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Trump's Healthcare Policy in Review

March 08, 2017

In our most recent edition of HGP's Health IT Market Review from January, we published a snapshot from Frost and Sulivan on what elements of the ACA were most likely to get the axe under the new administration. With the new American Healthcare Act now under review in the House, it seems like a good time to compare those predictions to what has been proposed. 

Indeed, the individual mandate which has received so much criticism from the Trump administration would be repealed if the new bill passes, replaced by a continuous coverage requirement which allows for a 30 percent premium surcharge to individuals who have a gap of more than 63 continuous days during the 12 months preceding coverage. In addition, the bill would retroactively eliminate for years beginning with 2016 all penalties connected with the individual and employer responsibility provisions of the Affordable Care Act, but not the associated employer and insurer reporting requirements.

While the Cadillac tax does not get repealed entirely under the new bill, it is postponed out further to 2025. A host of other ACA tax provisions, including the medical device excise tax, are also repealed under the new bill, with an estimated cost of $593.7 billion over ten years.

However, the primary focus of much of the new bill is on changing the Medicaid program set forth in the Affordable Care Act by transitioning federal Medicaid funding to a per-capita cap basis by 2020 and transforming the nature of the Medicaid program to center control within the states. States will also be eligible to apply for funding for reinsurance and other healthcare subsidies from the Patient and State Stability, provided they match a portion of the funds they receive. 

Ultimately, the bill does address many of the facets identified by Frost and Sullivan as likely to be amended under the new administration. We will be sure to follow this bill as it makes its way through the Congressional Budget Office, the House, and on to the Senate to see how it is received and gain more insight into its potential impacts.

Perhaps most importantly for the world of Health IT, the bill leaves all of the Affordable Care Act's legislation designed to improve healthcare quality and delivery intact. Value-based healthcare has strong bipartisan support, and so efforts to use technology to improve quality of care can be expected to continue whether or not this new healthcare bill is passed.

To read more, check out this Health Affairs Article by Timothy Jost or this Healthcare Informatics Article by Mark Hagland.