2020 Election and the Impact on Healthcare
To say that the recent election was contentious would be an understatement. In terms of health care, the presidential candidates were diametrically opposed, with President Trump favoring repeal and replacement of the Affordable Care Act and President-elect Biden favoring an enhancement of the ACA. With the Biden/Harris ticket winning the election we can expect them to work on a number of changes including:
- Expansion of coverage access
- Lowering of Medicare eligibility age
- Creation of a Public Option plan
- Premium free access to the Public Option plan for residents of states that chose not to expand Medicaid
- Enhanced tax credits to lower premiums
- Lowering drug prices
- Allowing Medicare to negotiate drug prices
- Limiting launch prices of drugs
- Limiting price increases
- Eliminating tax breaks for drug advertising
- Improving the supply of generic drugs
- Addressing maternal mortality rates
- Investing in more community health centers
- Expanding access to mental health care
- Eliminating co-payments for physicals, vaccinations, vision and hearing screenings, and preventative dental checkups for children of all income levels.
- Prohibiting employers and insurers from collecting or using genetic discrimination when making decisions about hiring or providing health care coverage, including the cost of a policy.
- Investing at least $1 billion yearly to help hospitals, physicians and other health care providers move to electronic health records systems.
- Adding 100,000 new nurses to the workforce in the next five years and establishing scholarship and loan repayment programs to encourage people to join the public health workforce.
- Increasing access to treatment services for opioid use disorder, curbing opioid prescriptions and prosecuting pharmaceutical companies that helped feed the nation’s addiction problems.
While the Biden/Harris health care plan is extensive, the ability to implement all of this hinges on two key but yet to be determined outcomes. First is the current challenge to the legality of the entire ACA by a group of Republican state attorneys general. The case is currently before the Supreme Court where the argument centers on whether striking the individual mandate from the ACA invalidates the entire ACA. Should the court rule in favor of the Republican argument the ACA could be eliminated and the country would be left with no national program. The second issue is control of the Senate. With Majority Leader McConnell’s history of opposing the ACA, it will be very difficult to get any expansion of the ACA outside of Executive Orders through the Senate. However, if the Democrats win both of the run-off Senate elections in Georgia, they would in effect control the House and the Senate making it much easier to pass the ACA measures favored by the Biden/Harris plan.
At the core, any government plan for health care should be able to pass a general litmus test. The questions for any plan should be around whether or not it:
- Increases access to health care for more people
- Improves outcomes of the care delivered
- Reduces the cost of health care
The Biden/Harris plan would appear to be positioned to positively address these concerns but time will tell how much can be implemented and what the ultimate impact of the changes may be.