Health Policy Implications of the New President
When it comes to health care, will the future bring disruptive innovation or just disruption?
The political tides have turned, and with them, so too has the fate of Obamacare. After year-after-year of largely symbolic votes to defund, delay, or repeal portions or all of the 2010 Patient Protection and Affordable Care Act (ACA), foes of the ACA are scrambling to create an alternative. Ezekiel Emanuel, MD, PhD, MSc, one of the architects of the ACA and keynote speaker at ACR 2016, has noted that replacing the ACA won't be easy. Nevertheless, early substantive actions are laying the groundwork for full repeal. In response to the din of the "repeal and replace" mantra, the first executive order signed by the new president makes some ACA provisions non-binding by means of deferrals, waivers, delays, and exemptions. The order also encourages the sale of health insurance across state lines. The individual mandate may be next on the chopping block, leaving insurers worried that healthy people would decline coverage, which would defeat a centerpiece of the ACA: helping cover care for the sick by distributing costs across a wider population.
"Change is inevitable. Progress is optional."— Tony Robbins
Being neither an expert on health policy nor having the ability to divine the future, I am looking forward to this month's #JACR tweetchat because the two moderators are health policy experts (though only time will tell if they can correctly prophecy the scope and impact of upcoming health policy changes). One of the moderators is John Ayanian, MD, MPP, the founding director of the Institute for Health Policy and Innovation at the University of Michigan. He was instrumental in successfully expanding Medicaid in Michigan. The other moderator is Mark Fendrick, MD, also from the University of Michigan, where he is director of the Center for Value-Based Insurance Design. Language related to value-based care appears in the ACA through Dr. Fendrick's efforts.
The tweetchat is on Thursday, January 26, 2017, at noon EDT. Remember to use #JACR in your tweets so they're seen by all tweetchat participants, not just your Twitter followers. The tweetchat discussion questions are as follows:
T1: What is the future of ACA health insurance exchanges and the impact on patient access?
T2: How will Medicare continue to innovate (ex., payment reform and value-based care)?
T3: What is in store for health savings accounts and the future of employer-provided insurance?