American politics and medicine have been bound together since the first formal laws regulating health care went into effect more than a century ago. Following the presidential election this past November, SmartBrief readers showed interest in news articles on what could happen to the Affordable Care Act under a new administration, how public health policy may be affected by political change, and what impacts Medicare may experience.
What does the future hold for the ACA?
What happened: In late November, a KFF Health News analysis suggested that there could be significant changes to the Affordable Care Act under the new administration, as Republicans are in control of both the House and Senate. Premium costs are likely to go up over time and Medicaid expansion may be curtailed, among other effects. President-elect Donald Trump, a longtime opponent of the ACA, may try to make use of executive orders and regulations to avert congressional opposition as he did in his first term, experts suggested. Past efforts to repeal the law have been unsuccessful.
What’s next: Changing the law under the new administration likely would require a major effort to clear political and procedural hurdles. Republican lawmakers have not said they want to entirely dismantle the act, but their “collection of policies” could add up to something similar to a repeal, says Sarah Lueck of the Center on Budget and Policy Priorities.
A recent Forbes analysis said the act is unlikely to be repealed, but a number of major changes could be in the offing, including premium subsidy cuts. Pandemic-era subsidy increases are set to expire at the end of next year, and a Commonwealth Fund report said that if they are not renewed, Americans’ out-of-pocket premium costs are likely to spike, and millions could lose coverage.
How might public health policy be affected?
What happened: Another KFF analysis suggested that Trump’s second term might mean significant changes to public health insurance programs, which could boost the number of uninsured Americans and raise barriers to reproductive health services. Other possible public health effects include challenges against federal health agencies, new Medicaid work requirements and less funding for safety net health programs.
What’s next: News stories have speculated about public health consequences since Trump began voicing his nominations for health agency positions, including Robert F. Kennedy Jr. to head HHS and Dr. David Weldon for the CDC. Both are known for holding anti-vaccine views. A New York Times article outlines Trump’s list of picks, and an NPR analysis suggests that advances against infectious disease may take a serious step backward under the new presidency.
What changes are afoot for Medicare?
What happened: The Washington Post reported that Kennedy and his advisers favor a major overhaul of Medicare’s longtime payment formula, and that they would focus more on preventive and primary care than on specialist care and surgeries. Their plan would involve a review of billing codes and likely would face major backlash from lobbyists.
A Fierce Healthcare story outlined the “more relaxed” regulatory environment some insurance companies are anticipating under the new administration. In an important side note, insurers including UnitedHealth Group and Humana noted significant stock price gains after Trump’s victory was announced.
What’s next: Trump’s win is likely to mean an environment more supportive of Medicare Advantage and mergers, and much less so of the Affordable Care Act and Medicaid, the Fierce report suggested. A recent post by the Association of Healthcare Journalists offers more detail on how funding cuts could affect Medicaid and the ACA, with millions of Americans potentially losing coverage.
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