Nearly 100 things insiders told us about Donald Trump's healthcare plans; The good, bad, and the very ugly
Though healthcare did not get the attention during the campaign as many would have hoped, President-elect Donald Trump has already laid out a plan that many feel will cause massive disruption to the industry. His 7-point plan begins with the repeal of the Affordable Care Act, which could result in the loss of insurance for up to 20 million people.
Also on his list: Allowing insurance companies to sell across state lines, creating health savings accounts to help pay for coverage, giving people the ability to deduct insurance premium payments from taxes, mandating healthcare price transparency, pushing Medicaid control to the state level and reforming access to pharmaceuticals.
One day after his election, we polled our readership of healthcare managers and clinicians to see what they think the short and long-term effects will be of Trump's policies on the healthcare sector, and we were flooded with responses. While most of them detail the deep concerns industry professionals have, a small few felt the businessman's idea could improve competition and lower costs.
On the other hand, many respondents paint a bleak picture.
Here are nearly 100 of the answers we got, broken down by the titles of the people who shared them with us.
"Young people will feel emboldened to avoid purchasing health insurance causing losses to the industry. Low-income people will lose access to insurance within 24 months and conditions will be established for a popular--and potentially successful--push for a single payer system (Medicare for all) in 2020."
Medical Data Abstractor
"Get sick, stay sick."
"Block grants to the States on Medicaid, capping federal match and forcing states to prioritize coverage. Some states who cover illegal aliens who are not edible for Medicare will have to make tough decisions."
"Cheaper health insurance!"
"Millions more losing coverage across the board. Pre-existing coming back."
"More people being able to afford health insurance through increased personal economic stability."
"He'll repeal the ACA, and hold onto the provisions people like without the proper balance to offset the actual costs. Prices will continue to rise because the coverage pool will be too large. Caps will return and people will once again go bankrupt or go without care. Layoffs and slow growth for the H.C. industry in general. Will not address the Rx price negotiation problem and costs will continue to be unaffordable even for those with HSAs or insurance."
"Massive disruption in the health insurance markets and many individual consumers being priced out of coverage due to the reinstatement of individual underwriting, the exit of young healthy consumers from the risk pool, etc."
"Increase on uninsured patients, closure of hospitals in rural areas, decrease in quality of care and denial of services."
Strategic vice president
"None. It takes a significant amount of time to turn a ship. Policy will likely take years to shift, even if the ACA is overturned."
State HIE outreach coordinator
"With the information that has been presented, it appears that there will be millions who will lose their health coverage and Medicaid will be put in a no-win situation in most states."
Medical director for healthcare informatics
"It will be an unmitigated disaster to the effort to control costs, which can only be achieved through universal healthcare coverage."
"Burden on taxpayer, waste of corporate resources, increase in healthcare costs."
Senior vice president of product development
"After the market gets things sorted out it will be positive."
"Allow patients to manage their health, not government agencies."
"Individuals will be discouraged from starting their own businesses."
"More coverage, lower costs, Providers will have more control over how they treat their patients, Hospitals will be able to provide more services and spend less on meeting multiple regulations".
"Insurance companies will have more influence in care provided. More access to care providers but emphasis will be on limitation of services provided and less programs for preventive care. in an attempt to improve insurance companies."
"Replace mandates with market-driven strategies to reduce cost to consumers and increase profitability for healthcare organizations."
"Confusion. More will be without healthcare now as they won't have health insurance. With Healthcare Reform more Americans have insurance then any other time. I worry the ERs will fill up again with people who use the ER as their PCP. Hospitals will be financially vulnerable as a large population will no longer have insurance."
Retired healthcare administrator
"Due to the lack of his understanding of the healthcare system, he will push the system backwards by at least 25 years and patient care will suffer and provider fraud will increase because of poor documentation."
"Greater confusion in the business of running a healthcare organization, be it a physician owner/operator; hospital exec; health services leader, etc."
Director of IT
"At first it will seem to help lower costs and give Americans more choices/freedom as well as financial stability, however that will quickly disappear as privatization becomes encouraged and large companies are allowed to buy up all of the small companies and individual practices, eliminating competition and leading to monopolistic practices in healthcare."
"The reality is that there has to be some compromise to change the system. I don't think the change will be cataclysmic. It will be evolutionary, rather than revolutionary."
"More price transparency More generic drug availability Portable heath care plans (plans that cross state lines)."
"My guess is they will de-fund the ACA and we will just lose the concessions we gave to get it passed."
Managed care director
"Since there is no plan in place, it will be devastating to the vast majority of people who have come to rely on healthcare."
"He has no positive effect on any aspect of government or life, in general."
"People will die because they are uninsured."
Senior clinical business analyst
"He has no clue how insurance pools work so only those who are sick will sign up for it therefore costs will skyrocket!"
"Many facilities will no longer be able to take advantage of "minimum Obamacare requirements" by having the maximum allowed deductibles for their employees."
Regional IT manager
"Hopefully fairer and more cost-effective options and more choice. The ACA was forced on us though most do not like it."
"Delay efforts within systems to comply with regulations but that will be a mistake for those organization that do."
"Does Russia have healthcare?"
"Delay implementation of improvements to health systems. Reduce CMS's drive to make providers accountable. Roll back progress in which healthcare industry recognized inefficiencies. Reduction in funding for pilot programs."
"I believe more funding will be given to Commercial Health Plans and Medicare Advantage Programs. Medicaid funding will be cut significantly. Privatization of Healthcare Funding is what I see."
"Initiate competition. Eliminating billing nightmare."
"Chaos but then loss of coverage to insured individuals. This leaves coverage for charity cases to be pooled by community. If a community decides it won't care for indigent patients, will they be legally forced to provide care?"
"Tax credits for people buying insurance in the individual market. Also, changing the mandated benefits and enabling people to buy the insurance specific to their needs and budget."
"The ACA had many bad components as it was written by lobbyists; however, I hope that certain aspects related to data and coding are retained."
Director of product management
"Healthcare may be slightly cheaper."
"For too long we have not been accountable for our costs. This may change."
"If he stands true to his promises, I expect it to get better."
"There will be some short-term volatility but that is necessary."
"Health care 'reform' will be simplified and support the small businesses that are the physician practices."
"Health systems have done a lot of work on community health, and this injects a high degree of uncertainty into the equation."
"Emergency room visits will be up over time as more people are forced to use ER and for more serious problems that they could not be seen by other healthcare provider. Closure of more community hospitals as more people will be uninsured, be sicker and do not have money to pay."
"Elimination of health care coverage for exchange patients. We will have in treatment patients suddenly without insurance."
"Increased costs of doctors visits and prescriptions."
"We will quickly be back where we were; 10 million or more people will lose access. Pre-existing conditions will once again block coverage. He may even repeal CHIPS."
Associate vice president
"The long term effects on healthcare will be devastating. All the gains that have been made in increased access will probably be turned back."
"The poor will suffer more."
Medical research librarian
"Pre-existing conditions for retirees, self-employed workers, and contractors will make adequate health care unaffordable if insurance companies are allowed to discriminate."
Director of health economics
"A significant slowdown or complete stalling of reform initiatives while this megalomaniac with a wrecking ball mentality gets taught how the business of medicine differs from real estate investing. He's proven time and again that he doesn't have or can't articulate his vision, let alone any sort of tangible plan. But there's some comfort in knowing that whatever is to come will be "really great.""
"Big business/big money will only get bigger with more burden on those that can't afford anymore costs. So, many with no health care insurance!"
"Long-term, I think people will be paying a lot more out-of-pocket due to lack of coverage, denial of claims, and high deductibles. Countries who are successful in healthcare have it governed, not privatized to businesses. I see this as a huge mistake that only benefit the business owners and everyone else will have negative results."
Director of IT project management
"Marketplace Dynamics change thru competition will be disruptive but the right thing to do."
Vice president of customer solutions
"Whether ACA is repealed and replaced or overhauled the components of ACA that support the migration from fee-for-service to value-based care and value based payment reform, such as ACO shared savings and bundled payment models, will remain in place."
"Lack of investment in health IT and standards."
"Improved efficiency, making medical advancements more possible and more available. More of the healthcare dollar going to healthcare and not to wasteful redundancies of paperwork and bureaucracy."
"Insurance companies denying coverage; increased healthcare costs; less regulation; less consistency across the country; advantages to the rich; payers unwilling to accept patient risk, etc."
"Maybe healthcare coverage and costs can be negotiated so more people can be covered at reasonable costs."
"Lower healthcare GDP."
Shift to HSAs and elimination of state line mandates driving more competition. Providers will stress due to the need to make better cost decisions and providing more pricing transparency.
"I am curious on his plans for High Deductible Health Plans and how the out-of-pocket and contribution amounts will change for consumers. As a business owner providing HDHPs and HSA options for my employees I am curious on if any changes are expected to that I maintain a mutually beneficial plan for both my company and my employees."
IT lead pharmacist
"As people move past their initial impressions of him and see what kind of leader he's going to be, I think he will positively effect healthcare. I believe his business experience and expertise will serve our nation well."
"Increase on uninsured patients, closure of hospitals in rural areas, decrease in quality of care and denial of services."
"Better, more accessible insurance and healthcare for all Americans."
Senior vice president of marketing
"Our healthcare costs will skyrocket again because people never anticipate getting sick but when they do, they expect free or low cost care. Doesn't work that way. Having insurance allows providers an incentive to provide maintenance, monitor ongoing health risks and stop them before they escalate and get expensive. Giving people the option will send sick people back to the ER."
"Acceleration of rural hospital bankruptcies."
"People will die because of delaying prevention if it is not covered at 100% as the ACA requires. The ACA is more than "requiring people to buy coverage" it has many regulatory items that no one seems to care about until it happens to them. My opinions here are my own."
"Insurance companies will survive and thrive."
"Change in the health exchange model, pay-for-value models (MSSP, Bundles, MIPS, MACRA) hopefully here to stay because it is in line with principles of lowering cost improving quality and choosing own providers."
"There are some things that should not be under free market control and healthcare is one of them."
"As a vendor in this space, there is now nothing but uncertainty. We have just moved through 2017 investment planning, and I don't know if any of the software plans to support CJR, EPM, or MACRA will stand if the Affordable Care Act is truly rolled back, completely. Without the CMMI, there is no model to support - and no product need."
"This will be catastrophic for many low income families and people with a previously diagnosed condition."
Professor of healthcare management
"Chaos from the provider's perspective and the patient's perspective, particularly if he tries to repeal and replace too soon."
"He will help protect hospitals with passing stronger security laws. He will improve VA hospitals."
"Young, low-risk people will opt out of health insurance and the rest of us will pay for their treatment if they have a catastrophic illness."
"Putting control back with the states and opening access to all insurance providers in states as well as holding providers accountable with price transparency will bring prices down and give individuals more choice."
"Top medical research moving to other countries. Abandonment of Healthcare IT. Healthcare tourism to Europe."
Executive director of IT
"Care will be reduced to vast segments of the population. It will just further exacerbate the problems this country is facing."
"Rising health care costs, individuals unable to receive services, a sicker population."
"We can only hope for the best."
"People lose their health insurance and companies lay off."
"Legislative changes around healthcare requirements for insurance, no change to value-based reimbursement and bundled payments."
"Decreased access to care and limited minimums for coverage."
Vice president of communications
"Bigger focus on Medicare Advantage to embrace the free market. Additional focus on states to legislate.
Share your view at our survey: How will Donald Trump's presidency affect healthcare?