The 2024 election and the implications for healthcare | HLTH 2024

Las Vegas – While AI and health tech issues are taking up much of the oxygen at the HLTH conference, the election is on the minds of many of those in attendance.

During a session at HLTH Tuesday morning, Seema Verma and Andy Slavitt weighed in on the 2024 election and the ramifications for healthcare. Stephanie Armour of KFF Health News, far left, moderated the discussion.

In two weeks, and perhaps a bit longer after mail-in ballots are tabulated, voters will decide if Kamala Harris or Donald Trump will serve as the next president. The next occupant of the White House could have a big impact on the nation’s healthcare policy.

During a session at HLTH Tuesday morning, Andy Slavitt and Seema Verma weighed in on the consequences of the 2024 election and its implications for healthcare, costs and access. Verma served as administrator of the Centers for Medicare & Medicaid Services during the Trump administration, while Slavitt served as acting CMS administrator under President Barack Obama.

In the 2024 contest, unlike recent elections, Slavitt said, “Healthcare is not the main event.”

Harris has made protecting the Affordable Care Act a key part of her campaign, which she highlighted at the Democratic National Convention. Trump attempted to abolish the healthcare law while he was president, although he has said in recent months he wants to improve the law. Slavitt noted the law remains popular, and while it’s not perfect, it has helped many get access to care.

“It’s hard to find something that’s a whole lot better,” Slavitt said.

Verma said that Trump was focused on the cost of healthcare for Americans during his presidency, and he’d likely retain that approach.

“He was in favor of wanting people to have more health insurance,” Verma said. “The concern was affordability.”

Verma added, “For both candidates, there is a larger concern of general affordability in healthcare.”

Harris has also made abortion rights a centerpiece of her campaign, and that’s likely been the single biggest health issue in the race.

The vice president said she wants to ensure women have freedom to make their own choices. She’s also pointed to women having emergency care delayed or denied in states with strict abortion laws. And she’s repeatedly referenced doctors being prevented from caring for patients in emergencies, even for women who weren’t trying to end their pregnancy.

“‘She wants to make things more affordable, easier, get rid of the red tape …. And she wants to protect reproductive freedom,” Slavitt said. “Those are the things we know for sure.”

Trump has said he views abortion as an issue for states to decide, though in their lone debate, he wouldn’t answer the question about whether he would sign legislation to prohibit abortions nationwide if it reached his desk.

Regulation over legislation

Both Slavitt and Verma generally agreed that the next president’s impact on healthcare will depend heavily on the people they choose to serve in key healthcare posts in the next administration.

“It’s going to be more about the personnel in place,” Slavitt said.

Similarly, Verma said, “It really is going to be turned to whoever’s running the administration.”

The entire House and half the Senate are up for grabs in the election, and they could be divided with narrow majorities, regardless of which party ends up in control.

For that reason, Verma said, the dynamics on Capitol Hill will make it hard to get things done.

“I don’t think we’re going to see a big, huge piece of legislation around healthcare,” Verma said.

If there are significant changes in federal healthcare policy, they will likely come from regulation, rather than legislation.

However, federal agencies could face new constraints in regulatory policy, due to a Supreme Court ruling in the summer relating to what’s called the Chevron doctrine. For decades, the court held that when Congress hasn’t spelled out its intent on federal law, courts should generally defer to regulatory agencies and their interpretation of statutes. The justices upended that precedent this summer.

Slavitt said that weakens the role of regulatory agencies.

“The spillover will be real,” he said. “You’ll see a more restrained set of regulations.”

He also envisions the possibility that agencies may simply turn to Congress. And he said that’s problematic.

“Congress just isn’t that good,” he said. “They can’t foresee the future.”

Slavitt said it could unfold in ways to please and anger different groups. He said it would be harder for a new administration to simply impose new work requirements for Medicaid, but it could also weaken public protections.

Verma offered a similar perspective about the difficulties with the new post-Chevron landscape, saying, “I think it makes it a lot harder for agencies.”

Federal agencies are likely to see more lawsuits, Verma said, including on issues “that we consider to be settled.”

Medicare and Medicaid

Verma said a second Trump administration wouldn’t see any cuts to Medicare, saying, “He’s very protective of the program.”

She noted the increasing scrutiny that has emerged around Medicare Advantage programs. While there is some bipartisan interest in Medicare Advantage reforms, Verma said some efforts may be going too far.

“My guess is the Trump administration may look at that and say, did we over-rotate?” Verma said.

As far as Medicaid, Verma said that another Trump administration would look at how Medicaid dollars are spent and will ensure the aid is going to recipients.

Verma also said a Trump administration would definitely give more deference to the states regarding Medicare.

Harris has proposed a new Medicare benefit, Medicare at Home, which would offer beneficiaries the chance to get services and aides to help senior stay in their homes.

Slavitt noted that the proposal appeals to the “sandwich generation,” the group of Americans who are raising children and caring for aging parents. “She wants to bring some relief,” he said.

Slavitt said that there are key details, including how a Harris administration would pay for such a program.

Still, he said, “That’s a really interesting and strong priority of hers.”

As far as Medicaid, a Harris White House would ensure that there are no work requirements to qualify for assistance, Slavitt said.

Chelsea Clinton talks about reproductive freedom during a session at the HLTH conference Monday.

The abortion question

Earlier in the HLTH conference, Chelsea Clinton, the daughter of Bill and Hillary Clinton, headlined a session on reproductive freedom.

Clinton, vice chair of the Clinton Foundation, made it clear that she’s supporting Harris, and she said the Supreme Court’s decision to upend Roe v. Wade has endangered American women. Nearly one in three American women live in a state that has an abortion ban.

Women outraged over the loss of abortion rights could make a difference in the election, Clinton said. She pointed out the abortion question is a defining issue in the presidential election but goes beyond the race for the White House. She noted that 10 states, including Nevada, host of the conference, have ballot questions regarding abortion rights on Election Day.

Since the Supreme Court ruling, Ohio and Kansas voters have approved measures to preserve abortion access.

“There is wide and resounding support for women to access the healthcare they need,” Clinton said.