Q: What were some of the most damaging actions taken to undermine the ACA during the Trump administration?Ī: The law was continually under siege during the Trump administration. McDonough was instrumental in developing and passing the ACA while working as an adviser to a U.S. Chan School of Public Health, discusses the road ahead for the Affordable Care Act (ACA). Martin is editorial director of Medical Economics.Janu– John McDonough, professor of the practice of public health at Harvard T.H. It’s what patients expect and what makes for an excellent physician. In case you missed it: Trump attempts market stablization of Obamacare Trump,” no matter the next act of Congress or how the payer industry responds to all of the above, physicians remain steady despite the uncertain road ahead. So no matter what the future brings, no matter the next executive order signed “Donald J. The skill sets that make physicians successful in private practice are the ones needed to assist patients with both the medical and financial side of their well-being. And physicians are providing it.Īnd even if “I don’t know” is the reply to a complex patient question, it’s better than the on-hold music of a payer hotline or trying to locate a non-frequently asked question on a website. Afraid of losing Obamacare coverage in the near future or in the middle of a lingering medical crisis, patients are turning to their physicians for guidance. It was time consuming (and often frustrating), but in the end, it strengthened the physician-patient relationship knowing there was some help on the road to better health.Īnd that’s where physicians find themselves again: As both the physical and emotional beacon for patients. The first few years post-ACA enactment were consumed with physicians and practice staff learning – and then explaining as best they could – all the ins and outs of marketplace plans, high deductibles, and sometimes even how coverage works for the newly insured. Next: Physical and emotional beacon for patients Physicians were cautiously optimistic about the new law, balancing fear of a mass patient influx due to greater insurance opportunities with excitement about possible better pay, especially in primary care. Seven years ago, the same uncertainty accompanied passage of the Affordable Care Act. See our cover story on page 14 for more information.)Īnd patients, fully aware of and confused by what’s going on in D.C., turn to the one source that knows everything about the future of medicine and the inner workings of insurance companies: physicians.īut this uncertainty comes with opportunity, one that physicians seem prepared to embrace.įurther reading: Replacing Obamacare not an easy path for new administration (And part of the reason more and more physicians are finding direct pay more attractive. It’s part of the business of running a private practice. “we’re paying you less starting today for the same thing you did yesterday”) or a Medicare memo announcing a major change in the program that you then have to decipher. You never know when an innocuous-looking envelope will appear from a payer with some “important news regarding your contract” (i.e. It’s a kind of “medical limbo,” awaiting the first domino to fall: will it be the repeal of Obamacare … and the coming of whatever replaces it? Will it be new leadership at HHS or CMS revisiting Medicare reimbursement reform? Will it be major changes to Medicaid? Will it be something else entirely that will shift the way physicians treat their patients – for better or worse?įor physicians, this sort of uncertainty is business as usual. Related: The complicated puzzle of moving past Obamacare I've heard from a lot of physicians lately who are, let’s say, less than enamored with our new president’s first actions since occupying the White House and the uncertainty ahead.
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