DR. DAVID BLUMENTHAL

CEO, Commonwealth Fund

Three themes will dominate healthcare policy and politics in 2019. The first will be the positioning of Democratic presidential hopefuls for the 2020 primaries and caucuses. The critical decision facing Democratic aspirants will be whether to embrace “Medicare for all” or something more moderate. A second theme will be ongoing trench warfare over the Affordable Care Act’s coverage provisions. The Trump administration will continue its efforts to hobble ACA marketplaces. A third will be drug prices. The administration seems intent on responding to the public outrage over painful drug costs. The new Democratic majority in the House will up the pressure through hearings and proposed legislation, and Republicans will be tempted to pile on. Given the pharmaceutical industry’s undiminished power in the Congress, however, don’t expect any decisive policy advances.

—AS TOLD TO HARRIS MEYER