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    How will the Trump administration change healthcare?

    Donald Trump’s surprising win in the presidential election has put a renewed focus on what will happen to healthcare under the new administration.

    For now details are scarce, but one thing president-elect Trump has emphasized throughout his campaign is repealing the Affordable Care Act (ACA) and replacing it with something better, saying in some stump speeches that it will happen on his first day in office.


    Hot topic: Anti-Trump document draws hundreds of physician signatures


    Republicans have tried to repeal the ACA, or Obamacare, since its inception, but now with control of both houses of Congress and the presidency, they have the power to do so. Repealing the ACA would result in 22 million people losing health insurance, according to the Congressional Budget Office, creating the question of what happens to those affected, and what, if anything, would replace the ACA.

    Based on last year’s Republican repeal attempt that President Obama vetoed, there are some clues to what provisions of the ACA might be repealed and which ones might remain in some form. The vetoed bill would have:

    ·      eliminated programs providing Medicaid coverage for Americans near or below the poverty line,

    ·      eliminated subsidies that helped people buy insurance on the exchanges,

    ·      eliminated taxes that fund the ACA, and

    ·      eliminated the tax penalties for not having insurance

    Parts of the law would have remained, including requiring insurance companies to cover young adults on their parents’ policies and to sell insurance to anyone, regardless of medical history. Medicare reforms also would have remained. Whether next year’s Congress will follow the same blueprint remains to be seen.


    Further reading: Doctors get new flexibilty in Meaningful Use reporting


    In speeches, Trump has often mentioned replacing the ACA, but offered few details on what that would look like. His campaign website makes no mention of replacing it, but states that his free market principles “will broaden healthcare access, make healthcare more affordable and improve the quality of care to all Americans.”

    John Meigs, Jr., MD, president of the American Academy of Family Physicians made clear in a letter to Trump that affordable and accessible care needs to be a priority. He also urged the new administration to reduce administrative burden, implement reforms that emphasize the value of primary care and reduce the financial burden to patients in obtaining primary and preventative care.

    Next:  "Medicine is in for an exciting ride"

    Todd Shryock
    Todd Shryock, contributing author


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