Health policy experts predict election outcome, healthcare changes

While healthcare has flown under the radar for much of this election season, it’s a topic that was not ignored at the Academy of Managed Care Pharmacy (AMCP) Nexus in National Harbor, Maryland.

During the October 4 session, “America's Landmark Presidential Election – What Lies Ahead?” attendees heard from two policy experts on their predictions for the election, and how they believe healthcare could change depending on the outcome.

Susan Dentzer, president and CEO of the Network for Excellence in Health Innovation moderated the discussion between Chris Jennings, president, Jennings Policy Strategies and former healthcare advisor to President Clinton and President Obama, and former Utah Governor Michael Leavitt, founder and chairman of Leavitt Partners, who served as secretary of HHS under former President George W. Bush.

Here are a few key points from the wide-ranging discussion.

Election outcome predictions

 “I’ve been waiting for some months now for a reality that I recognize to show up and thus far it has not,” said Leavitt, of this election cycle. He said he wished he had special insight to define the outcome of election, but that he did not.

He did predict, however, that it is very likely the U.S. will continue with a structure of divided power, with Republicans controlling one part of Congress and Democrats controlling the other.

Jennings acknowledged that, historically, it’s been very difficult for one party to win three straight executive branches. There are winds blowing against Clinton from a historical perspective and from a perspective of frustration with the establishment, he said. “…I think that those of us who believe that Hillary Clinton is going to win and believe she should win, would be very wrong to not take that message very seriously.”

Still, Jennings said, he believes Clinton will win.

Potential healthcare impact

While healthcare has not been center stage in this election cycle, Leavitt said the nature of the environment indicates it is going to continue to be an “extraordinary part” of the next administration.

He also said it’s important to consider the bigger picture: That healthcare is undergoing a historic transformation. The election marks another point of “recalibration in that larger and longer picture,” Leavitt said, noting that we are likely 25 years into healthcare’s transformation and it could take 40 years.

Jennings said that Clinton has pledged to build on and improve the ACA, and voiced support for a public option and Medicare buy in. Trump has pledged to repeal and replace the ACA, and embrace a Medicaid block grant program.

Read: Clinton vs. Trump: 5 critical election issues

If Clinton is elected, she will need to make significant investments in outreach and enrollment, investments in making premiums more affordable, and she will need to modify benefits to make them more value-based and implement creative options where there’s insufficient competition and choice, said Jennings.

While repeal and replace has been a common refrain among Republicans, Leavitt said he doubts a full repeal will occur, even with a Trump presidency. For example, he pointed to the “fragile nature” of the individual insurance market. “We’re not going to walk away from them because we have this widely held aspiration,” he said. “… We’re going to have to go back and fix what’s there.”

Still, Jennings said he takes the call to repeal and replace Obamacare very seriously.

What won’t change regardless of who is elected

Leavitt said there a remarkable amount of bipartisan agreement when it comes to payment and delivery reforms. In fact, he said one of the great legislative successes of the last four years is the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). It’s a “sweepingly important law,” he said, noting that it had bipartisan support.

Regardless of which candidate wins the election and which party dominates Congress, “We can bank of the movement to value-based care,” said Leavitt. “It will happen differently but the movement will be there.”