PwC Report Previews Biden’s Influence on Health Care Proposals, Policy Issues

November 12, 2020
Matthew Gavidia

A report by PwC discusses the health care agenda of President-elect Joe Biden, particularly how his term will shape the future of the Affordable Care Act, value-based care, and drug prices.

With the announcement of Joe Biden as the 46th President-elect of the United States, PricewaterhouseCoopers’ (PwC) 2020 Election Report discusses his approaches to health care reform and how his upcoming term will shape the future of the health care industry.

Kicking off the report, authors highlight that the election of Biden signals a return to the Obama administration’s approach to health care, which they referenced as:

  • building on the Affordable Care Act (ACA) through incremental expansions in government-subsidized coverage
  • continuing CMS’ progress toward value-based care
  • bringing down drug prices
  • supporting modernization of the FDA

When it comes to more bolder ideas such as developing a public option or raising the corporate tax rate, authors note that it could prove challenging without overwhelming Democrat majorities in both the House and the Senate.

So, what health care strategies and proposals can we expect from the Biden administration amid the possibility of a Republican-controlled US Senate?

In addressing coronavirus disease 2019 (COVID-19), Biden and Vice President-elect Kamala Harris have already appointed public health officials to their Transition COVID-19 Advisory Board, who will have an extensive impact on all aspects related to the management of the pandemic.

Moreover, the authors highlight that it is likely Biden will mount an intensified federal response in which he will enlist the Defense Production Act to compel companies to produce large quantities of tests and personal protective equipment. “The Biden administration also will likely return to global partnerships and groups such as the World Health Organization, especially in the area of vaccine development, production, and distribution,” wrote the authors.

As opposed to the Trump administration, which served in a more supporting role to local and state efforts, the authors hypothesized that the Biden administration will take on a more active federal role to address the pandemic. In fact, this stance is supported by Americans across demographics who reported in PwC’s Health Research Institute’s consumer survey that more money should be set towards the pandemic response.

Transitioning away from pandemic response, health care executives can expect an expansionary agenda from Biden’s health care proposals, noted the authors, which will look to patch gaps in coverage for Americans, aggressively scrutinize proposed health care mergers and acquisitions, and implement a replacement for the ACA should it be struck down.

“Health care executives should scenario plan for this unlikely yet potentially highly disruptive event, and plan for an administration marked by more certainty and continuity with the Obama years.”

Additionally, the authors wrote that all health care organizations should prepare for the possibility that millions more Americans could gain insurance under the new administration. If enacted, Biden’s proposals according to his campaign website would mean coverage for 97% of Americans.

“This could mean millions of new ACA customers for payers selling plans on the exchanges, millions of new Medicaid beneficiaries for managed care organizations, millions of newly insured patients for providers, and millions of covered customers for pharmaceutical and life sciences companies.”

As the US health care system continues to transform to a more consumer-oriented platform that will expand its digital and virtual offerings amid the pandemic, authors say that companies who have invested in capabilities for growth aligned with this new health economy will stand to gain disproportionately.

“Providers should consider reengineering primary care teams to reflect the patients’ health status and preferences, along with the realities of the workforce on the ground and new opportunities in remote care.”