Tuesday, October 25, 2016

Health Care Reform and the Presidential Election

As evidenced in the recent debates, the presidential candidates don’t agree on much. But they do agree on one thing – Obama Care as we now know it cannot go on.  Donald Trump wants to repeal it entirely.  Experts say a Republican president would have to clear a very high bar in getting Congress to kill the Affordable Care Act outright.  Hillary Clinton wants to “fix” the ACA, promising to broaden the accessibility of health coverage to otherwise excluded populations and reduce its cost.

Just this week, it was revealed that beginning next year, insurance premiums for customers who purchase insurance through healthcare.gov will increase an average of 22% while the number of providers participating in the market place will drop by 28%. Federal health officials were quick to note that an overwhelming majority of customers will qualify for financial aid which can sharply cut the amount they pay in premiums. Regardless, this sobering announcement all but ensures that on January 21, 2017 health care reform will be at the top of the new Congressional and Presidential agendas.

In the meantime, and with just two weeks left in the presidential race, I would guess that there is a small percentage of the American electorate—maybe more now after this week’s announcement—for whom the issue of health care, more specifically health care reform, will be the deciding factor when they step into the voting booth on November 8. I would argue, however, that the fate of health care reform does not stand with the new president alone and that the outcome of the presidential election is not the best predictor for what health care will look like eighteen months down the road.

The future of health care will lie more at the feet of Congress than who will reside at 1800 Pennsylvania Avenue come January. Let’s not forget that the most recent change in health care reform came in 2015 as part of the Bipartisan Budget Act of 2015 when then Republican Speaker of the house, John Boehner, struck a deal at the eleventh hour in an effort to insulate incoming Speaker Ryan. This deal changed the eligibility of off-campus hospital outpatient departments for reimbursement of services under the Outpatient Prospective Payment System, among other provisions.
When the dust of this contentious election season settles, that’s when we’ll find out if the new president and Congress will be mired in partisan gridlock or whether they’ll see their way to affecting some real progress.  It’s going to take a bipartisan approach to fix the problems facing health care. The model as it stands now is simply not sustainable.

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