United States Healthcare 2021: Intro

United States Healthcare 2021: Intro

United States Healthcare 2021

Today, we can close the chapter on an incredibly divisive and disruptive historic election period here in the United States. President Biden has been inaugurated, and this change in administration is guaranteed to bring changes to healthcare for Americans in 2021 and beyond.

First, let us be realistic that healthcare has been a major topic of presidential elections going back over 100 years. Second, other than restricting the Affordable Care Act (ACA) also known as Obamacare, the Trump administration had modest impact on healthcare. From our perspective, the single largest achievement regarding healthcare long-term, was a mandate on price transparency that became effective on January 1, 2021.

The Biden administration has a big agenda on healthcare. We wrote about it in a recent blog, “Projected Impact on Healthcare from a Biden Administration.”

In this blog, we discussed who President Biden nominated for secretary for the Department of Health and Human Services, also known as HHS. This is critically important as this department controls over $1 trillion of national health care expenditures, mostly Medicare at $640 billion and Medicaid at approximately $400 billion [2019].

During the campaign, President Biden proposed expanding Medicare to those between the ages of 60 and 64 years old, and expanding Medicaid in partnership with the states that had yet to expand Medicaid as part of the ACA; he even went as far as calling it a new, “Bidencare.”

We cannot begin to predict how much healthcare will be expanded; however, now having lived in healthcare for over five presidents, I am confident it will be expanded. Since President George W. Bush [43][1], nearly all expansions in healthcare have been through democratic presidents. This includes the creation of both Medicare and Medicaid by President Lyndon B. Johnson [1965]. Over the next decade, we are facing unprecedented and automatic expansion of Medicare with nearly 10,000 new beneficiaries every single day.

While trying to control cost, we see the trend towards new programs to expand the coverage of healthcare at the same time. We believe this means a continuation to move away from fee-for-service [FFS] care to a managed care type of environment. By using new and existing programs, in the form of expanding managed care in both Medicare and Medicaid, that promise to contract directly with physicians and not just insurance companies.

With more transparency and better access to their personal health data, we are confident that consumers will be more empowered to utilize readily accessible technology and become part of the solution of controlling cost while improving their own quality of care.


Further, we are optimistic that this improved technology opportunity will give patients more access to a more universal medical record.  Along with recent regulations to reduce data blocking by electronic medical record companies, both tech companies and providers will empower the patient; in turn, providers hope this will incentivize patients to give them more relevant health information, resulting in much lower cost.

By his past actions, the nominee to run HHS is very interested in a vibrant and competitive healthcare environment – this is very important! He is effectively going from a litigator and fierce defender of market competition to a regulator. This nominee for HHS is Mr. Xavier Becerra, who is currently the 33rd Attorney General of California.

More to come in our next blog.

[1] Created what is now referred to a Medicare Part D, adding prescription benefits.