Understanding the Political Healthcare Climate

The healthcare industry is abuzz with speculation about its future under the Trump administration and Republican-controlled Congress. While nothing is truly certain, let us help you understand healthcare policy intricacies that are sure to change the face of healthcare as we know it today. 

Paul Ryan’s Healthcare Reform Proposal

Donald Trump and Republicans in Congress vow to repeal and replace the Affordable Care Act. In the absence of any details from Trump, we can look to a proposal released by Republican House Speaker Paul Ryan titled “A Better Way”. Here’s a synopsis of the 37-page proposal:

  • Maintains the idea that everyone in the U.S. should have health insurance
  • Includes tax credits to help people pay for insurance
  • Protects those with existing illnesses and medical conditions from losing coverage
  • Maintains that a market approach could reduce healthcare costs and improve efficiency
  • Includes tax-free health savings accounts to help pay for deductibles and keep premiums down for young, healthy people
  • Limits tax breaks for employer-based insurance to encourage cheaper, high deductible policies
  • Offers high risk pools for people difficult to insure, like those with chronic illnesses

While dubbed “Obamacare light” by some, Ryan’s plan changes a key feature of Obamacare that spreads the cost of insurance across generations, with healthy and young people subsidizing older and sicker people who typically require more care. Ryan’s plan enables younger people to start saving for major health problems over time through health savings plans that would be partly funded by the government. Read the proposal.

Navigating the Healthcare Policies of HHS Pick Tom Price

Tom Price, a third-generation physician who worked as an orthopedic surgeon for more than two decades, has served in Congress for 12 years. With this background, it’s expected that Price will support physician-friendly policies.

Price calls for a complete repeal of the Affordable Care Act and supports major changes to Medicaid and Medicare. He proposes converting Medicaid into block grants to states which would give them more freedom from federal eligibility requirements. For Medicare, he supports enabling older or disabled Americans to buy private insurance policies.

Details of Price’s healthcare policies are outlined in his 242-page plan titled “Empowering Patients First”.

Implications of a Medicaid Expansion Repeal

With the Affordable Care Act on the chopping block, Medicaid expansion could also see changes. In a new brief, the Kaiser Family Foundation outlined what’s potentially at stake for Medicaid. Key findings include:

  • An estimated 11 million adults made eligible by the expansion could be at risk for losing Medicaid coverage
  • The progress of reducing the uninsured could be reversed with a loss of Medicaid coverage
  • At risk is $79 billion in federal funding received by Medicaid expansion states

Read the brief to learn more.

Posted in

MedeAnalytics

MedeAnalytics is a leader in healthcare analytics, providing innovative solutions that enable measurable impact for healthcare payers and providers. With the most advanced data orchestration in healthcare, payers and providers count on us to deliver actionable insights that improve financial, operational, and clinical outcomes. To date, we’ve helped uncover millions of dollars in savings annually.

Leave a Comment





Get our take on industry trends

How is telehealth impacting STARs performance?

February 21, 2024

STAR scores are a critical component of success for Medicare Advantage Plans, MSSP and REACH ACOs, driving them to maximize…

Read on...

Brief introduction to contract administration

February 16, 2024

At the top of the year, Rahul Sharma, Chief Executive Officer, and Lynn Carroll, Chief Operating Officer and Cofounder of…

Read on...

How to run a successful analytics rollout

January 10, 2024

Healthcare executives across the industry are citing value-based care and health equity as two of their top priorities in 2024.…

Read on...

Using analytics to integrate physical and mental health in whole-person healthcare

December 26, 2023

In the realm of healthcare, it is paramount to view physical and mental health as inherently interconnected aspects of wellbeing…

Read on...