How the shifting political landscapes could influence health and social care

Recently, GroundGame.Health sponsored an Executive Roundtable, Transforming People’s Lives, where Sara Singleton, a principal at Leavitt Partners, provided insights into the recent U.S. election and its potential implications for healthcare policy, especially around social determinants of health (SDOH). Sara discussed key themes she referred to as the “Four P’s”—politics, people, process, and policy—to help explain how the shifting political landscapes could influence health and social care.

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Politics: The Shift in Power and Priorities

Sara began by analyzing the recent election outcomes, with former President Trump’s return to office and the shift in Congressional control to Republicans. She noted that the primary issues motivating voters included the economy, inflation, immigration, and public safety. Healthcare was not a major election issue, but policies tied to affordability and accessibility will be influenced by this change in power. She pointed out that any health policy changes would likely be seen through a different lens compared to previous administrations.

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People: Key Players

With Republicans now in control, Sara emphasized that leadership changes in Congress would affect priorities. Specifically, Senator Mitch McConnell’s decision not to seek re-election as Senate Republican leader, and the narrow majority margins in both chambers would make it challenging to pass sweeping reforms. This change in personnel could lead to differing approaches to healthcare policy, as new leaders align around distinct conservative priorities. 

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Process: Reconciliation as a Policy Tool

Sara explained how the new administration and Congress will use the budget reconciliation process to push policy changes. Reconciliation allows certain budget-related policies to pass with a simple majority vote, making it easier for a single party to enact legislation without bipartisan support. The current Congress could potentially use reconciliation multiple times, offering Republicans more opportunities to move on fiscal and tax issues.

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Policy: What’s Likely for SDOH and Social Need

In terms of policy, Sara provided an outlook on how the new political dynamics could impact SDOH initiatives. She noted that large-scale social policy expansions, like housing and food security, are unlikely under the new administration. However, she identified a few areas that could still see bipartisan support or continued funding:

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1. Medicare and Medicaid: Sara suggested that although major expansions are unlikely, existing SDOH-related waivers and programs could remain, particularly those benefiting rural populations, veterans, and people with chronic conditions.
2. Food Security and Transportation: These areas may receive some attention, with food security potentially framed as a national security issue, which appeals to conservative priorities.
3. Focus on Efficiency and Cost-Saving: Sara noted that the administration might focus on cost efficiency within Medicare and Medicaid, possibly through pilot programs and targeted initiatives rather than broad new programs.

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Sara concluded by emphasizing the importance of SDOH work continuing at the community level, with local organizations remaining instrumental in advancing social care integration. She encouraged attendees to engage with policymakers early and find innovative, creative approaches to sustaining momentum on social needs integration, even if the federal policy framework shifts under the new administration.