Insights From Expert Analysis on the Future President's Healthcare Agenda

What does President-elect Trump and a Republican-controlled Congress claim is in store for healthcare over the next four years?

The National Health Spending Report from the Centers for Medicare and Medicaid Services has released new numbers showing an increase in healthcare spending to $3.2 trillion in 2015 and a 5.8% annual increase. A slightly lower increase was observed in 2014 at 5.3%. This is a disappointment for the outgoing Obama administration that has long touted the moderated healthcare spending seen since Obamacare was implemented.

Increased total dollar spending is not as concerning as the fact that the share of healthcare grew in relation to US GDP, a trend normally observed only in times of recession. The report noted 2 main factors as the cause of this jump, and one of them was the 9% increase in prescription drug costs.1

What does President-elect Trump and a Republican-controlled Congress claim is in store for healthcare over the next 4 years? Will controversial prescription drug pricing be addressed? Will digitalization and the advancing technology of the startup healthcare community be embraced? Will there be any potential advancement opportunities for pharmacy and pharmacists? Only time will tell, and many questions are still unanswered, but here are a couple expert predictions:

Health savings accounts (HSAs): keeping the basic structure as iterated by Obamacare, Trump may focus on expanding HSAs from their current association with high-deductible plans to include all individuals. These tax-free spending accounts could also then be passed to heirs without any financial penalties.2 Trump’s plan has not gotten as specific as House Speaker Paul Ryan’s. His plan, an established voice for the incoming administration, calls for multiple forms of HSAs and a monthly tax credit to offset the cost of health care coverage. The difference would be eligible to cover other medical expenses, such as over-the-counter medications.3

Free market drug negotiations: by removing existing barriers, Trump has indicated his willingness to allow Medicare to negotiate with pharmaceutical companies regarding drug prices. Even with pharma stock growing in days after the election due to the threatening price controls proposed by the Clinton presidency, Allergan CEO Brent Saunders believes the pharmaceutical industry may have a false sense of security and added that Americans have the right to be angry about price increases. Regeneron CEO Len Schleifer made a broad statement about the industry as a whole, mentioning that prices have been used to fill the gaps of innovation4. This could be part of a larger plot to down-regulate the Food and Drug Administration (FDA).5 However, Merck CEO Ken Frazier does not believe this policy has lasting power considering former FDA commissioners have previously been dubious of the safety of shipped-in medications.4

As with any incoming president, they have to keep their playing cards close. With all the uncertainty and controversy involved with this political session, we can only speculate what is going to happen. Trump is obviously an unexperienced politician, and that adds more confusion to the mix. The pharmacy blog “Med Ed 101” brought up a great point in their recent post about Provider Status and the election as pharmacists should not be distracted from their agenda due to a surprise outcome.6

Immediately associating a Trump presidency with negative outcomes for pharmacy is as absurd as immediately associating it with an absolute win because there is little clarity to say what is coming. If we know anything, it is that legislative change occurs slowly and that pharmacy provider status is unaffected besides for the typical bureaucratic changes that are expected after any presidential election.

References

1. Bryan, B. Healthcare Spending in the US Just Did Something that Rarely Happens Outside a Recession. Business Insider. http://www.businessinsider.com/healthcare-spending-as-percent-of-gdp-recession-2016-12. Accessed December 3, 2016.

2. The Rise of Trump Care: 6 Ways Trump Could Impact Healthcare Reform. HIT Consultant. http://hitconsultant.net/2016/11/15/rise-of-trump-care-impact/. Accessed December 3, 2016.

3. Court, E. Health savings accounts are a crown jewel of ‘Trump care.’ Market Watch.

http://www.marketwatch.com/story/health-savings-accounts-are-a-crown-jewel-of-trump-care-2016-11-17. Accessed December 3, 2016.

4. Here’s What Top Pharma Execs Expect Under Donald Trump. Fortune. http://fortune.com/2016/12/02/top-pharma-execs-donald-trump-obamacare-drug-prices/. Accessed December 3, 2016.

5. Rubenfire, A. Trump presidency could bode well for pharma, devicemakers. Modern Healthcare. http://www.modernhealthcare.com/article/20161109/NEWS/161109913. Accessed December 3, 2016.

6. Christianson, E. Pharmacist Provider Status and the 2016 Election. Med Ed 101.

https://www.meded101.com/pharmacist-provider-status-and-the-2016-election. Accessed December 3rd, 2016.