Health services research and policyOpinionAnticipated Impact of the 2016 Federal Election on Federal Health Care Legislation
Section snippets
The Patient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act (PPACA; also known as Obamacare) was the signature legislation of President Obama’s first term 8, 9. It was passed without any Republicans voting in its favor in either legislative branch, and in the ensuing years and three election cycles, it has been a unifying point of attack by the Republican Party [10]. Consequently, both the incoming Congress and White House administration have expressed their commitment to effectively repeal PPACA shortly
Authority Over Physician Practice and Payment
The Obama administration saw the advent of a range of measures shifting authority over physician practice and payment to the executive branch of the federal government. The new administration is likely to pursue a range of measures that would oppose this trend, instead shifting power back toward the federal legislative branch, if not to the individual states themselves. Such efforts would be aligned with a desire by incoming Secretary Price to support physicians’ autonomy and lower perceived
The Transition to Value-Based Care
The Medicare Access and CHIP Reauthorization Act (MACRA), passed in 2015 [28], represents the most influential piece of health care legislation since PPACA 6, 7. MACRA stabilized the Medicare Physician Fee Schedule by repealing the sustainable growth rate. In the process, MACRA also implemented a new system, subsequently named the Quality Payment Program (QPP), that will greatly reform the Medicare payment system to base a substantial fraction of Medicare payments on the quality and cost of
Tort Reform
Medical malpractice tort reform also stands to be altered given the election results. The Republican Party has a long-standing record of supporting such reform [33], for example supporting bills during previous administrations that set caps on compensation for noneconomic damages. In addition, prior legislation introduced by Price included a number of tort reform provisions, including a cap on noneconomic damages, a shortened window for filing suits, and administrative tribunals to evaluate new
Conclusions
We acknowledge that these predictions reflect our perceptions of the most likely federal provisions and agencies to be affected under the new regime. Ultimately, patients, payers, and radiologists and other physicians alike, will need to closely follow the federal health policy landscape once the next administration assumes power in January 2017.
References (33)
- et al.
MACRA, MIPS, and the new Medicare Quality Payment Program: an update for radiologists
J Am Coll Radiol
(2016 Dec 21) - et al.
MACRA, APMs, and the physician-focused payment model: implications for radiology
J Am Coll Radiol
(2017) - et al.
MACRA 2.0: are you ready for MIPS?
J Neurointerv Surg
(2016 Nov 24) - et al.
The episode, the PTAC, cost, and the neurointerventionalist
J Neurointerv Surg
(2016 Dec 1) - et al.
Alphabet soup: our government “in-action.”
AJNR Am J Neuroradiol
(2013) - et al.
Sustainable growth rate repealed, MACRA revealed: historical context and analysis of recent changes in Medicare physician payment methodologies
AJNR Am J Neuroradiol
(2016) - et al.
MACRA: background, opportunities and challenges for the neurointerventional specialist
J Neurointerv Surg
(2016) - 111th Congress. H.R. 3590—Patient Protection and Affordable Care Act....
- et al.
Patient Protection and Affordable Care Act of 2010: a primer for neurointerventionalists
J Neurointerv Surg
(2012) - Republican National Committee. Issues. ObamaCare. Available at: https://www.gop.com/issue/obamacare/canonical/....
Cited by (7)
Storm rising! the Obamacare exchanges will catalyze change: Why physicians need to pay attention to the weather
2019, Journal of NeuroInterventional SurgeryUnderstanding the impact of cost' under MACRA: A neurointerventional imperative!
2018, Journal of NeuroInterventional SurgeryAHCA meets BCRA; timeline, context, and future directions
2018, Journal of NeuroInterventional SurgeryThe qualified clinical data registry: A pathway to success within MACRA
2017, American Journal of NeuroradiologyContextualizing the first-round failure of the AHCA: Down but not out
2017, Journal of NeuroInterventional SurgeryPartnering with Insurers in Caring for the Most Vulnerable Youth with Diabetes: NICH as an Integrator
2017, Current Diabetes Reports
Dr Rosenkrantz is supported by a research grant from the Harvey L. Neiman Health Policy Institute. Dr Hirsch has received fees unrelated to the present work from Medtronic, Carefusion, and Codman Neurovascular. The authors have no conflicts of interest related to the material discussed in this article.