., Tenhouse said, “We hear that we’re going to move to a single-payer, universal coverage system. That requires big, large-scale changes,” she said. “But right now we have multiple agencies, each with their own rules and regulations.”
The lack of changes comes from the difficulty of getting a bill passed through Congress, the courts, and all 50 changes, which Tenhouse called “challenging.”
The presentation did discuss on one of the last major large-scale, bipartisan healthcare reform to last: the Affordable Care Act (ACA.)
“In the Senate, a bill needs 60 votes to pass—this requires bipartisanship,” Tenhouse said. The ACA could be one of the last transformational systems that we see able to pass the threshold,” Tenhouse said.
“There’s so much polarization in healthcare coalitions with redistricting, low numbers of moderates and a general lack of interest in working together. Since 2010, most healthcare bills have been more marketed and much smaller, not sweeping reforms.
Larger reforms bring out more stakeholders because you’re attacking more points, meaning more for people to nitpick on,” Tenhouse said.
Tenhouse expanded on the issue of partisanship in stunting healthcare reform. She used the example of the Repeal and Replacement Act of 2017 during President Trump’s first term.
The presentation also touched on the place of AI in healthcare by acknowledging both the usefulness of AI on the administration side as well as the increasing need for regulation, which she said has been “tricky” to accomplish.
Students in attendance also had time to ask Tenhouse questions. Senior Valeria Suarez asked, “What tools are there for people from low-income services or disadvantaged communities that struggle with changes in the healthcare system?”
“Many new policies affect other policies, but there may not be a huge change for individuals, so they aren’t informed about it,” Tenhouse said. “We have to look for better ways to educate individuals on policy changes and what they mean for them,” she said.
Senior Van Le inquired about the need for bipartisan change to offset the back and forth of pass-and-repeal when control changes hands between parties.
“I think what we have found is that when there is a huge bipartisan change like that, it is much more likely to stand the test of time and continue to exist for many years,” Tenhouse said.
“When one party has a bill passed through the Budget Reconciliation process, which only requires 51 votes, it’s a pretty partisan issue, and that’s where the resistance comes in. I think the goal is targeting smaller, impactful bipartisan issues like cancer research,” she said.
Third-year Emma Kudelka asked what part Tenhouse plays on a daily basis to help fuel bipartisan movement.
“I meet with different members of Congress who are over the committees of jurisdiction that oversee issues I care about, for example, energy and commerce in the household,” the alum said.
“I pull information about programs with constituent data from rural areas, trying to figure out how I can relate it to Congress,” she said. Junior Cayden Webster wanted to learn from the alum if there is any behind-the-curtain information that can explain the trend in continuing price hikes of prescription drugs, despite a only a few companies controlling the market.
“I remember hearing as a Hill staffer the idea of ‘We charge more in the U.S. because we’re doing all of this innovative work that other countries aren’t,’” Tenhouse said, “The current administration is negotiating on Medicare prescription drug costs with individual companies to figure out how to bring access to more people,” Tenhouse offered.
Tenhouse also mentioned the recent vote to avoid government shutdown, which includes more transparency related to PBOs (Pharmacy Benefit Organizers).
Looking forward, Tenhouse predicts that the next 20 to 30 years of healthcare reform will continue on the current trend of small, partisan action, hopefully followed by years of large, bipartisan reform.
