President-elect Donald Trump has three basic jobs right now: put a team on the field, craft an agenda for the first 100-200 days and coordinate with Congress to ensure the agenda's success, said Michael Leavitt, former Secretary of Health and Human Services and founder of Leavitt Partners.
Trump made several healthcare promises during the election, and now voters expect the new administration and Congress to put them into place, said Leavitt, who explained that one of the biggest expectations is the repeal and replacement of the Affordable Care Act.
In the next several months, Congress will pass a "repeal and replace'" bill, but it's still to be determined how that will be defined, he said.
"Pretending that the law never happened is not an option," Leavitt explained. "But republicans have no alternative but to fulfill the mandate for change that occurred in the last election."
Leavitt spoke about the future of the ACA on Monday, during Conversations on Health Care, a weekly radio show produced by Community Health Center. In it, he predicted five facts that will likely become clear during the Trump administration.
- ACA will be repealed in the first 100 to 200 days. Congress will repeal the parts they feel can be replaced, which will give them time to formulate a replacement.
- Bipartisanship is crucial to replacement. Leavitt went as far as to say that the reason the ACA wasn't successful was due to the fact Democrats rushed the bill and didn't wait for bipartisan support. He said he believes republicans are determined to not make the same mistake.
- Portions of the law will disappear, including the individual mandate. The challenge then becomes what to do about the 20 million people who have coverage with this and the other Americans whose coverage will be affected.
- Value-based care is a definite. Calling the transition from fee-for-service to value-based payments one of the greatest changes in healthcare over the last 60 years, Leavitt said it will continue to shift as it's "not just being driven by political ideology."
- Medicaid's future will give states flexibility. While there may be less funding in some of the optional populations, there will be a maintained commitment to "helping those who are in hardship."
"We have to acknowledge that government has moved over time into a much more partisan process that's driven by the fundamental belief that the other party won't do the right thing," Leavitt said. "The key here is to recognize the big danger is overreach … because we haven't had power to do everything in the way we want it done.
"I believe the Republican Party has a very impressive and historic opportunity to put in place a governing structure that will last for a long time," he added. "You have to have enough risk that everyone is willing to sit down and give up some of the things they'd like to have [to make it] sustainable."