5 Ways A Democratic Trifecta Could Change Health Care

With a Democratic-controlled Senate becoming more of a reality after Tuesday’s Senate runoff vote in Georgia, Democrats are in charge of the White House as well as both houses of Congress. What does it mean for health care?

Here are five ways a Democratic trifecta would impact health care, according to a recent Manatt Health webinar on the impact of the election.

1. Public option: Congress could implement a public option to compete with private health insurance Congress also could use the public option as a chassis for expanding Medicaid in states that chose not to expand it after the Affordable Care Act took effect.
2. Affordable Care Act: Congress and the new president could build on the ACA, expanding subsidy eligibility and value.
3. Medicare At 60: President-elect Joe Biden has stated his support for lowering the Medicare eligibility age to 60. Look for a Democratic-controlled Congress to go along with it, while addressing Medicare insolvency issues.
4. Drug Pricing. A Democratic-controlled Congress is likely to allow Medicare to negotiate prices with drug manufacturers. Congress also would place caps on drug price increases.
5. Surprise billing: One issue both Democrats and Republicans can agree on. Surprise billing legislation is likely no matter which party is in charge. The key issue is reaching agreement on the approach to provider payments in out-of-network settings.

In addition, if the Supreme Court strikes down the ACA in a ruling expected to come down in June, Congress could act to codify some ACA provisions, such as protection for those with preexisting conditions. Congress also could pass legislation before the court reaches a decision, making the court case moot. These legislative options include:

• Change the individual mandate penalty from $0 to an amount that would generate revenue for the government.
• Repeal Section 5000A of the Affordable Care Act, the individual mandate.
• Pass legislation severing the individual mandate from the rest of the ACA.
• Pass health reform legislation that replaces the ACA.
  Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected]. Follow her on Twitter @INNsusan.

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Susan Rupe is editor in chief, magazine, for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].