Why Embracing Resilience Will Help Whatever Happens Next in the Repeal/Replace Debate

So the Senate Republicans failed to pass legislation that would repeal and replace Obamacare.  What now?  Even if the House and Senate take a break from their efforts to repeal and replace the Affordable Care Act, the administration still has power to strengthen or weaken the law. The words “The Secretary shall” appear more than 1,400 times in the ACA (according to sources), thus giving the Secretary of the Department of Health and Human Services significant authority over the functioning of the law. The Internal Revenue Service and the Department of Justice, among others, can also impact the ACA through various enforcement (or lack of enforcement) actions.  President Donald Trump has, in an executive order, tweets and speeches, called for letting the law fail and implode. Shortly after the “skinny repeal” failed, President Trump tweeted, “let ObamaCare implode.”

Many health organizations will continue to see uncertainty around ACA measures, health policy changes, use of technology, and other issues, such as the question of whether the federal government will continue to make cost-sharing reduction payments to insurers. This uncertainly  caused by the administration’s decision to leave the fate of those payments up in the air each month has led insurers to raise premiums for ACA plans and pull back from participating in the marketplaces.

As I continue to tell my clients and teach my students, health organizations should build enterprise resilience as part of their core culture in order to prepare, plan and implement measure to counter this uncertainly, and to position themselves to succeed. 

Sam Hanna, MBA, CISA, CBCP, CRISC is the program director for the Masters of Science in Management of Health Informatics & Analytics (HealthInformatics@GW) program at The George Washington University.  Prior to this role, he held leadership positions at global professional services firms where he was responsible for creating and leading large multidisciplinary health industries practices, as well as an investment portfolio in new technologies, solutions and startups.  He is a frequent speaker and writer on topics related to entrepreneurship and innovation, health IT, analytics, and the intersection of translational sciences and the business of health.  He can be reached at hanna44@gwu.edu

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