{"id":92143,"date":"2016-10-17T11:02:04","date_gmt":"2016-10-17T15:02:04","guid":{"rendered":"https:\/\/www.bu.edu\/sph\/?p=92143"},"modified":"2020-09-17T10:33:34","modified_gmt":"2020-09-17T14:33:34","slug":"election-will-have-long-term-consequences-for-aca","status":"publish","type":"bu-article","link":"https:\/\/www.bu.edu\/sph\/news\/articles\/2016\/election-will-have-long-term-consequences-for-aca\/","title":{"rendered":"Election Will Have Long-Term Consequences for ACA"},"content":{"rendered":"<div class=\"banner-container banner-has-html\">\n<div class=\"videoWrapper\" style=\"position: relative;padding-bottom: 56.25%; \/* 16:9 *\/height: 0;\"><iframe loading=\"lazy\" width=\"855\" height=\"481\" src=\"http:\/\/www.bu.edu\/buniverse\/interface\/embed\/embed.html?v=kl2iY0\" style=\"position: absolute;top: 0;left: 0;width: 100%;height: 100%;frameborder=\"0\" scrolling=\"no\" allowfullscreen> <\/iframe><\/div>\n<\/div>\n\n<p>\n<div class=\"wp-prepress-component-metabar sphnews-prepress-layout-metabar\">\n\t<div class=\"wp-prepress-component-metabar-wrapper\">\n\t\t\t\t\t<div class=\"wp-prepress-component-metabar-date\">October 17, 2016<\/div>\n\t\t\n\t\t\t\t<div class=\"wp-prepress-component-metabar-credits\">\n\t\t\t\t\t<\/div>\n\t\t<div class=\"wp-prepress-component-metabar-share js-bu-prepress-share-tools\">\n\t\t\t<span class=\"icon-twitter\"><span>Twitter<\/span><\/span>\n\t\t\t<span class=\"icon-facebook\"><span>Facebook<\/span><\/span>\n\t\t\t<span class=\"icon-action\"><\/span>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<\/p>\n<p>Regardless of the outcome, the federal election in November is likely to have \u201cfundamental consequences\u201d for the future of the Affordable Care Act (ACA) and related health reform proposals, says a School of Public Health researcher writing in <a href=\"http:\/\/jamanetwork.com\/journals\/jamainternalmedicine\/fullarticle\/2565690\" target=\"_blank\" rel=\"noopener noreferrer\"><em>JAMA Internal Medicine<\/em><\/a>.<\/p>\n<p>In a Viewpoint article, co-authors David Jones, assistant professor of health law, policy &amp; management at SPH, and John McDonough, professor of public health practice at the Harvard T.H. Chan School of Public Health, say that the ACA \u201chas yet to become settled policy\u201d and will likely undergo change, no matter who is in the White House. What kind of change largely depends on whether Republicans retain control of the Senate, they say.<\/p>\n<p>If Hillary Clinton wins and the Democrats secure a Senate majority, Democrats will still \u201cstruggle to enact ACA enhancements\u201d if there is a Republican majority in the House, Jones and McDonough write. Clinton, the Urban Institute, and two other groups aligned with Democrats have proposed health reform agendas for 2017 that strengthen core provisions of the ACA. All four proposals assume that a Democratic president would block Republican attempts to repeal the ACA, and none call for establishing a single-payer system to finance health care, the authors say.<\/p>\n<p>Clinton wants all 50 states to expand Medicaid and would encourage states to establish \u201cpublic option\u201d exchange plans, reminiscent of what many Democrats unsuccessfully sought when the original ACA legislation was considered by Congress. She also wants to make insurance coverage more affordable by increasing the value of premium tax credits for households with incomes less than 400 percent of the federal poverty level who buy insurance through an exchange. Clinton\u2019s proposal would provide a tax credit for families whose expenditures exceed 8.5 percent of their household income, among other efforts to reduce consumer costs.<\/p>\n<p>\u201cA Democratic victory that included the White House and a Senate majority would likely further embed the ACA into state and federal health policy, and perhaps lead to further expansion and reforms,\u201d Jones and McDonough write.<\/p>\n<p>If Donald Trump wins and Republicans retain control of both chambers, a repeal attempt is likely, under plans advanced separately by Trump and House Speaker Paul Ryan. Their proposals would replace the ACA with legislation that permits the interstate sale of insurance, allows individuals to deduct the cost of health insurance premiums on their federal tax returns, and expands the use of health savings accounts.<\/p>\n<p>\u201cIf Trump wins, Republicans are likely to do better in battleground states hosting competitive Senate races, enabling Republicans to maintain Senate and House control,\u201d the authors write. \u201cLess certain is whether the Republicans could maintain unity to dismantle key coverage portions of the ACA that would eliminate health insurance coverage for many of the 21 million low and lower-middle income people who have gained coverage in the last six years.\u201d<\/p>\n<p>While the authors acknowledge that attitudes about the ACA likely will not be key in deciding the election, the results will have \u201cfundamental consequences for the future of national health reform,\u201d they conclude.<\/p>\n<p><em>\u2014<a href=\"mailto:chedekel@bu.edu\" target=\"_blank\" rel=\"noopener noreferrer\">Lisa Chedekel<\/a><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>[VIDEO] Changes to healthcare law, from expansion to repeal, largely depend on whether Republicans retain control of Senate.<\/p>\n","protected":false},"author":8472,"featured_media":92145,"comment_status":"closed","ping_status":"open","template":"","meta":{"bu_prepress_billboard":"","_bu_prepress_primary_term":"","_bu_prepress_primary_term_manual":""},"tags":[511,2174],"bu-publication":[3516],"sphnews-article-category":[3519,3531,3535],"sphnews-topic":[],"bu_edition":[],"media_type":[],"profile_tax":[],"_links":{"self":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/92143"}],"collection":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article"}],"about":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/types\/bu-article"}],"author":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/users\/8472"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/comments?post=92143"}],"version-history":[{"count":9,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/92143\/revisions"}],"predecessor-version":[{"id":175327,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/92143\/revisions\/175327"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media\/92145"}],"wp:attachment":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media?parent=92143"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/tags?post=92143"},{"taxonomy":"bu-publication","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-publication?post=92143"},{"taxonomy":"sphnews-article-category","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-article-category?post=92143"},{"taxonomy":"sphnews-topic","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-topic?post=92143"},{"taxonomy":"bu_edition","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu_edition?post=92143"},{"taxonomy":"media_type","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media_type?post=92143"},{"taxonomy":"profile_tax","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/profile_tax?post=92143"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}