This year’s election could have a major effect on adherence rates. Here are some possible changes in healthcare policy that could be enacted under Trump or Biden, and the impact on adherence.
Revocation of the ACA
In November, the Supreme Court will consider arguments made by the Trump administration and state attorneys general regarding the overturn of the Affordable Care Act. If the law is overturned, insurers would be able to deny coverage or charge higher premiums to patients with pre-existing conditions. If patients drop coverage because of affordability, ACA advocates maintain that rates of cost-related medication non-adherence could increase. A study in the American Journal of Public Health found that the rate of adherence among both working-age adults and young adults increased after the ACA was instituted. While the authors say their findings are not definitive, they suggest that health behaviors such as non-adherence “are responsive to changes in the policy environment.”
Expansion of Medicare and Medicaid
Former Vice President Biden’s platform promises a public insurance option and the expansion of Medicaid eligibility to cover more low-income Americans. How would an increase in the number of Medicaid patients affect adherence rates? A clue may be found in a study published in Health Affairs, which looked at Oregon’s Medicaid expansion in 2008. The authors found that the expansion significantly increased the use of medications related to the management of several serious conditions.
Drug affordability measures
Both President Trump and former Vice President Biden have promised to rein in drug prices. Would making drugs more affordable actually have an impact on adherence rates? A study in Circulation indicated that making medicines for chronic conditions more affordable improves adherence. The authors found that 1 in 8 patients with cardiovascular disease reported non-adherence of medications because of cost. So removing financial barriers, particularly for more vulnerable populations, may improve adherence.
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