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Nov 04, 2024

Healthcare Is On The Ballot Due To 2025 Presidential Decisions

TOPSHOT - Voters cast their ballots in the voting booths at the early vote location at the ... [+] Charleston Coliseum and Convention Center in North Charleston, South Carolina on October 16, 2020.

TOPSHOT - Voters cast their ballots in the voting booths at the early vote location at the ... [+] Charleston Coliseum and Convention Center in North Charleston, South Carolina on October 16, 2020. Many states across the country have seen record turnout for early voting for the 2020 election. (Photo by Logan Cyrus / AFP) (Photo by LOGAN CYRUS/AFP via Getty Images)

My recent community conversations indicate general awareness about healthcare policy during this presidential election is lower than in previous elections. The economy and immigration loom large, but we cannot forget healthcare is also on the ballot. The outcome of this presidential election will determine the fate of a few healthcare policies that will be decided during the next presidential term.

Last week, someone told me healthcare policy is not something he thought about. When probed he said, "We need to go back to the days before Obamacare because healthcare was better then." When I asked for an example, he didn't have one. He is 19 years old and covered by his dad's health insurance. A few other conversations confirmed that, other than abortion, people seem pretty checked out when it comes to healthcare and are not connecting their voting decisions to healthcare policy.

In a recent episode, the Tradeoffs Podcast, a non-partisan media organization offering no endorsement of policies and political candidates, highlighted three healthcare policy decisions the next president must make over the next four years.

Insurance premium support The Affordable Care Act legislation benefits to Americans include but are not limited to mandating insurance companies eliminate pre-existing conditions as an eligibility requirement, enabling children to stay on their parents' health insurance until age 26 and expanding access to insurance for Americans who could not afford it by providing financial support for insurance premiums.

Portions of this financial support for premiums, known as enhanced subsidies, are set to expire at the end of 2025. The next president will decide whether these subsidies will end. Data show ACA subsidy and insurance support have lowered the incidence of bankruptcy in some groups, suggesting an economic benefit from the legislation.

Medication abortion Two-thirds of abortions in the US occur via medication rather than surgery. Access is determined by the Food and Drug Administration(FDA), and there is disagreement in Congress about whether the FDA should continue to approve access to abortion medication. Erderlina Co, Associate Professor of Law at the University of the Pacific, says the next administration will have the power to make decisions about medication availability. "This will [depend on] whether FDA decides to revisit medication abortion, so who is running that agency can make a difference."

Medicare drug price negotiation The Centers for Medicaid and Medicare Services (CMS) now has the authority to negotiate lower drug prices with the pharmaceutical industry for certain medications. However, there are Republicans who want to repeal CMS' authority to do so. The next president will decide whether this authority continues and could be expanded beyond the initial ten medications. This issue will impact millions of seniors, including those on Medicare. According to the Kaiser Family Foundation, "Most seniors have prescription drug coverage through Medicare Part D, but majorities across party lines say drug costs are unreasonable."

WASHINGTON, USA - JULY 25: US Senator John McCain (2nd L) leaves the Capitol after his first ... [+] appearance after being diagnosed with cancer after the Senate narrowly passed the Procedural Vote for the replacement of the Affordable Care Act (ACA) at the U.S. Capitol in Washington, United States on July 25, 2017. ( Samuel Corum - Anadolu Agency ) (Photo by Samuel Corum/Anadolu Agency/Getty Images)

Also, Andrey Ostrovsky, former chief medical officer for CMS, says that during his tenure, Donald Trump and some Republicans in Congress attempted a 20% reduction in Medicaid. Medicaid expansion has enabled over 20 million Americans who otherwise would be uninsured to obtain health insurance. Since ACA's inception, despite its growing popularity and now 45 million Americans covered by the ACA, Congress has made 70 attempts to overturn the law.

In a different interview with Tradeoffs Podcast, Larry Leavitt, Executive Vice President for Health Policy at Kaiser Family Foundation, says, "If Republicans sweep this election, I think the ACA along with Medicaid will have big targets on their backs. If Democrats can hold on to one house in Congress, I think the ACA will be safe, even though it has not been a big topic in this election."

These upcoming health policy decisions may also have dire consequences for Americans serving as caregivers for parents, grandparents and other loved ones. An estimated 38 million Americans are providing unpaid caregiving services to loved ones at an estimated cost of $600 billion annually.

Despite limited debate and news coverage about healthcare policy in this election, healthcare IS on the ballot. Like the 19-year-old young man, some people believe being 'healthy' deems them unaffected by healthcare policy. That may be true for him this instant, but it isn't for hundreds of millions of Americans.

Before stepping into the ballot box it would be prudent for all Americans to reflect and review the information needed inform decisions about which healthcare policies will best support the healthcare needs of their loved ones and themselves.