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What political change could mean for health care

Health care leaders are thinking about what lies ahead after the presidential election. A recent webinar touched on areas of focus and potential developments.

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With another presidential election in the books, many health care leaders are likely thinking about the path ahead — what federal and state results mean for the future, who will take key positions with health care-related government agencies, and how politics will influence the medical environment and its leadership going forward. Sarah Fontenot, an attorney and nurse recently retired from academia, presented an American College of Healthcare Executives webinar on the topic, offering leaders in the field some insightful points to consider.

Fontenot said she wouldn’t go so far as to call this year’s vote a “health care election,” as inflation and the economy were the most popular topics of discussion during the campaign. But the process did generate debate on a number of important health care-related subjects such as insurance coverage, drug costs and abortion, all of which health care leaders should be paying close attention to, Fontenot noted.

Here are some key points and projections Fontenot raised during the webinar:

  • President-elect Donald Trump had spoken about choosing Robert F. Kennedy Jr. as HHS secretary, and he formally announced Kennedy as the nominee on Nov. 14. Kennedy and his advisers have been working on short-term plans for what they hope to accomplish post-inauguration.
  • Trump has said he wants the next Senate GOP leader to let him make recess appointments, which would allow him to fast-track other nominees and appointees without gaining Senate approval.
  • The president-elect has said for nearly a decade that he wants to see the Affordable Care Act and its subsidized insurance marketplaces repealed. If the ACA were overturned, Fontenot said, a number of health care advances would go away – Medicaid expansion, coverage for children up to age 26, health insurance exchanges, lifetime caps and out-of-pocket limits, incentives for preventive screenings, multiple-provider tuition and education loan programs, and protections for existing conditions. However, Republicans in Congress do not appear interested in repealing the law at this time.
  • Public health and the agencies that shape it could see major changes once Trump returns to office. Kennedy has said he wants more than half of the NIH’s research budget to go toward “preventive, alternative and holistic approaches to health,” including generic medications and diet. Fontenot noted that the CDC could see funding cuts, restructuring, alterations in its scope and mission, and other major changes.
  • Trump has said he wants to “bring soaring drug prices back down to earth,” but questions remain about whether he will support repealing the Inflation Reduction Act and drug price negotiations. When Trump announced his most recent presidential campaign, he said he might try to revive a “most-favored nation” executive order to ensure that Medicare would not pay more for physician-administered drugs than other developed nations do.
  • Trump also has said that he will work to protect Medicare and Social Security, and that he would not put his signature to a federal abortion ban, but he feels states should be allowed to implement restrictions.
  • The reversing of the Chevron doctrine on the interpretation of laws could have a major impact on publicly funded health insurance programs like Medicaid and Medicare, and it could affect how agencies regulate nursing homes and pay for drugs. A “flood of litigation” and turmoil in the health care system also could result, Fontenot said.
  • Fontenot advised members of the health care field to focus on leading proactively in turbulent political times. Fontenot suggested that they do so by working to improve patients’ and providers’ care experiences, prioritizing population health, keeping costs under control, and homing in on the needs and health realities of states and communities. Listening, learning, collaborating, networking and sharing ideas are key to improving the system, Fontenot said.

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