Health care leaders predict patients will lose under President Trump's health care plans

April 20, 2017

According to a newly released NEJM Catalyst Insights Report, health care executives and industry insiders expect patients - more than any other stakeholder - to be the big losers of any comprehensive health care plan from the Trump administration. Over 1,000 knowledgeable and influential executives, clinical leaders, and clinicians were surveyed ahead of last month's release and rejection of the American Health Care Act (AHCA).

The survey, taken in February 2017, asked respondents for their predictions of the effects of the Trump administration's health care plans. Nearly three-quarters (73 percent) said patients will be very or slightly negatively impacted. In addition, respondents were divided on the fate of the Affordable Care Act (ACA). More than 60 percent predicted that the ACA will be repealed -- with 27 percent of those indicating it will be repealed and replaced while 35 percent thought any the replacement would be indefinitely delayed. Meanwhile, almost 30 percent of those surveyed stated that the ACA would remain substantially intact.

"Overall, Insights Council members expressed pessimism about the health care landscape in the wake of the administration's proposed plans, citing no clear winners, only clear losers: patients, clinicians and provider organizations. Their concerns are being proved out in the administration's early moves," said Edward Prewitt, NEJM Catalyst's Editorial Director and a co-author of the report.

Insights Council members paint a bleak picture of the health care landscape under the Trump administration, predicting coverage for fewer U.S. citizens (74 percent of respondents), decreased benefits coverage (70 percent), increased premiums (69 percent) and decreased funding for research (67 percent). In addition, nearly 70 percent believe Medicaid enrollment will decrease.

Despite the longstanding call for ACA repeal from Republican lawmakers, and President Trump himself on the campaign trail, less than half of respondents (43 percent) thought a comprehensive plan on new health care regulations would pass in the first 12 months of the administration. Nearly one-quarter (24 percent) predicted that the plan will be revealed in the second year of the administration and 18 percent were skeptical that a plan will ever be put into place.

NEJM Catalyst Insights Reports are based on surveys of the NEJM Catalyst Insights Council, a qualified group of U.S. executives, clinical leaders, and clinicians at some of the most prestigious and influential organizations directly involved in health care delivery. The surveys focus on four key areas: Leadership, Care Redesign, Patient Engagement, and the New Marketplace.

A total of 1,058 completed surveys were included in the analysis with a margin of error of +/-3.0 percent. The makeup of respondents included 53 percent clinicians, 23 percent executives, and 24 percent clinical leaders. The geographic breakdown of respondents was 28 percent from the Northeast, 21 percent from the West, 23 percent from the Midwest, and 28 percent from the South. Notably, a significantly higher incidence of respondents from the South (32 percent) than the Northeast (23 percent) predicted that the ACA will be repealed and replaced.
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For more on the NEJM Catalyst Insights Report on the impact of the Trump administration on health care, including respondent predictions about the future of the ACA, visit: http://catalyst.nejm.org. An index of all NEJM Catalyst Insights Reports can be found at http://catalyst.nejm.org/insights/.

About NEJM Catalyst

NEJM Catalyst offers a combination of multimedia content, web events, expert panels and new research. NEJM Catalyst connects health care executives, clinical leaders and clinicians with practical approaches and actionable steps to implement changes in their organizations that improve the value of health care delivery and patient care.

About NEJM Group

NEJM Group creates high-quality medical resources for research, learning, practice and professional development. Designed to meet the demand for essential medical knowledge and innovation among academic researchers and teachers, physicians, clinicians, executives and others in health care, NEJM Group products include the New England Journal of Medicine, NEJM Journal Watch, NEJM Knowledge+, NEJM Catalyst, and Resident 360. NEJM Group is a division of the Massachusetts Medical Society. For more information visit http://www.nejmgroup.org.

NEJM Group

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