As we all take a collective deep breath after the conclusion of a long and quite nasty Presidential election, it is time to take a look at how health care will change when President-elect Donald Trump takes office. Donald Trump’s victory means an immediate push to repeal Obamacare. In addition to the Obamacare repeal, many health care lobbyists are also anticipating Republicans will cut federal funding on the Medicaid program by utilizing block grants or per-capita caps. Lobbyists are also expecting the insurance exchanges to fail. For today, lets look at the good, the bad and the future of the ACA and the healthcare industry.
In 2010, President Obama passed the Patient Protection and Affordable Care Act, also known as Obamacare. ACA requires all Americans have health insurance. If they aren’t insured through their employer, their spouse’s employer, or the government (Medicare, Medicaid) they must purchase a private health care plan (unless they get an exemption or pay a tax penalty). While most people will agree the ACA has its flaws it is also tremendously benefited millions of people. ACA has helped an estimated 20 million people gain health insurance coverage and reduced the number of uninsured by historical numbers, since being passed. Another significant change the ACA brought is that health insurance companies can no longer reject people due to pre-existing conditions.
While the intentions of the ACA are good, according to a Kaiser Health poll, favorability ratings have lingered around 40 percent due to some pretty large issues. After initially underpricing insurance plans, health insurance companies have continued to raise premiums, including an average rate hike of 25 percent expected in 2017. Three major insurers–Aetna, UnitedHealthcare, and Humana–have pulled out of several states where they once had policies, scaling back their involvement in Obamacare.
While Trump has referred to the ACA as both a “horror,” and an “economic burden” and he wants to bring free market reforms to the health care industry. He plans to ask Congress to repeal Obamacare in full, stating “No person should be required to buy insurance unless he or she wants to.” Trump also plans to work with Congress to pass a series of reforms including modifying existing legislation that prevents the sale of health insurance across states lines – increasing competition by allowing health insurance companies to offer policies in any state. Trump believes the increased competition will decrease the cost of health insurance. In addition to free market reform, Trump wants to:
- Transform Medicaid into a block grant program that gives states more control over how to allocate funds and benefits
- Make it easier for drug providers to enter the free market to give patients access to medication from overseas
- Require price transparency from healthcare providers to allow people to shop around and find the best deal for procedures
- Allow people to pass their Health Savings Account funds onto their inheritors so they can use them for healthcare expenses
- Pass legislation that lets individuals fully deduct health insurance premium payments from their tax returns to make coverage more affordable (businesses are already allowed to do this)
While free market reforms to health care sound appealing, many healthcare experts think repealing ACA would be “catastrophic”. A repeal of the ACA would leave around 22 million previously insured people uninsured in 2017. It could be detrimental to people’s health and could give insurers too much power by allowing them to create discriminatory and expensive polocies; deny coverage to people with pre-existing conditions; and drop patients who develop cancer. Additionally, young adults under the age of 26 wouldn’t be able to stay on their parents’ health insurance policy – which may leave many of them uninsured. Furthermore, an ACA repeal would make reproductive care difficult to obtain and could make medications such as birth control and prenatal care no longer part of health care plans.
These concerns are real but could be mitigated by a series of reforms President-elect Donald Trump has planned once the ACA is repealed. Only time will tell how the results of the Presidential election will impact the healthcare industry now and in the future. Let me know what you think in the comments.