Where Do We Stand in 2019?

The short answer – on shaky ground.


While having a two-party government instead of just one party in charge will slow what damage this administration can do to healthcare policy, it also means that unless there is some kind of revolt in the Republican party, very little will be passed on the Federal level. In the meantime, the administration can change things through the agencies (like cutting the advertising budget for Obamacare a.k.a. the Affordable Care Act so fewer people will sign up) and the states will go their own ways.

But it does help to know where we’re starting this year. Here are some of the healthcare policy events going on right now:


  • Voters made it clear during the 2018 election cycle that healthcare was the most important issue to them. That did not stop a federal judge in Texas from ruling that, without the individual mandate, the Affordable Care Act is unconstitutional. The ruling was so crazy that even the Wall Street Journal couldn’t bring themselves to support it. The good news is that, the judge is allowing the status quo to continue while the case makes its way through the appeals system and likely up to the Supreme Court. Almost as many states are appealing the decision as brought the case, and the House recently announced plans to intervene in the court case.

  • Big Pharma announced that it will be increasing drug prices again after delaying doing it last year. This puts them on a collision course with both Congress and the President who have publicly put lowering prices on their agendas. In order to avoid negative press, the price hikes on many name brand drugs (as opposed to generic) may be slower than previous hikes.

  • The government shutdown – the third this year – is affecting some of the health programs we don’t think about. Most of the big programs like Medicare and Medicaid are funded through the fiscal year, but the Food and Drug Administration is taking a hit because a significant amount of its funding comes through the Department of Agriculture. Additionally, health services for Native Americans, one of our most vulnerable populations, are in trouble, as are health plans run by the Environmental Protection Agency and the Department of Homeland Security.

  • Obamacare enrollment declined, which means more people are uninsured.

In the States

I don’t know about you, but I’m tired of the uncertainty of where healthcare is going. Uncertainty causes more anxiety than bad news. At least with bad news, the ground is solid and you know what you have to do to change it.

While it’s not all bad news, we patients have our work cut out for us. Between the life responsibilities everyone has and the extra full-time jobs that our conditions are, we hardly have time to be riding herd on lawmakers and a misbehaving healthcare industry. But for the first time in memory, the environment – politically, socially – is right for action. Everyone is for lower drug prices. The Affordable Care Act is more popular than ever, despite the lawsuit.

So this year, make your voice heard. Watch what your state and federal lawmakers are supporting or blocking, and let them know if you agree. Then get your friends to do it. Politicians fear nothing more than losing their jobs. If enough people make their opinions known, it can shape the direction of legislation. That’s how the system works.

Maybe it’s time to add your representatives’ office numbers to your contacts so that it’s a nice, easy Bluetooth call to let them know how you really feel about their bills.  You can do it on the way to your next doctor’s appointment.