So what's going to happen to health care now?

[Rocknurse]

So, for better or worse, we have a new President. What do you think will be the future of health care and the future of nursing as a profession? Will we be better off as nurses or worse? Will we be better off as patients or worse?

Not looking for a political argument....god knows we've had enough of those in the past few days. Emotions are running high and we all have opinions. I'm just curious as to what we can expect.

[kbrn2002, ADN, RN]

I have always had insurance through my employer at a fairly reasonable rate, I hope that continues. But the ACA has been anything but affordable in my state. I was truly shocked at the insurance quotes with the sky high premiums and ridiculously high deductibles my daughter was getting. I actually advised her to just take the tax penalty that first year because it was much less than the insurance would have cost her. Not to mention unless something truly catastrophic happened there is no way a reasonably healthy individual would ever see a penny from the policy as the deductibles are impossible to meet.

I am not at all certain what changes will eventually be made with a republican majority congress and a republican president but I do hope that somehow, some way the affordable part actually happens. But I fear that is an empty hope as the states with the highest premiums and deductibles on the open market have been the states that so wholly disagreed with the ACA that they refused any federal government funds in the first place. It probably won't be long before those federal funds go away for every state.

[elkpark]

The ACA will be..changed. It can't be repealed without a supermajority in Congress - which they don't have.

Nope, the Senate can use the reconciliation process, which only requires a simple majority, which the GOP will have.

Congress demonstrated in January that it could use the Senate's reconciliation process — requiring just 50 votes — to send a repeal bill to the White House. Although GOP lawmakers understood that Obama would veto that legislation, it was a strategic move,” said Tevi Troy, an ACA critic who is a former deputy health secretary and the chief executive of the American Health Policy Institute. Congress intentionally set it up so they could demonstrate a legislative pathway.”

Obamacare's future in critical condition after Trump's victory - The Washington Post

[kpk11]

I'm conflicted because on the whole, this is going to be a disaster for patients and everyone who might possibly need healthcare. But most of my family works in healthcare (nursing/PT/OT) and they all claim they were making more money in the early to mid-2000's. Even thinking about this and hoping the pay and job opportunities go up makes me feel like a jerk, but currently I'm working in healthcare and I can't even afford health insurance! Several older co-workers who have been in the field for longer than I have say the same thing - they hated Bush for so many reasons and it makes them feel dirty to admit that their pay was much better and working conditions easier under his regime! Or maybe declining reimbursement, increased burdensome Medicare regulations, etc. have nothing to do with the ACA and the drop in pay is from the recession a few years ago?

[Wandrlust]

I guess me and my husband are among the few unlucky ones. Our healthcare premiums went from $600/ month to $1200/month this January do to the ACA. He works for a large company almost 100,000 employees and they claim they can't keep up with the rising cost if insurance..well neither can we!! God, help us all!

[Workitinurfava, BSN, RN]

The middle class working folks will be hit the hardest, the cost of living will increase, pay won't increase and insurance will get more expensive. Thnx to the high heavens my husband works for the federal government so healthcare is affordable. Such is life.

[kbrn2002, ADN, RN]

The middle class working folks will be hit the hardest, the cost of living will increase, pay won't increase and insurance will get more expensive. Thnx to the high heavens my husband works for the federal government so healthcare is affordable. Such is life.

This has already been my reality for the past several years. Cost of living up but no COLA, insurance premiums rising [though admittedly not as much as some people's have]. I recently used this as part of my argument to justify getting a raise as I bring home less money now than I did five years ago thanks to insurance and taxes going up while my wages stayed the same.

[cherryelle07]

From what I understand Trump wants to focus on the cost of health care and not so much the insurance companies. He wants to create more price transparency with providers to give the consumer more power and financial awareness when making healthcare decision. I think he also wants to allow for the sale of health insurance across state lines. Might level the playing field and give customers more options. He also wants to make it so individuals can use health insurance costs as a tax deduction on their taxes. Medicaid and Medicare administration will be given to the States with little federal overhead with incentives to weed out fraud, waste, and abuse of the system to ensure the people who truly need to coverage get it.

Let's be honest, insurance premiums were rising long before Trump announced he was even running. While the ACA made health insurance easier to get, it did not address the issue of the bloated costs of equipment, medications, etc. I've had people tell me that they hesitated to get life saving treatments and medications, because their insurance companies refused to pay it and it was too expensive to cover out of pocket. Trump isn't even in power yet and people across the board have noticed their premiums and deductibles skyrocketing and that honestly has nothing to do with Trump and everything to do with the fact that insurance companies have no incentive to offer us affordable premiums. There is little competition in the current market. Insurance companies know they will retain their customers regardless, because there is really nowhere else to go. Most people have insurance through their employers, but those who don't really don't have many options and don't qualify for federal aid, because they make too much money. Many of them are self employed or are small business owners. So they are stuck with crappy Market Place insurance that really doesn't cover much outside of preventative care and health care in the event of something catastrophic and even then you are still responsible for thousands before the plan even kicks in.

[whichone'spink, BSN, RN]

As far as insurance, there might be some changes to the ACA. I do hope some things are kept, such as letting young adults stay on their parents' insurance until 26, disallowing denial of insurance for those with pre-existing conditions, and federal dollars for Medicaid expansion. For reimbursement by CMS, I don't think that will change so much. Value-based purchasing is the new thing, and I don't think it will go away. I am curious how gutting the ACA will affect our employment. Will census go down? Will there by massive layoffs?

I really feel for those who barely had insurance for 3 years and now they will lose it again.

[RiskManager]

From my perspective, we will likely be seeing more uninsured patients again and will be writing off more to bad debt. Say what you like about the ACA, but we found being paid something was better than being paid nothing and doing debt write-offs.

[Not_A_Hat_Person, RN]

I think we're going back to the bad old days, when anyone without insurance through their employer or a spouse or parent's employer was screwed. When an insurer could drop anyone at any time for any reason. When getting a mammogram, grief counseling, or sexually assaulted could result in the dreaded "pre-existing condition" label, which makes getting health insurance outside of a job impossible.

When my kids were born, I carried the family health insurance. I paid $800/month to cover 2 adults, with a pretty steep deductable. It took at least half of my paycheck, sometimes a lot more. Adding children would have increased it to at least $1,200 per month. When I met with an ACA navigator when I was pregnant, it was a huge relief to find out my babies would qualify for Medicaid. When I found out about my daughter's congenital heart problem about a month later, I was thrilled that even on Medicaid, she could get care at one of the best pediatric cardiac centers in the world. She will always have a pre-existing condition. She spent her first 6 weeks of life in the hospital; with open-heart surgery and about 3 weeks in the ICU. Her care cost more than my home.

I work per diem; it's flexible and minimizes our child care expenses. My job depends heavily on Medicaid funding. My husband works for the state. The kids are on Medicaid, while Hubby and I are on his insurance. Between the new president and my state's new Republican governor's plans to "right-size" state government, there is a good chance we will all lose our health insurance. I plan to find day care for my kids and look for a job with benefits. So much for pro-family policies. Have I mentioned that the new governor opposes statewide public preschool?

[Not_A_Hat_Person, RN]

Let's be honest, insurance premiums were rising long before Trump announced he was even running. While the ACA made health insurance easier to get, it did not address the issue of the bloated costs of equipment, medications, etc. I've had people tell me that they hesitated to get life saving treatments and medications, because their insurance companies refused to pay it and it was too expensive to cover out of pocket. Trump isn't even in power yet and people across the board have noticed their premiums and deductibles skyrocketing and that honestly has nothing to do with Trump and everything to do with the fact that insurance companies have no incentive to offer us affordable premiums. There is little competition in the current market. Insurance companies know they will retain their customers regardless, because there is really nowhere else to go. Most people have insurance through their employers, but those who don't really don't have many options and don't qualify for federal aid, because they make too much money. Many of them are self employed or are small business owners. So they are stuck with crappy Market Place insurance that really doesn't cover much outside of preventative care and health care in the event of something catastrophic and even then you are still responsible for thousands before the plan even kicks in.

This was the case long before ACA, except buying health insurance on the private market was impossible if you had any hint of previous health problems. Life itself was a pre-existing condition.

[DowntheRiver]

It's also difficult to align my fiscal conservativeness with my social moderateness. I'm an odd duck, I guess. I want everyone to have equitable health care access, but I don't think I should pay for ALL of it.

You are not a lone duck. I know many people (such as myself) who are fiscally Conservative but socially liberal. However, I believe it depends which side you lean on a bit more. Being socially liberal is more important to me so I side with Democrats. Love who you want, women should be able to make their own choice, give everyone affordable healthcare, and let's let some refugees in. It's tough, because I do not support the minimum wage hike that most Dems do and I believe we should have the right to bear arms. I'm not looking to get into any arguments here - I'm just trying to point out that there is a lot of gray area in the political spectrum - it is NOT a two sizes fit most category!