Policy

After shocker election, what are the ramifications for healthcare?

After an ugly, contentious campaign, let's turn our attention to healthcare — starting with a recap of key ballot initiatives.

Healthcare and Medicine Political Changes Symbolized by USA Flag, Stethoscope

Update: This article was updated at 10:42 a.m. Eastern time to include the latest information from the polls.

Tuesday’s election was, thankfully, about much more than finding a new U.S. president, though the majority of the electorate shocked the pundits by electing Donald Trump to occupy the White House for the next four years. It was an ugly, contentious campaign, so let’s now turn our attention to healthcare in the name of our sanity.

Beyond efforts to legalize recreational use of marijuana and raise taxes on cigarettes and soft drinks in multiple states, several jurisdictions had ballot initiatives that could fundamentally change aspects of the healthcare delivery system.

Colorado: Single-payer health insurance

In Colorado, voters overwhelmingly rejected Amendment 69, a ballot initiative that would have set up a single-payer system called ColoradoCare. At 11:30 pm Mountain time Tuesday, 68 percent of precincts had reported, and 80 percent of votes counted were against the measure.

According to the Colorado Independent, the amendment would have taxed employees, employers and income from capital gains and other nonwage sources. That revenue was to fund a statewide healthcare plan called ColoradoCare.

Predictably, the measure had powerful opponents in the business community — especially from commercial insurers, who would have effectively been put out of business in the state. But that wasn’t the only reason for the resounding defeat.

Per the Colorado Independent’s report:

Another major complaint dealt with the structure of ColoradoCare, which would have been its own political entity, governed by an appointed 15-member interim board and, later, by a 21-member elected board. Opponents said that the board would have had too much power over healthcare decisions and, because the interim board would have been politically appointed and voters wouldn’t have been able to repeal elected board members, the board’s power would have gone unchecked.

Lastly, ColoradoCare faced a major obstacle with women’s health groups. Because of a law passed in 1984 that prohibits the state from funding elective abortions, the transfer of healthcare administration over to the state would likely have prevented women from receiving abortions under ColoradoCare, at least unless the 1984 law was repealed. NARAL Pro-Choice Colorado, Planned Parenthood of the Rocky Mountains and ProgressNow Colorado opposed Amendment 69 on these grounds.

Colorado: Assisted suicide

Colorado voters did, however, appear to approve Proposition 106, to legalize physician-assisted suicide for adults with terminal illnesses. With 63 percent of votes tallied, yes led by 65.3 percent to 34.6 percent, the Denver Post reported.

Should the margin hold up, Colorado will become the fifth state with a medical aid-in-dying law, along Washington, Vermont, Montana and California.

California: State Agency Drug Prices

The votes are also in for California’s Proposition 61, said to be the most expensive ballot battle in U.S. history.

With over 99 percent of votes tallied, an Associated Press poll shows Prop 61 was rejected by 54 percent of respondents, trumping a 46 percent minority that voted in favor of the initiative. 

That counts as a win for multiple veterans groups, the California Medical Association, and of course Big Pharma, which invested $109 million in the ballot.

In basic terms, the initiative sought to cap state spending on prescription drugs, taking a cue from the Department of Veterans Affairs, which negotiates drug costs around 24 percent lower than standard market rates.

The yes” campaign, figuratively led by Sen. Bernie Sanders (D-Vermont), said the legislation would be “an important blow against the monopoly pricing power and profit-driven arrogance of the pharmaceutical industry.”

Instead of countering those claims, groups opposing the initiative argued that the structure of the ballot wouldn’t deliver on what was promised. Of particular note, they argued most Californians wouldn’t qualify for price discounts:

More than 88 percent of Californians are excluded by Prop 61, including more than 20 million Californians with private health insurance and Medicare, more than 10 million low-income patients in Medi-Cal and millions more who are uninsured. This 88 percent of Californians would see an increase in prescription drug prices.”

The pharmaceutical industry had been keenly watching the results. Such hard negotiations are commonplace internationally, but California would have been the first U.S. state to bring in such a measure.

Despite the ballot rejection, debates about medical costs and drug price manipulation will continue to swirl in the public domain.

No one is more aware of this than PhRMA, the main lobbying group for pharmaceutical companies, which reportedly increased its dues by $100 million in anticipation of a post-election pricing storm.

Montana: Biomedical Research Authority

The election in sparsely populated Montana featured a bond measure that could create a model for the rest of the nation to fund biomedical research. Known as I-181, the ballot measure would statutorily create a body called the Montana Biomedical Research Authority and fund the authority with $20 million in bonds annually for 10 years.

By 1 a.m. Mountain time early Wednesday, I-181 was losing by a 58-42 margin, with 75.1 percent of precincts reporting, Politico said.

Photo: YinYang/Getty Images

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