Healthcare executives predict no winners under Trump

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A new survey takes a pessimistic view of the healthcare landscape under the Trump administration.

A new survey finds healthcare executives have a pessimistic view of the healthcare landscape and rising uncertainty about the Trump administration.

The NEJM Catalyst report (PDF) includes predictions from members of its Insights Council, a group of executives, leaders and clinicians employed by healthcare organizations.

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There was little consensus over when the Trump administration might put forward a comprehensive plan for new healthcare policies and regulations, but in general, the group expects patients will see less insurance coverage, fewer benefits and higher premiums.

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“Overall, Council members express pessimism about the health care landscape in the wake of the Trump administration’s proposed plans, citing no clear winners, only losers,” the authors write.

Respondents also weighed in on mergers and acquisitions. Nearly two-thirds of respondents expect the current trend toward consolidation among providers to continue; 58% expected payer consolidation to continue under the current administration. 

Other key findings:

  • Most respondents see negative impacts on patients, clinicians and provider organizations. Responses were mixed for payers, pharmaceutical companies and employers.
  • The future of the Affordable Care Act looks uncertain, particularly with regard to whether or not the individual market exchanges will exist in two years. Only 28% of respondents expect the ACA to survive the Trump administration intact, but nearly two-thirds of respondents expect replacement to take more than a year.
  • More than two-thirds of respondents predicted a decline in Medicaid enrollment nationwide, with 42% predicting a “significant” decrease.
  • Healthcare organizations run by the federal government should be prepared for budget cuts. Between 60% and 70% of respondents predicted cuts for the Department of Health and Human Services, the Office of the National Coordinator for Health Information Technology, the Centers for Medicare & Medicaid Services and the Center for Medicare & Medicaid Innovation.
  • Two-thirds of respondents also said they expect cuts in funding for medical research. The report noted that this prediction proved correct soon after the survey concluded, when the administration presented its budget proposal.