Protecting the United States’ leadership in innovation is a priority Americans can agree upon. As political discussions on health care policy continue across the country, the impact to the health care entrepreneurial ecosystem should be taken into serious account.
As a founding member of a Washington, D.C. think tank, I interpreted ACA legislation and conducted American opinion polling in 2009. I recently re-polled American “likely voters” on health policy issues, to understand which components of reform are still popular.
The “repeal and replace” debate has brought health policy topics back into the national consciousness. Questions around how to provide affordable coverage and reduce costs are generating debate across the country, leading to a wide range of proposals.
Unfortunately, the multiple unsuccessful attempts to pass legislation created major market uncertainty. Health insurance companies had to price their 2018 plans using the highest risk assumptions, hiking up projected premiums. Many insurers have pulled out of markets entirely, leaving some areas with limited coverage options.
As a member of the health care entrepreneurial ecosystem, I have become concerned about how this destabilization impacts the entrepreneurs and startups I work with. Some examples include:
1. Affordable Health Care for Entrepreneurs: Health plans offered on the individual Exchange support the freelancer / independent “gig economy” and entrepreneur / small business market. The calculation of what it will cost to quit a day job, start a company, or join a small business tips in the wrong direction with rising health care costs. If people can’t afford health care, they are less likely to take a leap into entrepreneurship, meaning fewer digital health entrepreneurs.
2. Health Care Organizations as Clients: Due to an uncertain future, health plans, hospitals, vendors, and others have been effectively paralyzed from making big decisions. They are holding off on initiating major new projects, undertaking pilot projects, making procurement decisions, or signing new contracts with digital health companies.
3. Availability of Investment Dollars: A slow down of new funding going into this space is expected when angel, seed, and venture investors aren’t able to make big bets in the face of uncertainty.
The health care entrepreneurial ecosystem depends on a dynamic workforce, clients who will take bets on innovation, and investment capital.
Where does this leave us?
Political leadership has the opportunity to focus their energy on a productive conversation to initiate improvements. Unilateral action should be avoided in favor of bi-partisan suggestions:
Reinstate and fund the reinsurance and risk-corridor programs to provide more certainty to health plans
Increase penalty for not following individual mandate so that more people buy into the market, making the math of risk pools work, increasing insurance affordability
Double down on initiatives to save costs by fighting fraud, improving care quality, incentivizing wellness, and preventing medical errors and needless tests and treatments. According a poll fielded September 6-7, 2017, voters would be supportive of:
In conclusion, the opportunity to increase health care quality and increase health insurance affordability is upon us again. Improvements that serve the broader American public will have the added benefit of supporting health care entrepreneurs who are committed to a brighter, more efficient, and effective health care future.
Attributions and Methodology: This poll was conducted by John Zogby Strategies and sponsored by Health 2.0.
Methodology: 800 likely voters nationwide, accurate +/- 3.5 percentage points
28% Independent / Unaffiliated; 36% Republican; 36% Democratic