India has a high stake in the American Health Care industry since there is a huge IT spending by the Health care and Health Insurance industry in USA which also gets reflected in the outsourcing market. It is for this reason that HIPAA and HITECH Acts have been of interest to India as  prime Privacy and Information Security regulations which the Indian Business Associates of US Covered Entities were mandated to implement.

Even while the Indian industries are waiting for our own versions of HIPAA through the proposed Health Data Privacy and Security Act and the proposed Data Protection Act of India, HIPAA-HITECH Act provisions continue to be a “Best Practice Standard” for Indian companies exposed to Health Data which is classified as “Sensitive Personal Information” under Section 43A.

Hence any changes in the US Health Care market needs to be closely monitored by Indian companies to assess the financial impact that these regulations may have on the Indian companies. In this context the recent changes in the US in Health Care legislation needs to be watched by the Indian IT industry.

One of the election promises made by Mr Donald Trump was to repeal the present Affordable Health Care Act (ACA) regulations referred to as “Obama Care” and replace it with a better legislation. Now the US Congress has passed the “American Health Care Act -2017 (AHCA)” repealing the Obama Care with “Trump Care”. It has to go through the formalities of being passed by the senate before the President can proclaim it as a law.

The Trump Care does not affect HIPAA or HITECH Act provisions of Privacy and Information Security and hence it does not affect the HIPAA stakeholders both in USA and India. The Obama Care and Trump care both address the Health Insurance industry and the extent to which the citizens of USA should be provided with health insurance subsidized by the Government. Obama Care mandated “Health Insurance for All” and created an IT infrastructure for registration of individuals and for marketing insurance policies etc. People were made to obtain insurance if their income is above a particular limit or pay a tax penalty. If they were below an income limit, the Government would subsidize their premium. The entire project created a large IT business in USA, some of which must have benefitted Indian Companies also.

Trump was of the opinion that Obama Care was not feasible and the insurance companies were increasing the premia to an extent that there would be an unreasonable burden on the Government. Hence he wanted substantial changes or a replacement of the old act with a new act.

Under the new AHCA, it is not mandatory for everyone to take Health Insurance. If some body wants to take a new policy or renew a discontinued policy, when there could be pre-existing conditions, then the insurance agencies can charge a penal premium.

Also the cut off income for subsidization of premium has been brought down reducing the incidence of subsidy in the country as a whole.

Further there could be changes on existing policies with the States could introduce options to leave out some protections.

All this means that there has to be a tweaking of the insurance related data and a complete overhaul of many accounts.

This means that there would be another rush of IT work for making the changes in the accounts of individuals, removal of some from the subsidy scheme, changing the coverage etc. Essentially it could be a low end data updation work part of which could be automated or managed by the customers themselves. However the insurance companies need to revise their terms of insurance and hence IT work related to it would arise.

In summary we can therefore say that the switch over from Obama Care to Trump care would not affect the compliance requirements under HIPAA but may provide additional business for outsourced IT managers, subject of course to the new push for more domestic work force which Mr Trump wants.


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