The results of the election are in and the Republicans have taken the White House, Senate and House. This was a surprising turn of events and many are still trying to figure out what legislation we’ll be seeing next. Some pieces of the incoming administration’s agenda are taking shape. Here’s what we see happening and what we’ll be working on in 2017:
Affordable Care Act Repeal
The Republican Party has stated that they will immediately try to repeal and replace the Affordable Care Act (ACA), informally called Obamacare. It is unclear what this would be replaced with, but Donald Trump has indicated that he would like to keep the requirement to cover pre-existing conditions and the ability for children to stay on their parents’ health care plans through age 26. It would be extraordinarily difficult, though, to keep coverage requirements for pre-existing conditions without other pieces of the ACA, such as the health care mandate. Without this piece, premiums would skyrocket as more people with high health care costs had insurance and healthy people chose to go without coverage, thus increasing the cost for insurance companies.
Additionally, no true replacement bill has been written. It is not clear which pieces of the Act, if any, would be maintained. In addition to the above pieces, the ACA requires that insurers cover preventive care with no co-pay, a very popular provision that we wholeheartedly support. There has been discussion of jettisoning Medicaid expansion, crucial for low income populations to access care, but this is not certain. There has been little discussion of the non-discrimination guidelines in the Affordable Care Act and whether keeping and enforcing these guidelines would be part of any replacement effort. It is unclear what will happen to those who are insured through the health care exchanges.
From the Prevent Cancer Foundation’s perspective, we will fight to ensure that the Affordable Care Act stays in place to guarantee healthcare access. We do not want to see the 11 million people insured through the exchanges lose their healthcare coverage. We want to guarantee that preventive services are covered and protect Medicaid expansion. We will be working to ensure that everyone has access to preventive services with no barriers to access.
Paul Ryan has announced that he wants to end Medicare as we know it in the first part of 2017, replacing it with a private subsidy program for those who are not yet on Medicare. This privatization program would essentially put senior citizens, many of whom are retired, on the private health care market. In a world with no exchanges or guaranteed coverage for patients with preexisting conditions, this would have devastating effects. We stand against all attempts to privatize Medicare and end the program as we know it.
This is an area that is somewhat more hopeful. We have had broad bipartisan support for funding for the National Institutes of Health (NIH) and the Food and Drug Administration (FDA). The Republican House and Senate have both increased the budgets for NIH in their proposed budgets. Cancer does not discriminate based on party. We are hopeful that we can continue to work on increased funding for medical research and will continue to push for strong funding for the NIH and FDA, with proportional increases for the National Cancer Institute.
Prevention and Public Health
The Affordable Care Act created a Prevention and Public Health Fund, which has issued community grants for organizations engaged in health education, preventive health services and screenings for cancers and other diseases. This Fund has been crucial in addressing disparities in health care and supports grants for populations in inner cities as well as in rural areas affected by poverty. Members of Congress regularly turn to this Fund when looking for ways to save money, and it has been targeted for cuts or elimination regularly. We do not know what will happen to the Prevention and Public Health Fund during the talks of repealing the ACA. The Foundation strongly supports the Prevention and Public Health Fund and we will work to ensure that the Fund remains in place and is fully funded.
There are many additional issues that will no doubt arrive in the coming months. These are some of the initial policy discussions happening during this time of transition. To stay up to date on advocacy issues and learn how you can take action, join our advocacy team.