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SmartBrief readers focus on potential health care changes in 2nd Trump administration

It’s been a winter of some discontent in the health care space, as the Biden administration wound down and a sometimes controversial former Republican president regained the office, often with opposite aims. Leaders of large health insurance companies have been compelled by current events to examine their role in the nation’s health, and some have offered their views on needed procedural reforms. SmartBrief readers pointed their cursors at these and other hot-button health care issues in the month of January.

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US health care under Trump 2.0

What happened: Donald Trump’s return to the nation’s highest office is likely to come with significant consequences for the health care sector, a Chief Healthcare Executive magazine analysis posited in January. It suggested that cuts to Medicaid funding and Affordable Care Act subsidies would likely be on the table, while Moody’s Ratings warned that the result could be higher uncompensated care and worsening financial strain, especially for nonprofit medical centers. There was added concern that Trump’s plans to widen tariffs on imported medical supplies could further challenge financially strapped hospitals. 

What’s next: A February analysis by PwC said the administration will emphasize fiscal conservatism, public health reform and deregulation in the health care sector. A shift of decision-making to the state level, reductions in government spending, lower drug pricing and better care personalization are likely to be key points. Earlier debate on repealing or replacing the ACA appears to have lost momentum.

Marketplace enrollment, enhanced

What happened: The end of the Biden administration did not appear to dampen the public’s enthusiasm for ACA Marketplace coverage. The Hill reported a new enrollment record, in fact, with nearly 24 million sign-ups for the current year. The high figure is likely due to enhanced subsidies under the American Rescue Plan Act and Inflation Reduction Act. 

What’s next: Biden urged Congress to “double down on the progress we have made and ensure Americans have access to quality, affordable health care by extending the ACA premium tax credit this year.” A Feb. 18 Center for American Progress report  outlined five ways the enhanced tax credits have broadened Americans’ coverage and improved affordability. 

Cigna CEO commits to changes

What happened: The Cigna Group in January announced a plan to spend up to $150 million to update its prior authorization, provider services and patient advocacy processes this year, in an effort to improve physician and patient experiences. CEO David Cordani explained that the decision was a concerted response to the highly publicized killing of UnitedHealthcare CEO Brian Thompson and subsequent public outcry over the state of health coverage in the US. Cigna is among the nation’s largest health insurers, holding an estimated 11% share of the market. 

What’s next: Recent Healthcare Finance News and HealthExec analyses detailed how the multi-year process is likely to unfold. The initiative will include new concierge teams to assist with claims, as well as improvements in digital status tracking for prior authorization. The company also plans to tie executive bonuses to customer satisfaction, and it will release an annual report outlining business practices.

UnitedHealth re-examines practices

What happened: In mid-January, UnitedHealth Group CEO Andrew Witty expressed his concerns over the need for simpler, more affordable health coverage processes. Speaking on an earnings call, Witty touched on the need to make prior authorization approvals easier so patients can get the care they need in a timely fashion. He said that health care in the US must be “less confusing, less complex and less costly.”

What’s next: Tim Noel was promoted to the UnitedHealthcare CEO role after the death of Brian Thompson. Noel has been with the company for 18 years, serving most recently in its Medicare and retirement business areas. The company said he is committed to making health care work better for Americans. On Feb. 21, it was reported that the Department of Justice is investigating the insurer’s Medicare billing practices. 

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