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May 17 — Hillary Clinton (D) may be the better choice for health-care providers come November, a financial analyst who works with the industry told a group of health-care transactions lawyers May 17.
Brian Tanquilut, an analyst with investment banking firm Jefferies LLC in Nashville, Tenn., said Clinton historically has been supportive of providers because they're big employers. Her support dates back to the days when Clinton presented her own health-reform plan—which Tanquilut called Hillarycare—to Congress in the 1990s.
As for the presumptive Republican nominee, Tanquilut said he didn't really know Donald Trump's position on health care. Trump hasn't articulated his views, though the Republican platform generally calls for the repeal and replacement of the Affordable Care Act.
That may not be possible if Trump is elected, the keynote speaker at the American Health Lawyers Association's Health Care Transactions Conference in Nashville said. Tanquilut said top-ranking Republican senators have told him that they expect to lose the majority in the Senate if Trump becomes president. A Democratic Senate would block any repeal plans.
Tanquilut said Clinton was forced to start “going after” health care in fall 2015, when Bernie Sanders emerged as a serious challenger for the Democratic nomination for president.
She produced a few epic tweets in October 2015, including one critical of the pharmaceutical industry and rising drug prices, that drove health-care investor sentiment down. But then Sanders responded with a “Medicare-for-all” proposal that Tanquilut called “scary for all,” because government payers pay roughly half of what commercial payers do.
In contrast to Republican efforts to repeal and replace, Clinton likely will work to strengthen the ACA, Tanquilut said. From the perspective of investors, that would be the best course for health care.
Tanquilut also said, however, that he expects a Clinton administration to be more active in blocking provider mergers and consolidations. The candidate demonstrated in Hillarycare that she is anti-big pharma and anti-managed care, Tanquilut said.
He added that, if deals aren't done before the election, they may never be closed. While there already has been an increase in government scrutiny of the deals, that will only get worse, especially if Clinton becomes president, he said.
Another area of concern for the ACA, Tanquilut said, was raised by a recent federal court decision holding that the Obama administration illegally made cost-sharing payments to insurers (93 HCDR, 5/13/16).
Without those payments, insurers offering qualified health plans on exchanges will leave the market, causing the exchanges to fail, Tanquilut said. The court's decision “caused a lot of volatility” in health-care stocks last week, he noted.
Tanquilut predicted this may be another Obamacare case headed to the Supreme Court.
Commenting on another ACA initiative, Tanquilut also said he expects to see “red” states that resisted Medicaid expansion take it up again after the election. The state legislatures don't want to deal with this hot-button issue right now, but they realize that Medicaid expansion will bring revenue into their states and ultimately bring down the cost of health care.
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