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Topic: After Hours
As 2018 and Year 2 of the chaotic Trump Administration kick off, trying to predict what will happen in Medicare, Medicaid, and the Affordable Care Act is as challenging as ever. It’s a midterm election year with terrible headwinds for the GOP, so the legislative calendar is abbreviated, and partisan rancor will peak. That makes it less likely Republicans will get to do much damage but also more likely they will try to serve up red meat for their base, like a return to “repeal and replace.” Congressional leaders, fresh off their billionaire bailout tax bill, are already talking about taking up “reform” (aka cuts) of Medicare and Medicaid and other social welfare programs. The only thing that is certain is 2018 will be another battleground year for government health programs.
I worked on single-payer healthcare legislation for US Rep. John Conyers (D-MI), my hometown Congressman from Detroit and an early leader on the issue with Rep. Jim McDermott (D-WA) in the 90’s. It’s not surprising the idea has gone nowhere in the 26 years since. While my heart is in it as a means of universal coverage, Bernie’s “Medicare for All” proposal as dropped this week is a conversation piece, and that’s it. It’s DOA as legislation.
I am continually amazed by how many health plans in Medicare Advantage (MA) and Medicaid still cling to restrictive, “Dr. No”’90’s-style managed care practices like pre-authorizations, referrals, and concurrent review. With massive policy changes looming in Medicaid, and the influence of Star Ratings in MA greater than ever, health plans may soon have a gun to their heads: evolve medical management from restrictive to supportive, or die.
I sure hope Republicans enjoyed their victory lap for getting the American Health Care Act (AHCA) through the House by the thinnest margin, because there are two huge icebergs dead ahead: the backlash, and the Senate.
The Gorman Health Group 2017 Forum concluded last week in New Orleans with over 200 of our closest clients and partners. As we enter our 21st year, we returned to where it all began for us, with a little startup called Peoples Health, our first and closest client who now dominates southern Louisiana. The Forum ended the day JazzFest 2017 began, so many of us stayed to enjoy the festival and the best of New Orleans heritage and culture.
So the people spoke and we are heading for an epic cagematch smackdown general election between reality TV star Donald Trump and former Senator and Secretary of State Hillary Clinton. And you’re asking, what’s going to happen to Medicare, Medicaid and ObamaCare? The answer is plenty — below the waterline and out in the states. Stakeholders will need to pay attention or get left behind.