Sideline Consult

A Pragmatic Approach to Healthcare Changes in 2017

Bert R. Mandelbaum, MD, DHL (Hon)

Disclosures

December 22, 2016

In This Article

Healthcare in 2017: A Perspective

In the wake of the presidential election, a lot of people are fretting about changes to our healthcare system.

The president-elect promised to repeal the Affordable Care Act (ACA), and many patients are wondering how this might affect their own healthcare plans. Sports medicine practitioners want to know how their practices will change.

When I talk about these questions with patients, I start by offering reassurances. The vast majority of people who are covered by employers' plans should not expect any big changes. But even for those without insurance or coverage through the ACA, I believe it's important to take a pragmatic approach.

To any patients without adequate healthcare coverage, I point out that we are in the midst of open enrollment for the ACA. People can sign up for insurance under the ACA until January 31, 2017.

Congress may repeal the ACA soon after the new president's inauguration. But it's unlikely that Congress will simply cut off health insurance for the 20 million-plus people who are covered through the program without offering anything its place.

Encourage Patients to Get Insurance

In the meantime, most states offer good options for patients trying to get coverage on their own through the healthcare exchanges set up by the ACA. The policies offered there may be expensive, but they are more complete than many policies offered before the ACA, and the law provides subsidies for people who have difficulty paying. I tell my patients, "You can't afford not to have health insurance."

Also, the ACA prevents insurers from denying coverage based on preexisting conditions. That's huge, because there are 15 million survivors of cancer in this country. The ACA also allows adults to stay on their parents' plans until age 26. I'm optimistic that whatever changes the new administration makes will retain these popular provisions.

It's exciting that the president-elect has named an orthopedic surgeon as head of the Department of Health and Human Services. Although I don't know Dr Price personally, I've been following his career in Congress. I see him as a practical person who will do what's best for our patients.

The biggest problem we have with the ACA is that the risk pools in the exchanges are small and don't have enough healthy people in them, so many of the insurers are getting out of them. Too much money in the system is flowing out of the pockets of patients, physicians, and hospitals and into the pockets of insurers. What could be better for our patients than a president-elect and secretary of Health and Human Services making this problem a top priority?

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