How a Trump victory would change your health care | Wilnesh News

President-elect Trump’s return to the White House will have a significant impact on consumer health care.

Experts say Republicans’ goal of reshaping America’s health care likely won’t face any legislative hurdles after retaining a slim majority in the House and flipping the Senate, taking control of Congress and the presidency.

Health policy experts say families who get health insurance from Medicaid or Affordable Care Act marketplace plans could see some of the biggest disruptions as a result of reforms sought by Trump and Republican lawmakers.

They say such reforms would free up federal funds that could be used to help pay for other Republican policy priorities such as tax cuts.

Michael Sparer, a professor and chair of the Department of Health Policy and Management at Columbia University, said that currently less than 8% of the U.S. population is uninsured, which is the lowest proportion in U.S. history. He said when the Affordable Care Act was enacted more than a decade ago, the number was 17%.

“The ratio will start to rise again,” Spahr said.

Trump announced on Nov. 14 that he wanted to appoint Robert F. Kennedy Jr. to run the Department of Health and Human Services, which includes the Centers for Medicare and Medicaid Services. CMS is responsible for administering the Affordable Care Act marketplace and the Children’s Health Insurance Program (CHIP), among others.

Kennedy, a vaccine skeptic who has been accused of spreading conspiracy theories, has vowed to make major changes to the U.S. health care system.

A spokesman for Trump’s transition team did not respond to CNBC’s request for comment on the president-elect’s health policy plans.

Experts say the following changes to consumer health care are likely to occur during the incoming Trump administration.

It said the Affordable Care Act’s enhanced subsidies may not be renewed after they expire at the end of 2025, depending on how the election goes. Cynthia Coxvice president and director of ACA programs at KFF, a health policy research organization.

“If I were to bet on this, I would be more comfortable betting that they would expire,” Cox said.

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This government-backed aid, originally passed during the 2021 pandemic under the American Rescue Plan, significantly reduced the cost of insurance for people who purchased health insurance plans ACA Market. These clients include anyone without access to workplace schemes such as students, self-employed consumers and the unemployed.

According to a rough estimate provided by Cox, monthly premiums for an individual making $60,000 a year would now be $425, compared with $539 before the enhanced subsidy. Meanwhile, a family of four making about $120,000 a year now pays $850 a month instead of $1,649.

The cost of permanently extending enhanced Affordable Care Act subsidies could be approx. $335 billion over the next 10 years, according to Congressional Budget Office estimates.

“They’re worried about the cost, the possibility of tax cuts next year,” Cox said of Republicans.

Still, giving up health insurance is a ‘big’ gamble

About 3.8 million people will lose health insurance if benefits expire, Congressional Budget Office says estimate. Those who maintain coverage may pay higher premiums.

“The bottom line is uncertainty,” he said Sabrina ColletteCo-director of the Center on Health Insurance Reform at Georgetown University’s McCourt School of Public Policy.

Corlette added: “The good news for consumers in the market is that the enhanced (subsidy) will last until 2025, so there should be no immediate changes.”

Even if subsidies disappear, experts say it’s important to stay enrolled if you can, even if you have to trade off coverage to keep costs within your budget.

Carolyn McClanahan, a physician and certified financial planner in Jacksonville, Fla., says joining a plan, even a cheaper one with a higher annual deductible, can help pay for things like surgery. Provides an important hedge against significant expenses arising from unforeseen medical needs.

“I can’t stress enough what a gamble it is not to have health insurance,” said McClanahan, founder of Life Planning Partners and a member of CNBC’s financial advisory board.

For someone without insurance, “a heart attack can easily cost $100,000,” she said. “Do you have the money?”

Medicaid is the third-largest program in the federal budget, with spending reaching $616 billion by 2023. according to to the Congressional Budget Office. trump card electoral Pledge not to cut the two largest programs: Social Security and Medicare.

That makes Medicaid an “obvious venue” for Republicans to raise revenue to fund their agenda, said Larry Levitt, KFF’s executive vice president for health policy.

“Medicaid is going to have a pretty big goal,” Levitt said.

Levitt said the cuts “inevitably mean” fewer families will receive benefits. Medicaid recipients tend to be low-income families, people with disabilities and the elderly in nursing homes, he said.

Levitt said Medicaid cuts were an important part of the 2017 push by Trump and other Republican lawmakers to repeal and replace the Affordable Care Act, also known as Obamacare.

These efforts are No success in the end.

How Medicaid might be cut

New Medicaid cuts could take many forms, experts said, citing past proposals and rhetoric from the Trump administration, Republican lawmakers and the conservative policy blueprint known as Project 2025.

For example, the Trump administration may try to increase work requirements for Medicaid recipients, as it does During his first term, Columbia’s Spahr said.

Additionally, experts say Republicans may try to limit federal Medicaid spending allocated to states.

The federal government matches a portion of states’ Medicaid spending (usually 50% or more). There is no upper limit to this amount.

Levitt said Republicans may try to convert Medicaid to a block grant, which would provide a fixed amount of money to each state each year, or create a per-capita cap, in which benefits would be limited for each Medicaid enrollee.

Experts say lawmakers may also try to block Medicaid expansion under the Affordable Care Act, which expands who is eligible for coverage.

They can do this by cutting federal funding to 40 states (plus the District of Columbia) Expanded Medicaid Eligibility. Levitt said this would “shift significant financial risk to states, and many states would abandon Medicaid expansion as a result.”

Supporters of these plans say they allow insurance companies to offer consumers lower monthly premiums because they don’t need to cover as many services. At the same time, these plans can turn away people with pre-existing conditions or charge them more. During Trump’s term, enrollment rates short term plan spiked.

“The previous Trump administration and many Republicans called for expanded marketing and sales of short-term plans and other insurance products that do not have to meet the ACA’s pre-existing medical conditions standards and other consumer protections,” said Georgetown University’s Corlette.

Consumers may be attracted to these plans because of their low costs, but often don’t learn until too late how thin the coverage is, she said.

The Inflation Lowering Act of 2022, signed by President Biden, introduces many measures drug price reform.

Trump has vowed to repeal parts of the law, which also contains many climate-related provisions and tax breaks he is hostile to.

Experts say it’s unclear whether lawmakers will keep the drug policy unchanged. For example, Trump signed an executive order in 2020 aimed at lowering the cost of prescription drugs.

“It’s unclear whether Trump will be a friend of the pharmaceutical industry,” Spahr said.

For example, the Inflation Reduction Act gave the federal government, for the first time, the power to negotiate prices with pharmaceutical companies for certain drugs covered by Medicare.

The rule is expected to take effect in 2026 for 10 drugs, some of which are among Medicare’s “most expensive and commonly used” drugs and are used to treat conditions as diverse as heart disease, diabetes, arthritis and cancer. according to Centers for Medicare and Medicaid Services.

CMS estimates the measure will save patients $1.5 billion in out-of-pocket costs by 2026. The federal government will expand the drug list over the next few years.

The Inflation Reduction Act also caps Medicare out-of-pocket costs for insulin at $35 per month. They had no cap before. In 2020, Medicare Part D insulin users paid an average of $54 per month out-of-pocket per insulin prescription. according to Go to KFF.

The law also caps out-of-pocket costs for Medicare-covered prescription drugs at $2,000 per year starting in 2025.

KFF found that about 1.4 million Medicare Part D recipients had out-of-pocket expenses of more than $2,000 in 2020. These costs average $3,355 per person.