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What impact will Trump’s victory have on value-based healthcare?

November 9, 2016
by Rajiv Leventhal and Heather Landi
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With the stunning presidential election upset Tuesday night, Donald Trump will become the 45th president of the United States while Republicans maintained control of both the U.S. House and Senate. Indeed, the transition to a Republican administration and a Republican-controlled Congress come January will require the health IT industry to consider the short and long-term implications for healthcare policy and health IT-specific polices.

What are the prospects for healthcare legislation in Congress during the lame duck session? With a Republican-controlled Congress beginning in 2017, how will the landscape for legislative activity change? What will be President-elect Trump’s healthcare policy priorities and how will that impact health IT initiatives? Healthcare Informatics spoke with health IT industry associations and policy leaders Wednesday morning to get a sense of how the industry is assessing the impact of the election on healthcare policy and initiatives.

In the near-term, progress on health IT legislation, such as the 21st Century Cures Act, during the lame duck Congressional session will be a key focus, according to Tom Leary, vice president of government relations at the Chicago-based Healthcare Information and Management Systems Society (HIMSS).

“With the House and Senate maintaining Republican majorities, we have a pretty good sense of what their priorities were for this year and what will roll over into 2017. I think what we’re trying to reassess this morning is what will be the priorities during the lame duck and whether health IT and healthcare is part of it, or if a newer version of the Cures bill gets reintroduced in January 2017. As of yesterday, we were thinking it was primed to be moved in the lame duck in the Senate and then reconciled with the House and then to the President’s desk before the holidays, and we’re trying to reassess that today. So the next 48 hours or so will be telling for us,” he says.

He continues, “I do believe that the House and Senate are still are very much interested in ensuring the U.S. maintains its high level of superiority in biomedical research and the tenants of the Cures Act, whether it’s passed now or a newer version comes up in the new year, is really to keep the U.S. at the forefront of biomedical research, well into the 21st century. That’s bipartisan and bicameral, that’s a national priority.” He also expects a Trump administration and a Republican-controlled Congress will continue to move forward healthcare-related initiatives such as the Precision Medicine Initiative and Vice President Biden’s Cancer Moonshot.

There is a great deal of uncertainty about President-elect Trump’s specific healthcare priorities and policy platforms, yet during his acceptance speech early Wednesday morning, Trump promised to improve several aspects of the national landscape, including hospital infrastructure.

“We are going to fix our inner cities and rebuild our highways, bridges, tunnels, airports, schools, hospitals. We’re going to rebuild our infrastructure, which will become, by the way, second to none. And we will put millions of our people to work as we rebuild it. We will also finally take care of our great veterans,” Trump said during his victory speech.

Obamacare’s Future

On the campaign trail, President-elect Trump also spoke about repealing the Affordable Care Act (Obamacare), which would mark a significant shift in healthcare policy, and would have some implications for health IT, Leary said.

“We know it’s not as simple as pulling the plug on the legislation,” Leary says. “Depending on the outcome of two seats that are still up in the air, it’s still a very tight Senate, so being able to pass a sweeping repeal of Obamacare may not be as simple, procedurally, as the campaign trail might lead people to believe. But I think most importantly, and it’s not necessarily a health IT component, but what is the solution that’s going to cover those 22 million that are now insured, keep them insured, in the new plan?”

Leary continued, “He’s [Trump has] also talked about telehealth for veterans in his speeches and last night in his victory speech, he talked about healthcare and hospitals, as part of restoring a strong infrastructure within the U.S. So I would anticipate that his telehealth for veterans is not just a veteran’s issue but that he’ll utilize telehealth as a way to address some of the access needs whether it’s rural or urban communities that could equally benefit from telehealth services.” And, he said, “The other thing we’ll be looking at, is what his stance is going to be on standards development and innovation? So we’ll be looking very closely at those types of issues.”

When asked about the repealing of Obamacare, Jeffrey Smith, vice president of public policy at the American Medical Informatics Associations (AMIA), says that one of the things that will hit Washington D.C., at some point very soon—if it hasn’t happened already— is a “holy crap, we’re in charge now” realization on the part of Republicans. “What that will do is force people to move from talking points and get into the details of policy. They will find that this is an incredibly tightly wound ball of yarn and we cannot pull on one string and unravel it all,” Smith says.