Following the November 2016 election results, the future of healthcare reform hangs in the balance.
Republican control of the White House and Congress is expected to bring sweeping healthcare changes beginning in the earliest days of 2017. The Republican leadership has reiterated its intention to repeal and replace the Affordable Care Act (ACA), which also could include major reforms to the Medicare and Medicaid programs. Repeal of the ACA—whether in full or in part—would affect every health sector and stakeholder, including health insurers, manufacturers, laboratories, hospitals, providers, and most importantly, patients.
In addition to reforming the individual and small group health insurance markets and aspects of the group health insurance market, the ACA includes significant reforms to the Medicare and Medicaid programs. Examples of such reforms include filling the Medicare Part D “donut hole”, expanding Medicaid eligibility and creating both the Medicare Independent Payment Advisory Board and the Center for Medicare and Medicaid Innovation. In addition, the ACA amended the 340B drug pricing program, created a new approval pathway for biosimilar biological products, and established the Patient-Centered Outcomes Research Institute.