Trump Presidency Likely to Bring Major Changes to Healthcare

By Joan Spitrey via Multibriefs

Now that the 2016 election season has ended, there really is only one thing most are agreeing on — they are glad it's finally over. Since the first political ad aired more than 500 days ago, the race to the White House has been one of the most divisive and hotly contested campaigns in modern history.

The polarizing race set many precedents, pitting a "nonpolitician" up against the first major female candidate in U.S. history. But as Nov. 8 came to a close, Donald J. Trump was awarded a new career role as the 45th president of the United States.

Throughout the campaign, Trump made his opinions and goals for the Affordable Care Act clear: He wanted the law radically changed. Despite previous attempts by Republicans in Congress, changes could never be affected due to repeated vetoes by Democratic President Barack Obama.

However, when Trump begins his presidency, he will have the luxury of a Republican Congress that may actually put the proposed changes into action.

Earlier this year, Trump released his proposal for healthcare reform. The seven points listed focused primarily on insurance reform and access to healthcare.

Should the ACA become completely unraveled, chaos could ensue in the healthcare sector. Many organizations have made sweeping changes and investments to maintain the current ACA requirements, and changes may not be so readily welcomed.

For example, the suggestion to remove the individual mandate that requires all Americans to have insurance could leave millions of newly insured citizens without insurance — potentially placing the burden of care back on hospitals as they are the only perceived access points for care to the uninsured.

However, to counter the new actions, the proposed reform would modify the existing law that inhibits the sale of health insurance across state lines. By opening the market, Trump thinks insurance costs should go down and make it more affordable to consumers. This comes as a welcome thought for many as the average premium nationally is expected to rise 22 percent in 2017.

Trump wants to require transparency in pricing, which could have a significant impact on healthcare, especially doctors and hospitals. This would allow patients to shop for the best prices for procedures, exams or other procedures. Again, a strangely unprecedented thought in healthcare, yet common practice in all other business entities.

Not only would patients choose based on reputation, but also on the value of their dollar compared to other practitioners or facilities. However, this could have significant impact on nurses and other healthcare workers as administrators would continue to look for areas to price cut in order to keep the patients' costs down.

Of specific interest is the lack of discussion on the areas that have directly affected the infrastructure of healthcare — Electronic Health Record Incentive Programs (meaningful use) and the ever-controversial Value-Based Modifier Payment that ties reimbursement to patient satisfaction scores. These significant changes to the way healthcare is provided continue to be areas of great dissatisfaction to most healthcare workers, but do not appear to be on the radar in discussions about how to improve the ACA.

Although Trump repeatedly stated he wanted to make immediate changes, we can all agree that few things move quickly in Washington. Therefore, although the changes may be drastic, they are not likely to happen quickly or be as far sweeping as most think.

What can be learned from this experience is change is certain to come — whether we're ready or not.

Joan Spitrey has been a registered nurse for more than 16 years, specializing in critical care and acute care services. She currently is a clinical nursing instructor, sharing her passion with the next generation of nurses. She can be found blogging at

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