The 2020 Democratic National Convention: What’s in it for the health industry?

Erin McCallister Senior Manager, Health Research Institute, PwC US August 27, 2020

The healthcare priorities for Democratic presidential nominee Joe Biden and his running mate, Sen. Kamala Harris, have come into focus since the Democratic National Convention last week. HRI’s analysis of the keynote speakers’ talking points and the party platform suggest a continuation of policy from the previous Democratic administration, including a continued expansion of coverage via the federal government, support for the Affordable Care Act (ACA), heightened pressure on drug companies over prices and overseas supply chains and a boost in corporate taxes, among other changes. The speakers also emphasized that they would mount a robust response to the pandemic that has gripped the US over the past eight months.

Healthcare was a main theme

Former Vice President Biden, in his acceptance speech, laid out a plan for tackling the pandemic, which has led to the deaths of more than 180,000 Americans and triggered a nationwide economic calamity. Biden’s plan emphasized rapid tests, national production of medical supplies and personal protective equipment, additional resources for schools and a national mask mandate.

Biden also said his administration would elevate scientists to provide the public with “the honest, unvarnished truth. They can deal with that.” Harris spoke about the disproportionate effects of COVID-19 on people of color and promised that a Biden-Harris administration would work to protect “the doctors, the nurses, the home healthcare workers and frontline workers who are risking their lives to save people they never met.”

House Speaker Nancy Pelosi highlighted an aid bill that passed the House this year but has not yet been taken up by the Senate. The legislation would provide additional funding for prevention, diagnosis and treatment of COVID-19; prioritize FDA review of certain drugs; increase emergency use of diagnostic tests not approved by the FDA; and expand healthcare coverage for COVID-19 preventive services and vaccines. It also includes provisions for the medical supply chain, the national stockpile and telehealth services.

Former President Barack Obama, under whom Biden served as vice president, embraced an ongoing expansion of healthcare coverage (Obama signed the ACA into law in 2010). Obama also suggested that Biden could lend his experience during the H1N1 and Ebola crises to manage the COVID-19 pandemic. Former Democratic presidential nominee Hillary Clinton cast Biden as a defender of healthcare workers who are treating COVID-19 patients and a supporter of “healthcare for everyone.”

What’s in the Democrats’ 2020 healthcare platform?

These elements along with several others are included in the Democrats’ healthcare platform:

For pharmaceutical and life sciences companies:

A reduction in prescription drug prices.
Increased funding for the NIH.
An acceleration in onshoring of critical supply chains, including in medical supplies and pharmaceuticals; and an end to incentives for offshoring.
An expansion in effective tax credits supporting domestic manufacturing.

For payers:

Direct, increased support to states to enroll eligible adults in Medicaid; a boost in the federal government’s funding for Medicaid; more incentives for remaining states to expand Medicaid under the ACA.
A proposal for the federal government to pick up 100% of the tab for COBRA insurance.
A public option on the exchanges, automatically enrolling low-income Americans.
An emphasis on parity for mental health and substance use disorder treatments envisioned in the Disorder Parity Law.
An embrace of policies leading to increased competition in the private insurer market.
An end to the subsidies cap and an 8.5% threshold for premiums-to-income ratio.

For providers:

Boosted federal funding for community health centers and rural health clinics.
An end to surprise medical billing.

Across industry:

A more active use of antitrust laws to address industry consolidation.
A new national pandemic surveillance program.

HRI impact analysis

The Democrats’ proposals on healthcare, laid out during the convention, envision a continued expansion of the federal government’s role in covering Americans and protecting them from the vagaries of the market. Many of the proposals involve injecting more federal dollars into parts of the system—to the states to help them cover Medicaid beneficiaries, to rural health clinics and community health centers, to consumers wishing to use COBRA coverage. The proposals also reveal areas of bipartisan support, particularly desires to move some critical drug and medical device manufacturing to the US, to address drug prices and to end surprise medical billing.

The Democrats also would likely look to bolster the ACA, even as its constitutionality is once again challenged in the US Supreme Court. This fall, the court will hear arguments and likely issue a decision in the months after the election. It is possible the justices will strike down the law in its entirety or in part. Just how a Biden-Harris administration would handle the fallout has not been spelled out. Short of such a dramatic turn of events, a Biden-Harris administration likely would build on the 2010 law, restoring funding for some elements that have been partially defunded by the Trump administration and perhaps making changes aimed at expanding its reach and impact.