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Wall Street analysts attempt to make certainty out of healthcare's uncertain future

Come January, a new Republican administration will enter the White House and with this new administration comes a wave of uncertainty as to whether they will repeal the ACA, and when, according to Medscape.

Wall Street analysts met at a briefing in Washington, D.C., earlier this week to discuss where they think healthcare will trend and whether or not the administration will repeal the health law. Sheryl Skolnick, PhD, managing director of Mizuho Securities USA in New York City, said, "What you're seeing right now is a desperate attempt to make certainty or surety out of uncertainty, when ... in my view, it is tremendously uncertain right now."

Healthcare's future remains largely uncertain because although the Republicans have a majority in the Senate, it is not a huge majority which makes ACA repeal a lofty goal. What may be more realistic is the administration making ACA changes through the budget reconciliation process, which Medscape reports "cannot be filibustered and requires fewer votes to pass."

President-elect Donald Trump recently said he supports the ACA mandate that requires payers to cover pre-existing conditions. Congress may pursue an avenue in which they send an ACA repeal to President-elect Trump, which keeps the pre-existing condition coverage in place, but stops subsidy funding and gets rid of the individual mandate.  However, without another plan that maintains American coverage, the fallout could be tremendous with millions of Americans losing coverage.

Matthew Borsch, MBA, a vice president and senior investment research analyst at New York City-based Goldman Sachs, maintains a "glass is half-full" outlook and maintains the new administration could have a "bipartisan embrace of healthcare reform." He says the administration could follow a series of steps to replace the ACA, such as retaining or converting subsidies to tax credits and restructuring the individual market, as well as have a requirement for continuous coverage to replace the individual mandate. Changes such as these could "end up with a solution that actually enlarges the individual market from its current size of 17 million because you bring in healthy segments of the population," Mr. Borsch noted.

Other analysts did not feel the same hopefulness with a bipartisan government, saying if the new administration replaces the ACA, the replacement will be "exactly the same thing" but with a different name. Dr. Skolnick said, "Whatever plan they're going to come up with is going to be as good or as bad as any other plan ... So pick one and get on with it.... Get it in there. Get it in the Senate and give the market certainty again."

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