Clinicians express uncertainty about impact of Trump presidency on health care

The election of Donald J. Trump as the 45^th president of the United States left clinicians unsure about how his administration will handle many health care initiatives and policies. Healio spoke with experts in different disciplines, including cardiology, infectious disease and endocrinology, to examine the specific ways in which his administration may address Medicare and Medicaid, NIH funding and the FDA, among other issues. All of the physicians who spoke with Healio expressed uncertainty regarding the future of the Affordable Care Act (ACA), which Trump promised to repeal and replace during the presidential campaign.

Below is a compilation of the Healio articles discussing how health care may be affected during the Trump administration.

Infectious Disease

The future of the ACA, and how major government health agencies will be run, were the biggest concerns cited by infectious disease experts. “The concern is that [Trump’s] real drive is a relentless worshiping of capitalism and a belief that money can solve everybody’s problems,” Jeanne Marrazzo, MD, MPH, told Infectious Disease News. “The commitment to the underserved informs a lot of what we do in infectious disease.” Read more.

Endocrinology

Endocrinologists discussed access to Medicaid and the cost of health care, particularly in regard to how these factors will affect patients with diabetes. “I will be surprised if the Medicaid expansion, to the degree that it happened, will remain with the new administration, new governors and Congress,” Vivian A. Fonseca, MD, FRCP, told Endocrine Today. Read more.

Hepatology

Clinicians who spoke with HCV Next voiced more questions than answers, although many were anxious about the potential impact on the ACA, the FDA and direct-acting antiviral therapy. “It is too soon for us to speculate how the Trump administration will address health care,” said Steven Echard, IOM, CAE. “Our policy agenda remains focused on funding for hepatology research and training and access to care for patients with liver disease.” Read more.

Cardiology

Cardiology professional societies and industry groups expressed hope that the administration and Congress will work to improve patient access to care, while acknowledging that uncertainty exists about what health care initiatives might occur. “We believe patients must remain the first priority if the current system is overhauled because everyone in our nation deserves access to affordable insurance coverage and quality care,” Steven R. Houser, PhD, FAHA, told Cardiology Today. Read more.

Gastroenterology

The uncertainty regarding the future of the ACA was a top concern for many gastroenterologists; they also discussed the Medicare Access and CHIP Reauthorization Act (MACRA) and NIH funding. “The devil will be in the details,” Joel Brill, MD, told Healio Gastroenterology. “Millions of people have gained coverage [through the ACA], so to repeal that without having a plan in place to offer coverage to those people obviously could be of great concern to them.” Read more.

Orthopedics

Less is known about the future of the Comprehensive Care for Joint Replacement or MACRA, according to the physicians who spoke with Orthopedics Today. Several members of Congress and the American Academy of Orthopaedic Surgeons have begun writing to CMS to “relax some of the more stringent restrictions and mandates inside of CJR and MACRA,” according to Louis F. McIntyre, MD. Read more.

Ophthalmology

Health care professionals in ophthalmology focused on the potential impact on pharmaceuticals and ambulatory surgical centers in addition to the ACA and FDA, and American Academy of Ophthalmology CEO David W. Parke II, MD, endorsed the nomination of Rep. Tom Price, MD, (R-Ga.), as secretary of the U.S. Department of Health and Human Services. “We can think of no better voice to lead our nation’s critical health care programs,” Parke said. Read more.

Rheumatology

The future of biosimilar therapies is an area of particular interest for rheumatologists. There are concerns with the way biologic therapies are tiered and prescribed, according to Michael C. Schweitz, MD: “We hope to be able to educate the new administration about these issues.” Read more.