President Trump and former Vice President Biden have radically different health policy proposals around the Affordable Care Act (ACA), COVID-19, drug pricing, and healthcare transparency.

Avalere experts can offer the following observations on the implications of the election results:

• A win by Vice President Biden will preview a 2021 focused on expanding public health insurance coverage through the ACA, Medicare, and enhanced subsidies, while looking to drug pricing reform to finance the proposals. Importantly, the specific details of financing, eligible populations, and timing of these policies would still need to be decided.
  • Importantly, the viability of many of the Biden campaign’s proposals will depend on Democratic control of the Senate and their willingness to pursue legislative changes through reconciliation or after enacting filibuster reform.
• A win by President Trump will continue his administration’s focus on providing additional flexibilities to states to manage their healthcare markets. Earlier proposals providing state-level choices to pursue block grants, loosening benefit design requirements, and encouraging less comprehensive insurance plans like short-term limited duration insurance will likely continue to move forward. In addition, the Trump administration released 4 major executive orders on drug pricing this summer and in a second term is expected to continue to push forward towards tying Medicare drug prices to international prices and other, similar policies.
  • Much of a Trump administration’s second term healthcare agenda is expected to be done through administrative action, rather than legislative, given the low likelihood of a Republican controlled House of Representatives.
• Regardless of the winner, the Supreme Court will be ruling on the constitutionality of the ACA’s individual mandate, likely in mid-2021. While significant changes to the ACA remain unlikely, the ruling puts the health insurance coverage of millions of Americans at risk and may force the winner of the presidential election (and Congress) to act rapidly.

“The results of the election will influence the ongoing response to the COVID-19 pandemic, the future of the ACA, and the drug pricing debate,” said Chris Sloan, Associate Principal at Avalere Health. “Not since 2008 has healthcare played this large of a role in the campaign, which—when combined with the COVID-19 pandemic—represents a major inflection point in the US healthcare system.”

To speak with an Avalere expert on healthcare implications of the 2020 presidential election, please connect with us.