The Future Of Health Insurance in a Trump world

Tuesday, November 8th delivered a shocking result in the presidential race which will impact the healthcare landscape almost immediately after January 20th, 2017. While the healthcare industry has spent the last 6 years adjusting and implementing the Affordable Care Act (aka Obamacare), it's almost guaranteed that one of the first priorities of the Trump administration will be to repeal ACA. With a Republican controlled House & Senate, it is highly likely that large portions of the law will be rolled back, with the entire law repealed not entirely out of the questions. What this means for healthcare providers though is relatively unknown at this point.

Since Obamacare was passed, the mantra of the GOP has been "repeal and replace", but what will replace look like? There are currently 20 million additional people with health insurance as a result of ACA and a full repeal would strip all these people of their plans. At the very least, it is expected that subsidies to purchase health insurance on the exchanges will be rolled back, This will limit the ability of new people to obtain insurance or existing subscribers to maintain current plans. Another likely outcome is a reduction in Medicaid distributions to the states, which will have an impact on social service organizations and lower income households.

The Trump team has not yet outlined what healthcare policy may look like, however we can look to previous statements by the candidate and his VP for clues. Trump has stated that core provisions of the law, such as the prohibition against pre-existing condition restrictions will remain in place. We can also expect that overnight 20m people will not lose health insurance. A better idea of what healthcare policy in 2017 may look like could come from the House Republicans "Better Way" plan, which encourages the use of Medicaid block grants, self-funded health savings accounts and the promotion of Medicare Advantage plans. It is not guaranteed that any of these will become law, but they are good starting points for providers to prepare.  

Over the next 58 days, we will begin to get further clues of what healthcare policy may look like. One clue will come from whom is appointed Secretary of HHS. Another clue might be early collaboration with Speaker Ryan on "Better Way". Regardless, there is change coming and healthcare providers need to be prepared.