Healthcare after the 2018 midterm elections: As control shifts, certainty settles in

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The Democrats’ midterm wins likely will slow, but not stop, the Republicans’ pursuit of their healthcare agenda, which has focused on recasting the role of the federal government in the US health industry.

Without overwhelming majorities that would grant veto and filibuster power, Democratic lawmakers will have little room to pursue their own agenda, which includes shoring up the Affordable Care Act (ACA), strengthening Medicare and Medicaid, expanding consumer protections and using the federal government to provide relief for consumers struggling with healthcare spending. Download the report now.

Implications to the healthcare industry discussed in this report

The Democrats new influence on the President's agenda

In regaining power in Congress for the first time since 2014, Democrats say they will focus on about a dozen goals, including lowering prescription drug prices, supporting teachers, addressing corruption and money in politics, rethinking public and affordable housing and checking corporate monopolies. Democratic lawmakers also will try to strengthen the ACA. Healthcare providers stand to benefit from successful efforts to bolster individual and group markets, even as device and pharmaceutical manufacturers could find themselves more at risk for scrutiny as attempts to control rising healthcare costs focus increasingly on drug prices.

Federal agencies: Business as usual, though with more oversight

Democrats will gain more oversight authority, allowing them to hold hearings on the administration’s actions and subpoena agency leaders. These actions may hinder and slow the agencies’ work. Democrats likely will question CMS as it considers additional Section 1115 Medicaid work requirement waiver applications. Hearings could potentially run parallel to legal proceedings in Kentucky and Arkansas challenging the legality of the waivers.

Change in statehouses: States to control their healthcare destinies

States are becoming an important battleground for healthcare policy. New state-level Democratic administrations will likely face budget pressures from state Medicaid spending, and will seek to fortify their states’ ACA exchanges. Democratic governors, especially those working with supportive state lawmakers, likely will take action to counter federal moves to weaken the ACA.

Macroeconomic trends, more than government policies, exert the most influence

Elections draw headlines, and have true consequences, yet some issues persist year after year, administration after administration, for all lawmakers and policymakers. These include the ongoing impacts on the economy of nearly 30 million uninsured Americans. Lawmakers and policymakers will need to address the continued growth in health spending, particularly for nondiscretionary programs such as Medicare, Medicaid and Social Security, which crowd out opportunities for discretionary priorities. They will need to work on improving health outcomes for Americans.

What the healthcare industry can expect after the midterms

Despite a divided federal government and diverging state healthcare policies, the next two years likely will be more predictable for the industry than the previous two.

Contact us

Sundar Subramanian

HIA Strategy Consulting & Growth Platforms Leader, PwC US

Gurpreet Singh

Health Services Leader, PwC US

Karen C. Young

US Pharmaceutical and Life Sciences Leader, PwC US

Benjamin Isgur

Health Research Institute Leader, PwC US

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