Beyond 'Repeal and Replace,' Further Health Reforms Loom

Philip Betbeze, January 5, 2017

The changes will not be immediate or drastic, observers say. But they are coming.

S. Lawrence Kocot
S. Lawrence Kocot

The old saying, "May you live in interesting times," may sound like a blessing.

U.S. healthcare leaders know it is a curse.

All they've been working toward and preparing for since the Patient Protection and Affordable Care Act was enacted almost seven years ago has been turned upside down in the wake of the Republican election sweep.

Yet, for all their campaign promises to repeal the ACA, most congressional Republicans and President-elect Donald Trump must know that healthcare costs are too much for many Americans, and abolishing Obamacare with no replacement could be politically dangerous.

Trump May Slow, Not Stop, Transition to Value-based Care

A report from consulting firm KPMG and an opinion piece published on LinkedIn by a Navigant executive predict that the Republican Congress and the executive branch will change the healthcare reform efforts initiated through the ACA, but the concept of value-based care will stay.

Changes Will Be Gradual
The report and the LinkedIn piece also agree that changes to the ACA itself could come more slowly than recent election-season rhetoric would suggest.

Republicans in Congress won't want to unravel the law in a chaotic fashion, given the possible problems in coverage that could result from a blanket repeal—and possible political consequences during the 2018 elections.

That means drastic, immediate changes are likely off the table.

It's likely the executive branch will weigh in most quickly, with Congress looking for areas of bipartisanship, says S. Lawrence Kocot, who leads KPMG's Center for Healthcare Regulatory Insight and was an advisor to the CMS administrator during the George W. Bush administration.

Trump, GOP In Congress Could Use "Must-Pass" Bills To Bring Health Changes

The Trump administration may quickly move to relax certain regulatory requirements of the ACA through Executive Order or regulatory guidance (non-enforcement).

Philip Betbeze

Philip Betbeze is the senior leadership editor at HealthLeaders Media.

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