Twelve gubernatorial races were also held this year. While the outcome of the North Carolina election has not been officially announced, Republicans did pick up control in Missouri, New Hampshire, and Vermont with the remaining states maintaining existing party control.
Health Issues to Watch:
Affordable Care Act: While wholesale repeal of the ACA would likely require 60-votes in the Senate, many pillars of the ACA could be repealed using budget reconciliation, which only requires 50 votes. A previous Republican Budget Reconciliation package from December 2015 would have eliminated key provisions of the law including subsidies, mandate penalties, and Medicaid expansion. Republicans in Congress have been vocal about prioritizing ACA repeal and are likely to pursue major dismantling of the law.
Payment and Delivery Reform: The appetite for payment and delivery reform is likely to continue as the push from fee-for-service to value based payment has broad bipartisan support. However, the recent political backlash against the Centers for Medicare and Medicaid Innovation (CMMI) may change the vehicle by which such changes are pursued.
Drug Prices: The likelihood of significant drug pricing reforms decreases, but is not eliminated, based on this year’s election results. The pressure on drug prices will continue; however, Trump and/or a Republican Congress are less likely than Democrats to implement changes unfavorable to industry.
Entitlement Reform: Finally, the chances of tax and/or entitlement reform increase, alone or as part of an ACA replacement plan. Proposals to address entitlement spending could include policies like Medicaid block grants or premium support in Medicare. House Republicans have also supported policies that would cap the employer tax exclusion for health insurance. The debt ceiling is expected to expire in March of 2017, which could spur discussions about government spending and entitlement programs.