What Will Be Trump’s Impact on MACRA? – MACRA Monday

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

Next week we’ll be kicking off our weekly series of details from the MACRA Final Rule. However, before we start going through the changes and what you need to know about MACRA, I wanted to cover an important topic of concern for many practices. I’ve heard a lot of practices that are afraid of what they consider the uncertain future in the coming Trump presidency.

While I believe that healthcare could see significant impact from a Trump presidency, I don’t believe that MACRA will be impacted by the change in presidency. First, MACRA was as bipartisan as you could find in Washington DC. Even if Trump wanted to replace, modify, repeal MACRA, I can’t imagine it getting enough support in the senate and house. If this is true, Trump won’t even try to do anything with MACRA. Second, Trump has plenty of bigger fish to fry. When you look at the various priorities that Trump has said he has for his presidency, nothing indicates that MACRA will be anywhere near those priorities. Third, it’s hard for me to imagine that Trump would see a problem with the move to technology in healthcare.

What also is worth noting is that MACRA is separate from ACA (aka Obamacare) and even ARRA (the HITECH Act). I’ll leave the predictions for what will happen with ACA for other people. I have no doubt that ACA will be impacted by the change in presidency, but even if they did a full repeal of Obamacare (which looks like it’s impossible), MACRA will still remain and be in force. If MACRA was part of Obamacare, I’d have a different view, but since it’s not then I think MACRA will continue forward as planned.

Those of you hoping for MACRA to disappear due to the new president and those of you waiting for MACRA to change after the comment period is over are grasping at straws. Love it. Hate it. Feel however you may about MACRA, I really don’t see any scenario where MACRA is not part of the future of healthcare.

What do you think? If you disagree, I’d love to hear why in the comments. If you agree, I’d love to hear from you as well. With that view, we’ll be continuing MACRA Monday blog posts for the foreseeable future so that our readers are ready.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • John, I agree that MACRA is not going anywhere. While the regs were just recently finalized, they were based on a statutory compromise of epic proportions, approved, as you noted, in a strongly bipartisan manner. That said, we have heard recent rumblings that Ryan wants to privatize Medicare and Trump wants to modernize it. Change on that scale is not likely to happen any time soon, given the fact that the razor-thin GOP majority in the Senate means that the GOP would need some Democrats to come along for the ride (the broad Medicare changes I’m alluding to would not likely fit in to the budget reconciliation mode of doing business, which requires only a bare majority in the Senate). While Trump and Pence have said that health care is one of their first priorities, it seems unlikely that we will see significant change take effect in less than a couple of years.
    If you are interested, here are links to my recent posts about what the change in administration may mean for folks interested in health care and health care innovation issues:

  • One way or another MACRA will fail. It will set back innovation and improvement in Health IT another decade. The anger among the front line providers left is palpable. We have had enough of the draconian regulations interfering and burdening our lives to death. So maybe he won’t be proactive and kill it, but when everyone sees the massive damage it has done to the practice of medicine all without any improvements in the value, costs, care or burden, it will be re-legislated. MU and PQRS were failures. You can argue that we spent 35 billion on EHRs all which have done nothing to improve care, cost, efficiency, or burden. There is essentially zero functional interop between systems. As for reporting data, what a joke. Its a mess, complicated and horribly time consuming inaccurate and costly. So one way or another its breaking the very people you are depending on to take care of you, to do your surgery correctly, to listen to you. Unhappy MDs equals unhappy patients. I want you to find one front line MD that thinks MACRA is anything but a nightmare. So one way or another… MACRA is gonna die.

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