An unexpected victory for Republican Donald Trump has prompted many to consider what the president-elect's administration will mean for healthcare.
Chris Van Gorder, president and CEO of San Diego-based Scripps Health, recently provided Becker's Hospital Review with his projections.
Mr. Van Gorder acknowledged no one knows exactly what will occur with the ACA under the new administration, or what Congress will agree to support or change. But, he said, generally speaking, he believes there will be less of a big government approach to healthcare with Mr. Trump as president.
He went on to outline his seven specific expectations:
1. He expects Mr. Trump to continue the ongoing shift from fee-for-service to value-based care. However, he said he believes Mr. Trump could move to change a number of key elements of the ACA, including the mandates for individuals to have health insurance and for many business to offer coverage to employees.
2. Mr. Van Gorder said he also believes a Trump administration will rein in Medicaid expansion. California is among the states that has expanded Medicaid under the ACA. The state's Medicaid program, known as Medi-Cal, now covers roughly one-third of Californians.
3. He projects discussions about privatizing Medicare could begin again. "That could mean a proposal that would shift some of the cost risk of the program to beneficiaries by providing vouchers or other methods for purchasing private insurance," Mr. Van Gorder said.
4. Additionally, Mr. Van Gorder noted that Mr. Trump has said he wants Medicare to negotiate drug prices — but this will require a compromise between the President and Republicans in Congress who have previously opposed doing so.
5. Mr. Van Gorder projects there might be a different approach to mergers and acquisitions, and antitrust enforcement on deals such as the Anthem-Cigna merger, in the future.
6. He said he also expects a change in the federal government's approach to labor unions.
7. And certainly, Mr. Van Gorder said, Americans should expect a more conservative appointee to the U.S. Supreme Court to fill Supreme Court Justice Antonin Scalia's vacancy. Such a move would have an impact on cases involving healthcare issues, he noted.