On September 16, Arent Fox LLP hosted an interactive discussion featuring two of our health policy authorities on what the health care community can expect for the Affordable Care Act following November’s election.
What You Should Know
The hour-long conversation touched on a number of important topics. The key takeaways included:
- There is considerable health care policy fatigue in Washington, making it unlikely we will see major changes to either the ACA or new health care policies after the election. With that said, much will depend on the specific composition of Congress, as well as who wins the White House. Either way, expect Speaker of the House Paul Ryan (R-WI) and Senate Democrats – who could take control of the chamber – to play a major role.
- The focus of a Trump Administration is likely to be to repeal the ACA and replace it with a more market-based alternative, but that is unlikely given the composition of Congress. Furthermore, Mr. Trump has been unclear about his own health care policy agenda and has at times suggested his support for alternatives that would have even more progressive support than the ACA (e.g., single-payer health care).
- A Clinton Administration would build on the ACA’s core philosophy, while tweaking the law to deal with parts that are not functioning well. Particular attention would be paid to marketplaces, which are dealing with significant premium increases and insurer withdrawals, as well as increasing efforts to increase access to the ACA through State Medicaid expansion and permitting certain individuals to “buy in” to Medicare coverage before age 65. Secretary Clinton has also signaled a significant focus on prescription drug pricing.
- Congress will largely be responsive to the White House on health policy issues in 2017. If Secretary Clinton wins, expect pressure on Republicans to make tweaks to the ACA that allow it to function better. If Mr. Trump wins, Republicans in Congress will likely try to use the budget reconciliation process to change the ACA as much as possible – assuming that they retain majorities in both chambers of Congress.
Who Was Talking?
Counsel Lanhee Chen was a senior appointee at the US Department of Health and Human Services during the George W. Bush administration. He is the David and Diane Steffy Research Fellow at the Hoover Institution and the Director of Domestic Policy Studies in the Public Policy Program at Stanford University. A CNN political commentator, Lanhee focuses on health law and policy issues surrounding Medicare, Medicaid, ERISA, and the ACA’s impact on states, private enterprises, and all parts of the health care economy.
Senior Government Relations Director Sonja Nesbit is a former Obama Administration appointee who served in the US Department of Health and Human Services and now provides short and long-range strategic health policy advice to hospitals, health systems, device and drug manufacturers, professional medical societies, and patient groups. Prior to her appointment, she served for over a decade on the staff of the Ways and Means Committee in the US House of Representatives.