Former HHS secretary and former governor of Utah Michael Leavitt offered his view on the future of the ACA during a radio show called "Conversations on Health Care."
Mr. Leavitt is founder and chairman of Leavitt Partners, a healthcare intelligence firm based in Salt Lake City. He is an expert in health policy and currently advises President-elect Donald Trump's healthcare transition team.
Here are five key takeaways from Mr. Leavitt's remarks.
1. The ACA likely faces repeal. "The one certainty in the next several months about healthcare is that there will be a bill that will pass Congress that will be titled repeal and replace," Mr. Leavitt said. How this will be defined is still unclear, but Republicans face a mandate from voters to change the law, according to Mr. Leavitt. However, he added, "Pretending that the [ACA] never happened is not an option," indicating a replacement will be conscious of the progress that has been made.
2. A few portions of the law are certain to disappear. In particular, Mr. Leavitt pointed to the individual mandate as an item on the chopping block. He noted that lawmakers will have to carefully consider a replacement for this due to the millions of Americans who have gained coverage under the law.
3. The replacement must be bipartisan. "One of the commitments that Republicans have made is that they don't intend to do this in a way that does not involve a bipartisan support," Mr. Leavitt said. The current political climate, he said, is one "driven by the fundamental belief that the other party won't do the right thing," and those in power often also overreach. He blamed bipartisanship for lack of success with the ACA.
"We've got this appetite now because [Republicans] haven't had power to do everything exactly the way we want it done. I believe the Republican Party has a very impressive and historic opportunity to put in place a governing structure that will last for a very long time if they have the discipline not to overreach," Mr. Leavitt said.
4. Medicaid will change to give states more flexibility. Because states are divided in adopting Medicaid expansion, the program is in a "peculiar situation," according to Mr. Leavitt. Due to this discord, he says the program is likely to undergo change in the next administration, "mostly giving states more flexibility." This is consistent to Mr. Trump's plans to give states block-grants to fund the program. "We may actually see less funding in certain of the optional populations… but I don't think there's any lack of commitment to taking good care and helping those who are in hardship," he said.
5. Value-based care is here to stay. Mr. Leavitt called the transition to value-based care one of the most important changes in healthcare in the last 60 years, and felt certain Mr. Trump will be supportive of continuing the transition. "The change is not being driven simply by political ideology; it's being driven by an economic imperative that if we want to continue to have great healthcare, we have to change the way it's paid for," he said. "I believe the Trump administration will not only agree with that but they may in fact hasten it.
Listen to the full interview here.
More articles on leadership and management:
Michael Dowling: 6 priorities for health system leaders in 2017
Dr. Henry Heimlich, inventor of life-saving choking maneuver, dies at 96
Maryland health secretary leaves position