We have just been through an election that shocked the world and our nation and that has left us questioning what is likely to happen – especially in terms of healthcare. President-elect Donald Trump campaigned on repealing and replacing Obamacare, in recent weeks, he has backed away from earlier, stronger notions of replacing, at any rate, we don’t know what “repeal and replace” would look like. One thing I know for sure is that we can’t go back to what we had before. There are 20 million newly-insured people, many through expanded Medicaid programs, young people are able to remain on their parents’ plans, and pre-existing conditions are no longer a barrier to getting insurance. Those are all good features of the Affordable Care Act that no thoughtful politician would want to replace. Despite the heated rhetoric, I don’t foresee any real movement to repeal and replace the ACA altogether because it is not in the best interests of the country.
What is likely to happen, then? I believe the first priority should be to allow insurance companies to sell across state lines. In too many communities, there are limited options, even a single option, which gives insurers plenty of latitude in setting their prices.
When there are multiple companies competing for customers, prices come down. I know this from personal experience.
Earlier in my career, I managed Western Health Plans in San Diego, Reno and Las Vegas. In the San Diego marketplace, we had four other competitors. Western Health Plans competed by offering a different network of physicians, and we competed on price. We didn’t always offer the lowest price, but we were acutely aware of how the other companies set their prices, and our prices reflected the competitive marketplace.
Obviously, what happens with ACA will have a major impact on all of our work. As always, Gallagher Integrated will be watching developments carefully and bringing you the best advice from thought leaders across the industry as the story evolves.