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Election Night Preview for Healthcare Leaders

Analysis  |  By Jack O'Brien  
   November 02, 2020

Healthcare stakeholders weigh in on what to watch for on election night.

As the 2020 presidential race between President Donald Trump and former Vice President Joe Biden wraps up this week, focus remains on what the election results will mean for healthcare companies.

This election cycle has been dominated by the implications for the industry, both in terms of how Trump or Biden will handle the ongoing COVID-19 pandemic and what will happen to the Affordable Care Act (ACA) going forward.

Related: Andy Slavitt on the Upcoming Election and Ongoing Pandemic

Healthcare is also top of mind for voters, as nearly four in five adults said that healthcare policy will influence their votes in the election, according to a Sapphire Digital survey released in mid-October.

Ahead of Election Day, HealthLeaders spoke with healthcare stakeholders about what they are paying attention to as the campaign concludes.

Where the candidates stand

Crowe LLP, a Chicago-based consulting firm, released a policy scorecard released last month which analyzed the healthcare tax proposals from each candidate.

Trump:

  • "Provide Medicare beneficiaries with high-deductible health plans the option to make tax-deductible contributions to health savings accounts or medical savings accounts."
  • "Provide Indian Health Service health professionals, U.S. Army Nurse Corps members, and participants in Native Hawaiian scholarship and loan repayment programs with a tax exemption in return for obligatory service requirement."
  • "Repeal and replace the ACA, but retain certain popular protections added by the ACA."

Biden: 

  • "Increase tax benefits for older Americans who purchase long-term care insurance using their retirement savings."
  • "Establish a refundable tax credit that would reimburse companies as well as not-for-profit organizations for the extra costs of providing full health benefits to all of their workers during a period of work hour reductions." 
  • "Increase eligibility for the premium tax credit by raising eligibility limits. Also increase the amount of the credit so eligible taxpayers can enroll in more generous health plans."

Related: Healthcare Dominates Final Trump-Biden Presidential Debate

Heather Meade, a principal at Washington Council Ernst & Young, told HealthLeaders that while the primary focus remains on who will win between Trump and Biden, an important narrative to watch will be which party controls the Senate.

Meade said that the ability to move healthcare legislation through the upper chamber in the next Congress will be crucial regardless of who is elected.

If Biden emerges victorious, Meade said the likely next steps from a new Democratic administration would center on COVID-19 and a potential stimulus rather than a healthcare reform package. She added that the Biden administration would likely focus on a legislative package that provides funding for both potential vaccine distribution and coronavirus testing.

'Stability' versus 'uncertainty'

Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association (MGMA), told HealthLeaders that the Biden healthcare platform is "ambitious" but also "doesn't have a lot of details." 

Gilberg said that if Biden is elected he has the potential to "create a little bit more stability" in the system by strengthening the ACA, establishing a public option, and lowering the age to enroll in Medicare to 60.

Meanwhile, he said that there will likely be more "uncertainty" in the healthcare industry if Trump is re-elected, given that the administration has yet to produce a comprehensive healthcare plan to repeal and replace the ACA.

Additionally, Gilberg said there is likely to be a difference between the approach to regulatory reform depending on who wins Tuesday night.

"On some of these issues, such as value-based care, price transparency, and surprise billing, I could see a Biden administration potentially going a step farther than what Trump has proposed," Gilberg said. "What you're likely to see under a Biden administration that is different [from the Trump administration] is spending more time issuing regulations. The Trump administration has talked about a lot of things but they haven't really implemented much nor have they rolled back much, like through their Patients Over Paperwork initiative. It's difficult to tell a group of executives who run medical practices that they have less paperwork and red tape than they did four years ago."

Related: Senate Confirms Barrett to Supreme Court, Focus Shifts to Fate of ACA

Ted Kennedy, Jr. works as a member of Epstein Becker Green's healthcare and life sciences practice. Kennedy, son of former Sen. Ted Kennedy, D-Mass., served as a member of the Connecticut Senate from 2015 to 2019.

Kennedy said he is focused on four main areas of healthcare policy distinction between Trump and Biden: coronavirus regulatory relief, surprise billing, drug pricing, and health coverage expansion.

He said that it is unlikely that a Biden administration would pursue a 'Medicare-for-All' style proposal and would instead focus on lowering the age of Medicare eligibility to 60, as Democratic vice presidential nominee Sen. Kamala Harris, D-Calif., discussed at the sole vice presidential debate last month. 

Related: Pence, Harris Spar Over Future of Healthcare Policy at VP Debate

"[Harris] specifically mentioned allowing Americans to buy in to Medicare at 60, and I think the reason why that idea has legs now is because of the 'job lock.' In order to make room for newcomers in the marketplace as we try to emerge from the pandemic, allowing people to buy in is just a good idea so that [consumers] can have job flexibility," Kennedy said. "I also think the overall cost of commercial plans will go down because you are taking these individuals who are probably more high utilizers, people between the age of 60 and 65, out of the risk pool. This means that the cost for regular commercial health insurance below 60 is likely to go down because of that."

Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.

Photo credit: 10/24/2020,USA:The debate gave Trump a bump in a crucial swing state, betting data suggests. / Editorial credit: StratosBril / Shutterstock.com


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