President-elect Donald Trump
Uncertainty over President-elect Donald Trump’s healthcare proposals could stall efforts to shift from fee-for-service to value-based payment models, according to an analysis released shortly after this morning’s final election results.
“Trump’s candidacy raised more questions about his healthcare proposals than it provided answers. This uncertainty--if not addressed early in his tenure--could frustrate industry players, new and established, they will likely be looking for clear direction on how they should proceed,” said the analysis from PwC Health Research Institute (HRI).
Researchers created two reports--one if Trump won and another if Democratic candidate Hillary Clinton--but only released the Trump analysis.
The biggest unknown is just how far Trump will take his promise to “repeal and replace” the six-year-old Affordable Care Act, Benjamin Isgur, leader of HRI, told FierceHealthcare.
“He has talked about repealing the ACA and it brings up a lot of questions for the healthcare industry,” he said. “How does one define repealing the ACA? Will his administration literally repeal every element of the current law, which when passed was well over 1,000 pages? Now, over six years of implementations, there are thousands of pages and regulations.”
“During the early days of the Trump administration, health leaders will be asking questions and they’ll want to know his plans so they can get their operations in order.”
Isgur said it would be far-fetched to think Trump intends to repeal it word for word. However, he said, there may be mandates, such as the individual mandate that employers buy insurance, that he will try to revoke.
Meanwhile, some of his proposals, which include cross-state selling of insurance and expanding health savings account, create more of a free market system, which is unlike our current system. “It will be a very big change,” he said.
“During the early days of the Trump administration, health leaders will be asking questions and they’ll want to know his plans so they can get their operations in order,” Isgur said.
However, he also said Trump must address the macroeconomic trends of financing the health system. For example, although the issue wasn’t discussed a lot during the campaign season, Isgur said that the Medicare Trust Fund is projected to be depleted by 2028.
“We are a decade away from Medicare not being fully funded. It will be up to the new administration to figure out how they are going to shore up the Medicare program,” he said, adding Trump will also have to take action on rising healthcare costs, which outpaces general inflation.
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