By Ken Perez, vice president of healthcare policy, Omnicell, Inc.
Ken Perez
A record 158 million Americans voted in the 2020 presidential election, a staggering increase of 17% versus 2016. Joe Biden garnered 81.3 million votes, while Donald Trump received 74.2 million—both more than any U.S. presidential candidate in history. In the Electoral College, Biden received 306 votes, while Trump got 236.
In the U.S. Senate Georgia runoff elections, Democrat Jon Ossoff defeated Republican incumbent David Perdue, 50.5% to 49.5%, and Democrat Raphael Warnock prevailed over Republican incumbent Kelly Loeffler, 50.9% to 49.1%.
The Democrats’ sweep of the two Georgia runoff elections resulted in a 50-50 split between the Democrats and the Republicans in the Senate. Because Vice President Kamala Harris serves as president of the Senate and holds the tie-breaking vote, the Democrats are the majority party in the upper chamber, allowing Sen. Chuck Schumer (D-N.Y.) to become the Senate Majority Leader and giving the Democrats the chairmanships of the Senate’s 24 current committees.
In the House, the Republicans registered a net gain of 11 seats, narrowing the Democratic majority to 10 seats. Currently, the Democrats have 221 representatives, the Republicans have 211, and there are three vacancies.
With Biden’s win, the Democrats’ sweep of the U.S. Senate Georgia runoff elections, and the Democrats’ retention of their majority in the House, the Democrats have control of the White House and majorities in both chambers of Congress for the first time since 2010.
As for the judicial branch, with Amy Coney Barrett’s confirmation by the Senate on Oct. 26, 2020, there are six conservatives and three liberals on the Supreme Court.
Citing former President Barack Obama’s famous triumphal statement in 2009, “Elections have consequences,” many Democrats view their control of both the executive and legislative branches as a clear mandate to aggressively pursue their agenda. Some from the progressive wing of the Democratic party are urging Biden to “go big” and use his “honeymoon” period to drive his most aggressive reforms, including a public option plan, expanding Medicaid, enhancing the Affordable Care Act’s health insurance marketplaces, lowering the Medicare eligibility age to 60, and promoting unionization and collective bargaining for healthcare workers.
Others, including moderate Democrats, advocate pursuit of a less-ambitious, more moderate bipartisan agenda, including reversal of many of former President Donald Trump’s executive orders, supporting telehealth, promoting value-based care and alternative payment models, increasing price transparency, and somehow tackling prescription drug prices.
Whether the aggressive or moderate scenario will come to pass will be largely determined by several factors.
First is the effectiveness of the COVID-19 vaccine rollout. In Biden’s inauguration speech, he rightly said, “Our work begins with getting COVID under control.” It is job one for the Biden administration for 2021 and perhaps 2022. It is not an overstatement to say that most everything—the nation’s public health, economic recovery, and the political climate in the nation’s capital—hinges on the success of the coronavirus vaccine rollout.
Guest post Ken Perez, vice president of healthcare policy, Omnicell.
Ken Perez
During the 2016 presidential campaign, Democratic candidate Hillary Clinton reiterated the longstanding Democratic pledge to allow Medicare to negotiate drug prices and demand higher rebates for prescription drugs. In response, and aware of the general public’s mounting concern about rising prescription drug prices, Donald Trump shifted to the left and repeatedly called for Medicare to directly negotiate drug prices. For example, at an MSNBC town hall on Feb. 17, 2016, Trump said, “If we negotiated the price of drugs, Joe, we’d save $300 billion a year.”
However, none of Trump’s three most substantive policy statements issued in the fall of 2016—including the healthcare section of the Trump-Pence Campaign website, his “Contract with the American Voter,” and his healthcare plan issued two days after the election—mentioned the challenge of rising drug prices or the idea of Medicare negotiating drug prices with pharmaceutical companies.
On Jan. 31, 2017, President Trump met with a group of pharmaceutical industry executives, including the CEOs of Amgen, Celgene, Eli Lilly, Johnson & Johnson, Merck, and Novartis, as well as Stephen Ubl, head of the Pharmaceutical Research and Manufacturers of America (PhRMA).
While during the meeting Trump called drug prices “astronomical” and said, “We have to get prices down for a lot of reasons … for Medicare and Medicaid,” he stopped short of the aforementioned negotiation of drug prices by the federal government. Trump pressed the pharmaceutical companies to bring drug manufacturing and production back to the United States. In return, Trump pledged to work to reduce corporate taxes, support deregulation, and streamline the FDA to expedite drug approvals. One can interpret those broad statements as a draft outline of the deal with pharma that will be struck by the Trump administration.
Where would such a deal leave the drug pricing issue? While Trump clearly expressed concern about high drug prices, the drug makers can offer him something else that he may want even more: jobs for U.S. workers that come from boosting production at existing plants and opening new plants on U.S. soil. Imagine the photo ops!
Guest post by Abhinav Shashank, CEO & co-founder, Innovaccer.
Abhinav Shashank
On Nov. 9, 2016 the United States of America witnessed a major turnaround in the administration. Republican candidate Donald Trump is the 45th president-elect of the United States. Donald Trump plans to bring about numerous changes to “Make America Great Again,” and true to his Republican roots, Trump’s plans for the healthcare focus on some key facets which have always been a concern for the GOP.
Trump has outlined his healthcare plan for America that is centered around mainly the following key facets. A study conducted by the Commonwealth Fund with RAND Corporation using simulation analyzed his plans and came up with probable impacts.
1.) Repeal Affordable Care Act
Donald Trump and the GOP want to fully repeal the ACA and replace it with something new, dubbed “Healthcare Reform to Make America Great Again.” However, the intention is to achieve a better law with some parts of ACA.
Planned changes: Pre-existing condition clause will remain. As the Republican plan “the better way” dated June 22, 2016, Trump plans to continue with it as no American should be denied on the basis of pre-existing medical conditions or demographics. Remove the individual and employer mandate, as no one should be forced to buy health insurance. Reduce the growth rate of Medicare spending and implementation of new taxes and fees.
2.) Use of Health Savings Accounts (HSA)
A Health savings account is a tax-advantaged medical saving account available to the people of US, which allows people to contribute or draw money from for paying off medical expenses, tax-free.
Planned changes: Under Obamacare, HSAs were available to only individuals who were enrolled in “High Deductible Health Plans.” Keeping the basics same, Trump proposes to expand HSAs, allowing all individuals to use HSAs where the contributions would not only be tax-free but will also accumulate over time. Moreover, he would allow HSAs to become a part of a person’s estate and would be passed on to heirs without any penalty.
3.) Making premiums tax deductible
Before ACA came along, there were substantial tax advantages available to people who had their employer cover for them, but that privilege did not extend to people who took up private, individual-market policies not provided by the employer. To solve this disparity, ACA had the provision of means-tested advance premium tax credits, known as APTCs – where the government reduces the cost of insurance by providing APTCs to bridge the gap between the cost of premium and payment limit.
Planned changes: Trump’s plan will allow individuals to fully deduct their premiums from their tax returns under the current tax system, facilitating a free market to provide insurance coverage to companies and individuals. The scheme Trump has will abolish APTCs and let individuals use pre-tax money to purchase individual market insurance.
The aim is to provide people with an incentive to pay for coverage when they are healthy, and not make it mandatory.
4.) Funding Medicaid through block-grants
Under the current law, Medicaid gets join funds by the federal and state government and the federal government contributes 50 percent to 75 percent of the total costs and the rest is borne by the states.
Planned changes: Trump proposes to fund Medicaid all over the country through block grants. Under this, the federal government would give a fixed amount of money to states and let them fund their programs.
The rationale behind this is that state governments know best about their population and should have the sole authority on how the money should be spent and will fare better without federal administration overhead.
