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Exploring the Biden Administration's Potential Impact on Patient Experience

Updated: January 22, 2021

Joe Biden has become the 46th President of the United States. In what was deemed one of the most pivotal elections in our country’s history, healthcare was on center stage for many voters. The focus now shifts to President Biden’s plan for our country moving forward. He will be entering his term as the U.S. continues to break somber records, tallying more than 140,000 new COVID-19 cases on a daily basis and over 24 million total cases since the pandemic began. Hospitals are overflowing and understaffed. Clinicians are being pushed harder than they ever have. Nurses are being stretched to the point of mental exhaustion. Hospital administrators are seeing their facilities sinking. Despite being large, visible, and pressing issues, these are only a small piece of the pie that is healthcare in the United States. In looking ahead at a Joe Biden presidency, these are some of the issues that we forecast will be addressed.

COVID-19 Pandemic Response and Relief

Although cases are not currently on the same upward trajectory as late in 2020, there is still a significant community spread. Many healthcare professionals saw a slight respite after state lockdowns were forced but are once again facing the harsh reality of case numbers outweighing facilities, supplies and staffing. Hospitals and care groups are looking for additional federal funding, particularly as many are being faced with the ramifications of suspending elective and low-priority surgeries.

There is also still discussion on recent stimulus payments. Since March, the federal government has provided over $200 billion to hospitals and providers. A portion of this allocated money has come in the form of Medicare loans, which will need to be repaid, barring loan extension or forgiveness. Hospital systems and care groups also will need clarification from the Biden administration on payback and ongoing relief rules through the Coronavirus Aid, Relief and Economic Security (CARES) Act.

Many voters and healthcare officials were encouraged by President Biden’s choice to name a COVID-19 task force. Made up of multiple physicians, commissioners, agency officials and researchers, this group will help smooth the transition between administrations. However, despite support for addressing this transition, many remain still uncertain of future mask mandates, vaccine production schedule, the efficacy of treatments, therapeutic medications, and future prevention of similar outbreaks.

Healthcare Insurance Coverage and Promotion of the ACA

As a result of the COVID-19 pandemic, millions of Americans were either furloughed or terminated from positions they held at the beginning of 2020. Although the rise unemployment rates has slowed since the beginning of 2021, many remain uncertain about the future of their health insurance. For the vast majority of insured Americans, health insurance is connected to their employment, and without coverage, patients may avoid needed preventative care and could be faced with major medical expenses in the event of an emergency.

President Biden has vowed to build on what was put forth by the Obama administration. He will likely address premium subsidies and their cost, pushing for expansion. The current language around this aid provides subsidies for households that make up to 400% of the current federal poverty level. We believe that the Biden administration will also move to change ways the Trump administration has challenged insurance exchanges. However, the biggest component of the Affordable Care Act that will undoubtedly draw opposition from GOP House and Senate members will be the inclusion of a Medicare-like program to be offered as a public option, competing with private insurance carriers and plans.

Medicare and Medicaid Expansion

Combined, Medicare and Medicaid provide coverage for over 100 million people. The Biden administration will likely move to expand eligibility for both. President Biden has said that he would prefer to lower the age of Medicare eligibility to 60, while including dental, optical and hearing coverage as standard components. With current Medicare guidelines, patients need a supplemental insurance plan to cover these latter components.

Historically, Medicare spending has not been entertained on the right side of the aisle. Like the possibility of a Medicare-like public option, this issue will draw opposition. Regarding Medicaid, the Biden administration may need to get creative to change the program. There will likely be proposed rollbacks of Trump administration actions, specifically in terms of reporting requirements and payment limitations. The Biden administration will also likely push for an increased federal match rate for Medicaid.

Prescription and Health Care Costs

This is the biggest area where both former President Trump and President Biden have similarities. Under a Biden presidency, we will likely continue to see a push to end “surprise” medical bills and lower prescription drug prices. This could come through the government negotiating drug prices on behalf of Medicare beneficiaries. This has received pushback from the Senate over the past 2 years, but may see an easier path with a split Senate. “Surprise billing”, however, will likely get a bipartisan consideration. This refers to a situation where a patient receives hospital care in-network, but is treated by an out-of-network provider. The patient is then billed directly by said provider, often at a much higher rate.

Telehealth Capabilities and Coverage

The capability of connecting with patients through telephone and video services has provided benefits for both patients and the care groups. In some settings, telehealth, more than any other service, has saved hospital systems and care groups from massive layoffs, facility closure, or complete elimination of services. Telehealth has allowed providers to connect with patients who may have elected to avoid a clinic setting due to COVID-19 concerns. Many providers have received overwhelming approval from patients and have bolstered trust and continuity of care thanks to telehealth services. The Biden administration will be tasked with extending or making permanent telehealth waivers that were established in response to COVID-19.

Reproductive Health

Expect President Biden to reverse the restrictions placed by former President Trump on federal funding for agencies providing abortion counseling, such as Planned Parenthood. President Biden and Vice President Harris have been vocal on their stance concerning Roe v. Wade, and we will likely see this administration push to maintain this position and increase federal funding to protecting the reproductive rights of women without excessive government restriction and access to low and no-cost contraception coverage.

Although this is not an exclusive list, it likely encompasses what the Biden administration will try and tackle over the next four years. As in previous administrations, there will be assumed pushback from both the House and Senate, but regardless of political stance, these are issues are country is facing and will have to address together.

Predicting the Impact on Patient Experience

With these topics being at center stage in the healthcare plan of the Biden administration, patients will need open channels of communication between their providers more than ever. Providers will be tasked to clarify patient concerns and confusion about care costs, national/global recommendations concerning ongoing COVID-19 response, vaccine administration and drug prices.

We will likely see encouragement of healthcare shopping over the next four years, and patients will continue to pursue telehealth options due to their lower cost, convenience, and safety. In the coming four years and beyond, providers should offer increased and personalized communication to their patients, re-map the traditional patient journey, and fine-tune internal processes to promote the desire for patients to return, invest in telehealth communications and continue to acknowledge patient fears and concerns.