I can imagine having this category on a current episode of the game show Jeopardy, and the topics under this category filled with questions about the policy changes resulting from a Trump presidency. Every major foreign and domestic policy of the Obama administration has been called-out by President elect Trump for elimination.
Now that he will soon hold the presidential office and will enjoy a Republican owned national government, the world waits to see if, or how these policies will be impacted. Mr. Trump’s campaign was filled with threats of repealing, obliterating and canceling key policies of the prior administration, but there was no substantive discussion about how, when or why these changes will be enacted.
We of course are most interested in the future of the Affordable Care Act and how any resulting changes to this program will impact Peach Tree’s patients, our reimbursement and our federal health care support. In the absence of real information, the media and political bloggers feel the need to fill the void with speculations, worse-case scenarios and threats. The only real fact we can hold on to at this point is that NO one knows what will happen next – especially Mr. Trump. I caution you to interpret the news and speculations of the media very carefully at this point, and not to confuse this information as fact yet.
There are a few important facts we can hold on to at this point to decrease the fear of a complete ACA repeal.
- Approximately 20 million Americans are newly insured through the ACA, 8.6 million of those from the Medicaid expansion. This is a staggering number of low-income working Americans to simply throw back into the ranks of the uninsured at a time when growing the working class economy is a hallmark issue for this new administration.
- The ACA is a very complicated law, with direct connections into Medicare, Medicaid, private insurance, pharmaceutical pricing, small business development and many other core aspects of American business. It will not be an easy process to unwind the entire law quickly or without replacement plans in place. An immediate repeal of the ACA would likely bring the Medicare program and many other key services to a halt until new rules could be written.
- Funding and support for Federally Qualified Health Centers like Peach was developed and expanded under previous Republican administrations and has always enjoyed strong bi-partisan support in Congress. The effectiveness and value of the FQHC program has been well-documented and widely understood on both sides of the aisle.
We can expect the ACA speculation machine to ramp up its output over the coming months, but we can also expect very little substantive discussion about this very complicated problem. Mr. Trump will presumably replace the cabinet secretaries and most of the political appointees in the Departments of Health and Human Services, Labor and Treasury – that directly administer the Affordable Care Act and the funding for FQHCs. These new appointees will inherit a supremely complicated and slow-moving federal service administration that will not be easily shut down or turned around in short order. There will almost certainly be change, but there will also be a good deal of warning (several years perhaps) that changes are on the way.
Peach Tree leadership is prepared to plan for many different scenarios in our future budget years, and will always remain transparent and proactive with our staff and partners as we react to changing legislation. In the meantime, try not to worry and focus more on the present. This moment is the only thing we can truly count on.