Inbox: Trump's Win Sparks Discussion over ACA's Future

Editor's note: We work hard to write about issues that will help physicians run their practices in a manner that is both prosperous and efficient, while still delivering quality patient care. And we are delighted when our readers let us know what they are thinking. This month we are excerpting a slideshow by Gabriel Perna on what the election of President-elect Donald Trump may mean for the future of healthcare. The article has been edited for space and are followed by comments made by readers at PhysiciansPractice.com.

President-elect Donald Trump's Impact on Healthcare

Donald Trump has been elected the 45th president of the United States, and along with the Senate and House maintaining their Republican majorities, a tidal wave of healthcare policy changes could be just around the corner.

While specific details have yet to come out regarding health policy under President-elect Trump, speculation has already begun on what could happen immediately. For one, the Affordable Care Act (ACA) could be in imminent danger. House Speaker, Rep. Paul Ryan, and Senate Majority Leader, Sen. Mitch McConnell, have already spoken about repealing the healthcare law in the early days of the Trump presidency.

In a press conference, McConnell said of repealing the ACA, "It is a pretty high item on the agenda. I would be shocked if we did not move forward to keep our commitment to the American people."

Along with a repeal of the ACA, here are a few other things that could happen to health policy under President-elect Trump in his first year in office.

Ann comments: "Finally, the disaster of Obamacare will come to an end! Maybe now we will get some common sense healthcare that people can actually afford."

Shari responds: "Not to mention access."

DeeLonna says: "I think you are speaking of access to providers and unfortunately if [doctors] do not contract with the ACA plans, you cannot go see them. This is "why" it is hard to find doctors that contract with these plans. It was difficult to find specialty providers for people with low income insurance plans in the first place. There needs to be an incentive to providers that will contract with these plans so they will open up their patient panels to see these patients. Unfortunately, the reimbursement on some of these plans may be a lot less so doctors are unwilling [to participate], due to low reimbursement."

Terence says: "I think as long as we have for-profit insurance companies involved, the profit motive will encourage insurers not to cover the poor or the sick. The most rational solution is a single-payer system that will truly be able to provide coverage to everyone by spreading the cost over everyone."

Daniel responds: "Agree. Just go single payer and get it over with."

Vince comments: "All those calling for the repeal of ACA should recall what it was like when patients were denied insurance due to pre-existing conditions. Providing affordable insurance to those patients without also having an individual mandate is impossible. It is akin to allowing people to drive without car insurance and then asking car insurance companies to sell insurance to someone AFTER they have had an accident so that they can get their car fixed."

Deborah responds: "Providing 'affordable' insurance WITH the mandate failed. It is no longer affordable; that is why it is up for repeal and REPLACE. …. It didn't work. So now we need to help come up with a way that does work. Ultimately people have to accept some responsibility for their own health. We cannot legislate people into caring…"

Wesley says: "Deborah, you are correct. The ACA is a massive mistake that is unaffordable."

Estelle comments: "Everyone wants to get rid of pre-existing conditions except the insurance companies. However, if the Republicans pass a ban on pre-existing conditions as a standalone law, the insurance companies will simply stop providing health insurance…"
Mary Jo says: "The biggest problem in healthcare is that no one has control over the insurance companies - what they charge the consumer, what they pay the physician, or what they pay their CEOs in big bonuses each year. The patient ultimately pays the price. Someone needs to make sure that the insurance companies are looking out for both the patients and the doctors."