The legislative impact of a Donald Trump presidency is hard to predict, but it certainly muddles the future for some healthcare legislation, according to Chris Sherin, Director of Congressional Affairs at the American College of Radiology.
Donald Trump’s No. 8 win wasn’t anticipated by many outside of his camp—it left news anchors scrambling to explain the result to their viewers and threw legislative plans for the lame duck congress into disarray. The post-election uncertainty will also affect pending healthcare legislation such as the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016, not to mention existing legislation such as the Affordable Care Act (ACA), which Trump has promised to repeal as a major part of his platform.
Changes to the ACA will strongly reverberate throughout the industry, and the ACR is prepared to fight for pro-radiology provisions in a potential replacement—although details on a replacement have been few.
“There’s a healthy sense of the unknown, but he has given some signals about rolling back regulations, allowing insurance across state lines and maybe something about drug costs,” said Sherin. “We will be closely monitoring how these broad ideas get distilled.”
Medical professionals can take solace in the fact that Trump is unlikely to repeal the Medicare Access and CHIP Reauthorization Act (MACRA), preserving some sense of stability in turbulent times.
While Sherin is optimistic about the passage of the CHRONIC Care Act, he acknowledges that it may have to wait until 2017—even with bipartisan support from Senators Orrin Hatch, R-Utah, and Ron Wyden, D-Oregon.
“I think the CHRONIC Care Act has some chance of getting accomplished in the lame duck, but it’s unclear because of some factors that were working against it—even before the election,” said Sherin. “Plus they have to do something about the budget. … I wouldn’t rule it out, but if it doesn’t happen I could see Hatch and Wyden trying to work it in during the next session.”
The bill is a priority for Hatch and Wyden, both ranking members of the Senate Finance Committee. While it doesn’t impact radiology as directly as some legislation, it preserves the existing structure of state licensure, changes to which could dilute the quality of telehealth.
Most states require physicians to be licensed to practice in the originating state, and some require physicians to have a state license in the state where the patient is located. Because medicine is typically regulated at the state level, state-by-state licensure helps ensure that doctors know and abide by the correct laws.
Another legislative interest for the ACR’s Government Affairs office is how healthcare legislation is funded. Even if it doesn’t affect radiology, the bills have to be paid for—and imaging services are frequently in CMS’ or Congress’ crosshairs, according to Sherin. However, the ACR is somewhat limited to a wait-and-see approach for the moment.
“There’s a huge wrench thrown into the process with President-elect Trump assuming the Oval Office in January, so it’s going to be interesting to see how the agenda changes,” said Sherin.