Course | Intermediate | Healthcare Reform
This course explores trends in the ongoing development of state and federal healthcare policies and covers topics related to the national healthcare debate. It also discusses increased employer and consumer awareness and its impact on healt...
Save
Course | Advanced | Healthcare Reform
This course addresses the broad provisions of the Affordable Care Act (ACA) of 2010, CMS's proposed alternative delivery and payment models, and Standard Quality Measures.<div><br></div><div>Estimated course completion time: 1 hour and 30 m...
Save
Column | Healthcare Reform

A Framework for Predicting the Trump Administration's Health Policy Moves

Column | Healthcare Reform

A Framework for Predicting the Trump Administration's Health Policy Moves

Considered unpredictable by many, the policies of President-elect Donald Trump’s administration are beginning to take shape in health care.

In the wake of the 2016 U.S. presidential election, most pundits and pollsters admit that they don’t know what will happen under the administration of President-elect Donald Trump. 
To many, he seems unpredictable.


Healthcare policy may be an exception to the unknowns. If one lays aside the most hyperbolic campaign rhetoric, puts the various substantive policy proposals of the Republican party and Trump in boxes, and looks for what is most repeated, the fog begins to clear and we see that health care is a priority, involving 11 specific targeted policies.

The Five Boxes

The most substantive and recent aggregations of healthcare policy positions from the Republican party or Trump include:
  • Paul Ryan and House Republicans’ “A Better Way” plan, released on June 22, 2016, often referred to as “the Ryan plan”
  • The Republican National Committee’s “Republican Platform 2016,” issued on July 19, 2016
  • The “Health Care” section of the Donald J. Trump for President website
  • “Donald Trump’s Contract with the American Voter,” delivered at Gettysburg, Pa., on Oct. 22, 2016
  • Trump’s healthcare plan, released on Nov. 10, 2016, and certain post-election comments.

The Most Common Policies

For years, “repeal and replace” has been the repeated refrain of the Republican party and Trump with respect to the Affordable Care Act (ACA). So not surprisingly, all five of the major Republican plans call for such action, as do three policies designed to replace the access provisions of the ACA:
  • Increasing the focus on health savings accounts, tax-advantaged savings accounts that can be used to pay for certain medical expenses
  • Allowing people to purchase insurance across state lines in all 50 states
  • Transforming federal funding of Medicaid into block grants so the onus for managing the program falls on the states

Retaining Popular Features of the ACA

In spite of Republicans’ highly critical comments about the ACA, both the Ryan plan and post-election comments by Trump acknowledge the importance of maintaining two widely popular elements of the law: allowing young adults to the stay on their parents’ health plans until the age of 26, and requiring health insurers to cover people with preexisting health conditions.

Other Policies

Although they do not appear in all five boxes and fewer details about them have been provided, there are five salient goals common to the Ryan plan and Trump’s healthcare plan:
  • Providing financial support from the federal government for people in state-run high-risk pools who find themselves priced out of health insurance coverage
  • “Modernizing” Medicare by allowing private health plans to compete with traditional fee-for-service Medicare, providing individuals with a premium support payments to help cover the cost of premiums
  • Cutting red tape at the Food and Drug Administration to expedite the approval of life-saving medications
  • Protecting individual conscience in health care, allowing providers the freedom to exercise their conscience, such as deciding not to deliver abortion services
  • Applying the Hyde Amendment, which mandates that federal taxpayer dollars not be used to pay for abortion or abortion coverage except in certain circumstances

Republican and Donald Trump Proposed Health Policies


“Trumpcare”

What some have started calling “Trumpcare” clearly will be more state-run and market-based than the current system.

In spite of the unfairness in comparing the 37-page Ryan plan with the 310-word Trump healthcare plan, not to mention past tensions between the Speaker of the House and the President-elect, the 11 policies highlighted here are mentioned in both pieces.

Still, even with Republican majorities in both the House and the Senate, it is unrealistic to expect that all of them will become law. The devil will be in the details of legislation produced by congressional Republicans. Trump, an admitted political novice, will need to learn how to practice the art of the possible, the Beltway’s version of the art of the deal.


Ken Perez is vice president of healthcare policy, Omnicell, Inc., Mountain View, Calif., and a member of HFMA’s Northern California Chapter.

About the Author

Ken Perez

Advertisements

Related Articles | Healthcare Reform

Blog | Healthcare Reform

House bill may provide insight into coverage priorities if White House and Senate flip in November's election

The best-case scenario for Democrats is to come out of election night with a 50-50 split of the Senate, which would allow them to pass a package of tweaks to the ACA, with the Vice-President (assuming Biden wins) casting the deciding vote.

Blog | Payment Models

Intermountain Healthcare to provide hospital-at-home services for some higher-acuity patients

The move to hospital at home for higher-acuity patients by some health systems can create savings for their Medicare Advantage and other full risk products and for its Administrative Services Only clients.

News | Coronavirus

COVID-19 pandemic weakens push for public option

The COVID-19 pandemic appears to have weakened the push of states to implement public option health plans.

Blog | Managed Care

State public option efforts waiver in face of the COVID-19 pandemic

HFMA's Chad Mulvany says although COVID-19 may have "dampened enthusiasm" for Washington state's public option, he is not sure the blame for its slow start rests solely, or even partly, on COVID-19.