Policy and Regulation News

How Health Insurance Industry Faces the Presidential Elections

Time will tell which party will hold more power over the management of the health insurance industry.

By Vera Gruessner

The upcoming US presidential elections may impact the future of the health insurance industry and the way healthcare costs are addressed in this country. Whether the Democrats or the Republicans take the White House, the continuing rise in the growth rate of healthcare spending will need to be better managed in the coming decades.

Affordable Care Act

The policy plans and proposals of either party is likely to affect the way the health insurance industry will operate in years to come. For example, former First Lady and Secretary of State Hillary Clinton wishes to expand upon the Affordable Care Act and further stimulate the growth of Medicaid programs across states.

Additionally, Clinton seeks to restrict the rising prices of prescription drugs among pharmaceutical companies. This will ensure working class families and the elderly are able to better afford prescription medication.

Other proposals from the Democratic party have been to create a Medicare-for-all option in which consumers would have universal healthcare coverage. However, some policy analysts have found that the costs for such a program would be staggering and higher than estimated by lawmakers.

  • Past Successes, Future Challenges of the Affordable Care Act
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  • CMS Addresses Duplicate Discounts, State Medicaid Rebate Requests
  • On the other side of the equation stands the Republican Party, which is seeking to repeal the Affordable Care Act and institute a replacement plan to this landmark healthcare law. House Speaker Paul Ryan introduced the replacement plan and its goals of selling health plans across state lines, increasing the age of Medicare eligibility, and implementing high-risk pools.

    “There’s not many experts in D.C. that think the ACA can be undone,” Dr. Josh Luke, Professor at the University of Southern California and former Hospital CEO, told HealthPayerIntelligence.com. “When you talk about value-based care and patient-centered care, I don’t know that you’ll find many people that think the focus should be taken off of the patient and put back on strictly reimbursing on a fee-for-service basis.”

    “To date, Trump’s healthcare plan has been very vague. What you expect to see from Donald Trump, he has wanted to enhance privatization of healthcare, which is going to also create additional competition and similar to what you’ve seen in the Medicare Advantage space in recent years.”

    Along with these provisions, the replacement plan consists of broadening the range of premium costs based on age, which would essentially increase the costs of health insurance for older adults. The GOP is also seeking to abolish the individual mandate requiring every eligible American to purchase health insurance or risk a tax penalty.

    While it may have various opponents from the Republican party, the Affordable Care Act has been able to reduce the uninsured rate in the US to less than 10 percent with an additional 20 million Americans gaining healthcare coverage since the law’s inception.

    At the Democratic National Convention, former US Senator Tom Daschle discussed the future of the Affordable Care Act.

    “I think this has been a remarkable transformational moment in the country [due to the ACA]. The opportunity people have to enter the health insurance market is strong.  The opportunity for young people to get insured under their parents is impressive. Today, we have 21 million Americans who are insured due to the Affordable Care Act,” former US Senator Tom Daschle stated.

    “There’s a lot to be proud of but there’s a lot left to do. There’s a lot of work left to be done organizationally around payment reform and healthcare delivery. We’ve got to bring healthier people into the market and work on risk-sharing. We are looking to continue to build, to make the market stronger, and to encourage healthier people to enter the health insurance market.”

    Some negatives of the law has led health insurers to face challenges and end up raising monthly premium costs in order to cover their financial losses associated with operating through the health insurance exchanges and offering health plans to those with expensive pre-existing conditions as well as keeping young adults on their parents’ insurance plans. Clearly, the ACA has brought both benefits and challenges for the health insurance industry to overcome.

    Time will tell which of these policies will be implemented across the United States and which party will hold more power over the management of the health insurance industry.

     

    Dig Deeper:

    How Presidential Election will Impact the Affordable Care Act

    Sanders’ Universal Healthcare Coverage May Have Pitfalls