Immediately following the election of Donald Trump as the 45th president of the US, Americans reacted to the uncertainty of what his healthcare policies might bring.
I am not a health policy expert; like you, I get most of my information from the media. Like you, I read that according to the Obama administration, 100,000 Americans rushed to buy health insurance (Abelson, 2016).
And like you, my inbox was filled with questions about whether women should schedule appointments for IUDs yesterday.
Yes, our health policies may change, but probably not overnight. We will have to wait and see how much change will come — and when it will take effect.
The Healthcare industry should be worried. They worked hard to plan for the changes that would happen once the ACA took effect, and now they’re scrambling to anticipate and accommodate another set of changes. It is estimated that 11 million people, according to the nonpartisan Congressional Budget Office, will lose their health insurance if Trump does what he says he will do. The healthcare industry will have to be prepared to lose these insured Americans, some of them healthy and some not.
Most of the newly uninsured make too much money to qualify for Medicaid, but find it difficult to afford health insurance. Will these people again turn to the ED for care? Possibly. However, one good thing is that the fear of potentially losing coverage has spurred a few more of the currently uninsured to obtain coverage. So for now, things are stable.
According to his website, Trump wants to “repeal and replace Obamacare.” But Trump also recently told the Wall Street Journal that he hoped to amend the health law rather than erase it entirely. Most experts are saying it will be difficult to repeal the entire ACA because of the slim chance of securing the 60 Senate votes needed. But a budgetary process called reconciliation could change several provisions. Through reconciliation, Medicaid expansion and subsidies could be eliminated, state marketplaces to buy insurance could be eliminated and tax penalties for the uninsured could be eliminated.
It is unlikely, though, that either coverage of young adults on their parents’ insurance or preexisting conditions preventing the purchase of insurance would be repealed. These policies are very popular with all Americans.
The biggest changes are likely to affect women. First is the issue of abortion, which is tricky. We do not really know what Trump plans to do. More is known about what Mike Pence thinks. He is clearly pro-life. His track record includes signing a bill to prevent abortion for a diagnosis of disability, and he led the effort to defund Planned Parenthood in Indiana. He has even said, “We’ll see Roe v. Wade consigned to the ash heap of history where it belongs,” at a town hall in Michigan in July 2016.
Other issues include the open Supreme Court seat that is likely to be filled by a conservative, and whether the Hyde amendment, a legislative provision that disallows use of federal funds to pay for abortion unless the pregnancy arises from rape, incest or to save the life of the mother, can continue by be circumvented at the state level. The Trump administration has not yet clearly explained what they plan to do. Stay tuned.