2016 Family Medicine Experience

Analyst Says Election Holds High Stakes for Health Care

September 29, 2016 02:01 pm David Mitchell Orlando, Fla. –

Political analyst David Wasserman speaks with family physician Sonja Heuker, M.D., of Cincinnati. Wasserman was the keynote speaker Sept. 22 during the Family Medicine Experience in Orlando, Fla.

In a little more than five weeks, U.S. voters will go to the polls and choose a new president.

"The stakes for health care and family physicians are enormous," political analyst David Wasserman said Sept. 22 during a keynote speech at the Family Medicine Experience (FMX) here.

Wasserman, U.S. House editor for The Cook Political Report and an election night analyst for NBC News, offered a thorough breakdown of the campaign.

If former senator and secretary of state Hillary Clinton wins the presidency, maintaining Democratic control of the White House, Wasserman said it would likely mean a continuation of the gridlock that has existed between the Obama administration and the Republican-controlled Congress.

It also would likely block Republican efforts to repeal or meaningfully change the Patient Protection and Affordable Care Act (ACA). He said he would expect Clinton to push for greater Medicaid expansion and a crackdown on high drug prices.

Story Highlights
  • Political analyst David Wasserman said during a speech at the Family Medicine Experience that the stakes are high for health care in the upcoming presidential election.
  • A Hillary Clinton victory likely would mean no repeal of the Patient Protection and Affordable Care Act (ACA), he said, but it also likely would continue the gridlock between the White House and Congress.
  • A Donald Trump victory could clear the way for repeal of the ACA, but Wasserman questioned whether Republicans could agree on a replacement plan.

A win by businessman Donald Trump, on the other hand, would likely mean Republicans would maintain control of both houses of Congress, Wasserman said. That scenario would set the stage for repeal of the ACA, though it's unclear if GOP legislators could agree on a replacement bill.

A Trump victory also would leave Medicaid expansion up to the states, and Trump has indicated he would reduce barriers for the pharmaceutical industry to bring new products to market.

In a nonpartisan presentation, Wasserman said the 2016 campaign is suffering from "electile dysfunction" because voters see both candidates as flawed.

Clinton, who turns 69 in October and would be the second-oldest candidate ever elected president, has been dogged by questions about her health. Her campaign also has been marred by congressional investigations into her response to the attack on the U.S. diplomatic compound in Benghazi, Libya, and her use of a private email server while she was secretary of state. Wasserman cited a CBS/New York Times poll that reported less than one-third of voters find her trustworthy. Her favorability rating, 37 percent, is the second-lowest on record for a major party's presidential candidate.

"That would normally mean your candidacy was doomed," Wasserman said, "unless you're running against Donald Trump."

Trump, 70, would be the oldest candidate ever elected president, has never held public office and has the lowest favorability rating ever at 28 percent. According to an ABC/Wall Street Journal poll Wasserman cited, more than 60 percent of voters think he is unqualified for the job.

"Republicans," Wasserman said, "seem like they are trying to lose this election."

One poll indicated more than 60 percent of Republican voters feel betrayed by party leaders. Wasserman said that's because in the last election, some GOP legislators made campaign promises to do things -- such as repeal the ACA and defund Planned Parenthood -- that they could not deliver.

"In our system, change is slow," Wasserman said. "You can't get everything you want if you don't have the presidency."

Wasserman said this election is more about elite versus non-elite than a typical red versus blue contest. To identify trends in voting, he looked at retail stores and restaurants that did business in at least 40 states and operated at least 100 locations.

He found an interesting fact. In 2012, Barack Obama won 75 percent of counties that had a Whole Foods store but only 29 percent of counties with a Cracker Barrel restaurant. It might sound like a joke, but what Wasserman termed the "organic/nostalgia sort" has actually held true for at least the past five presidential elections. In 1992, Bill Clinton carried 59 percent of counties with a Whole Foods store but only 40 percent of counties with a Cracker Barrel restaurant. George W. Bush won 75 percent of counties with a Cracker Barrel restaurant but only 44 percent with a Whole Foods store in 2000.

Of course, much more than the White House is at stake. Democrats need to gain only four seats to take control of the Senate. The GOP has 23 senators up for re-election compared to only 10 Democrats vying to keep their seats. Key states to watch, Wasserman said, are Indiana, New Hampshire, North Carolina and Pennsylvania.

The Democrats face a much more difficult task trying to take back the House, where the GOP holds its largest majority since 1928. It's possible, Wasserman said, that the Democrats could pick up 10 to 15 seats, but they would need to win 35 of 37 "competitive" seats to reclaim the majority. The significance of gaining roughly a dozen seats would be that Speaker Paul Ryan, R-Wis., might need to reach across the aisle more often to pass legislation.

Why else is 2016 important? The next president will have the opportunity to nominate a judge to replace Justice Antonin Scalia, who died in February, on the nation's highest court. Three of the remaining Supreme Court justices are older than 75, meaning the next president likely will make multiple nominations to the court.

"The Supreme Court is a testament to advances in pharmaceutical medication," Wasserman quipped.

So who will win? Nearly 20 percent of voters are either undecided or supporting a third-party candidate, Wasserman said. Millennials, in particular, could play a huge role in determining the election's outcome. Thirty-three percent of that demographic is undecided or leaning third party.

On election night, keep an eye on Vigo County in Indiana, Wasserman advised. That county has sided with the winner in every presidential election since 1956.