Following midterms, what’s ahead for health care?

The Affordable Care Act (ACA) is likely to stay in place following the Democrats’ majority win in the House of Representatives, according to analysts, but the health care law may continue to be tweaked at the state level and through administrative policies.

Health care is a top issue for voters, but priorities vary by party, according to Robert Blendon, Richard L. Menschel Professor of Public Health and Professor of Health Policy and Political Analysis at Harvard T.H. Chan School of Public Health. Blendon said in a November 6, 2018 article in Modern Healthcare that he expects that each party will continue to play to its base on this highly polarized issue.

Commenting in the same article, John McDonough, professor of the practice of public health, said that he expects that there will be efforts by House Democrats to reverse the Trump administration’s budget cuts to ACA outreach and marketing during open enrollment periods. But McDonough, who helped write the ACA, doesn’t expect the caucus to start championing single payer health insurance, also known as Medicare for All. While the idea may gain traction during the upcoming presidential primaries, for now, he said, it’s a “provocative message with little impact inside Congress.”

The election will have a more immediate impact on Medicaid expansion. Ballot initiatives passed in Idaho, Nebraska, and Utah that commit the states to participating in the ACA’s expansion of Medicaid to all residents who make less than 133% of the poverty line (about $16,000 for an individual or $33,000 for a family of four).

A growing body of research suggests that when states expand Medicaid, low-income Americans get more access to health care, which improves their health outcomes. Ben Sommers associate professor of health policy and economics, told Vox in a November 7 article, “It makes a major difference in patients’ ability to access health care, to pay their bills, and in many studies, we see improved health outcomes too.”

Read the Modern Healthcare article: House sweep pits Dems against Trump (and maybe Pharma)

Read the Vox article: Idaho, Nebraska, and Utah vote to expand Medicaid

Learn more

Affordable Care Act weakened but still stable (Harvard Chan School news)

Medicaid expansion under ACA linked with better health care, improved health for low-income adults (Harvard Chan School news)