As President-elect Donald Trump has not been very forthcoming about his plans for office and what he intends to do, primarily in the healthcare arena, many experts are trying to read the tea leaves to grasp Trump’s views on prescription drug costs and healthcare overall.
Many believe that Trump and Congress will take steps to dismantle portions of the Affordable Care Act. To shed some light on what could happen the coming years, several players in the healthcare and benefits field shared their ideas on what a Trump presidency might look like for the next four years.
Bill Bade, consulting actuary for Milliman
The supplemental benefits market has undergone unprecedented change and growth since the introduction of the Affordable Care Act. In particular, high-deductible health plans create an opportunity for carriers, distribution partners and technologies to build compelling solutions to perceived gaps in medical coverage. At the same time, state and federal government proposals to restrict supplemental products remain a concern. Based on our survey of carriers, the regulatory climate is the No. 1 risk to the hospital indemnity market, beating out other risks such as competition. I am anxiously waiting to see how Donald Trump’s healthcare policies will differ from those of President Barack Obama.
Joe Ellis, senior vice president of CBIZ Benefits & Insurance Services
Trump’s plan to repeal the ACA will be met with ample opposition. He promises to introduce legislation within his first 100 days. His reforms are significant, involving myriad provisions of the ACA. Trump will focus on free market solutions. The individual mandate and employer mandate will be targets of his plan. He will continue the restrictions on exclusions for pre-existing conditions, and make sure people with coverage will not lose it. And I believe he will re-introduce traditional underwriting in health coverage. This will not be an attempt to exclude people from coverage, but to allow insurers to assess risks and charge accordingly. While difficult from a state regulatory perspective, Trump will try to open the doors to carriers selling products across state lines.
Shan Fowler, senior director of product strategy at Benefitfocus
Get ready for a repeal of Obamacare, sort of. Certainly both Trump and congressional Republicans would act fast to symbolically slay the ACA dragon that has vexed them for the past six years. Yet there’s enough downside to repealing popular ACA features like no pre-existing conditions and dependent coverage to age 26 that “repeal and replace” may look more like “refine and rebrand.”
[On] Trump’s plan to provide tax breaks to individuals buying health insurance on the individual market, one of Obamacare’s bigger failures is leaving non-subsidy-eligible families exposed to hefty premium increases without the offsetting benefits of employer-based or subsidized coverage. It’s the kind of plan that Trump specializes in—populist in its appeal, yet without details on how he’ll pay for it.
Strategically, a Trump win may put Paul Ryan and House Republicans in the driver’s seat of healthcare reform. Trump, like Nixon, doesn’t seem overly interested in healthcare reform except as retribution against Obama and Democrats. That perspective, combined with a lack of many details around his health policy, might leave a vacuum of broad healthcare reform ideas that congressional Republicans may be all too willing to accept. So, in the same way that Nixon let Democrats in Congress take the lead on major domestic laws like the Clean Air Act and Clean Water Act so that he could focus on opening up China and fighting the Soviets, so too may Trump pawn off his healthcare reform ideas to Congress so he can focus on building a huge wall.
Jeff Oldham, VP of consumer strategy at Benefitfocus
We already know that Trump is all about HSAs, and we can assume that we’ll be seeing a lot more implementation across younger generations that can afford high-deductible insurance plans. This will be interesting in light of Trump’s plan to lower the overall cost of healthcare. We soon may see insurance sales competing across state lines to drive down cost. If Trump moves forward with his immigration reform plan, we also may see costs decrease as he ceases to provide healthcare to undocumented immigrants.
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