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Friday, Nov 11 2016

Full Issue

Trump's Vague Policies Leave Key Questions On Future Of Health Coverage, Quality, Medicare

Since the campaign offered few specifics on how Donald Trump would repeal and replace the health law, many issues are in flux. Questions include: Will Republicans continue to guarantee coverage for people with pre-existing conditions; what happens to the low-income people who have been added to the Medicaid rolls; how will the administration deal with growing Medicare costs; and will efforts continue to move health payments toward paying for quality instead of quantity.

On his transition page Thursday, Trump hinted at softening the coverage guarantee for those with pre-existing conditions under the ACA, saying聽high-risk pools -- state insurance programs for individuals who are sick or otherwise unable to get coverage -- would cover those with large medical expenses who have 鈥渘ot maintained continuous coverage.鈥 Repealing the ACA, a law passed in 2010 that brought insurance to about 20 million people who previously lacked it, could leave those聽with pre-existing conditions without insurance. (Tracer and Kapur, 11/10)

President-elect Donald Trump鈥檚 most updated health care proposals don鈥檛 say whether a Trump health care policy would require insurers to cover pre-existing conditions or whether the law would continue an expanded Medicaid program. Those are two of several questions that advocates and observers are posing about how Trump plans to replace the Affordable Care Act, which bars insurers from denying covering to people with pre-existing health conditions. Then there鈥檚 this. The biggest challenge that Republicans face in attempting to advance health reform is how to continue covering the 20 million people who gained have insurance under the ACA. (McIntire, 11/10)

The post-election headline grabber is 鈥淩epeal and Replace鈥 鈥 when it would happen, what it would look like, what kind of transition would bridge the Affordable Care Act to whatever comes next. But there are a host of other gnawing health issues. Here are five we鈥檙e watching. (Kenen, 11/10)

President-elect Donald Trump's promise to dismantle the Affordable Care Act is unlikely to also undo widespread efforts to nudge the U.S. healthcare system toward value-based payment, including with experiments devised by the ACA-funded CMS Innovation Center. 鈥淭he concept of value in healthcare has been around a long time,鈥 said Helen Darling, interim president and CEO of the Washington, D.C.-based National Quality Forum. Fundamental ideas like the importance of transparency and data to patients, providers and competition existed well before the Affordable Care Act, and they are as Republican as they are Democratic, she said. 鈥淪ome of those things are more Republican than Democrat, frankly,鈥 she added. (Whitman, 11/11)

Within the government鈥檚 health agencies, Mr. Trump鈥檚 campaign also proposed eliminating the Food and Drug Administration鈥檚 鈥渇ood police,鈥 which it said 鈥渄ictate how the federal government expects farmers to produce fruits and vegetables and even dictates the nutritional content of dog food.鈥 But the proposal was quickly taken down from the campaign鈥檚 website. The Food Safety Modernization Act of 2011, which strengthened the F.D.A.鈥檚 oversight of food, is popular among many Republicans as well as with food manufacturers, tarnished by massive food recalls. (Shear and Harris, 11/10)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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