The short answer is: It’s not entirely clear. The cost for healthcare is rising for most consumers, as many face rising insurance premiums along with higher copays and deductibles. This trend is impacting the urgent care space—and the presidential election.
A new poll shows nearly one in four American voters reported having a medical condition that worsened after they delayed visiting an emergency department, because they feared the expense from what insurance would not cover.
Some of this is fallout from the Affordable Care Act, under which many choose high-deductible, lower-cost plans. Some of the trend is due to the shift many employers have made toward offering high-deductible insurance plans that leave employees paying for more healthcare costs out of pocket. The number of people enrolled in high-deductible health plans has increased 40 percent in the last six years, according to the Centers for Disease Control and Prevention.
“Insurance companies are misleading patients by setting so-called ‘affordable’ policies that cover very little until large deductibles are met,” said Dr. Jay Kaplan, president of the American College of Emergency Physicians. “Many people don’t realize this until they need medical care, and then they are shocked at how little their insurance pays.”
The rising tide is a major affordability issue the next president will try to tackle. But most of the discussion during this campaign season focuses on insurance and not medicine or delivery of care. Asked about healthcare policy at the most recent presidential debate, here’s how candidates Hillary Clinton and Donald Trump responded.
What will you do to bring the cost down and make coverage better?
- Wants to keep the Affordable Care Act but “fix it” to bring costs down for individuals and small businesses
- Touted the success of ACA in extending insurance to 20 million more Americans
- Wants to repeal the Obamacare and start over
- Advocates for a system with more competition to expand insurance plan options and bring down costs
The Advisory Board analyzed the candidates’ plans for healthcare and what each might be able to accomplish if elected given the political realities. Both have called for increased price transparency in healthcare, and both advocate that the U.S. start allowing importation of prescription drugs from other countries and Medicare be allowed to negotiate drug prices. But that’s about where the common ground ends for Clinton and Trump.
Clinton has proposed policies to stabilize the exchanges, including increasing enrollment and limiting consumers’ financial burden – but the proposals could be tough to pass through Congress. Trump has called for full ACA repeal but wouldn’t necessarily have an easy time garnering consensus from GOP lawmakers on a replacement plan, The Advisory Board said.
“No matter the results of the November elections, one thing is clear: The healthcare industry is entering the next era of healthcare reform. Hospital and health system leaders must transform the delivery system to meet two profound and lasting market evolutions: population health and consumerism,” according to The Advisory board.
Clearly the consumer-driven healthcare trend is a main driver of the urgent care industry, so it behooves urgent care operators to tune in to ongoing healthcare reform discussion and pay attention to the politics.