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A few weeks ago, I wrote a post about how the two U.S. presidential candidates' views and policies would affect healthcare and senior living design and construction.

Maybe you read it, maybe you didn't.

But now that this election is finally over, I thought it might be good to dig a little deeper into what may be in store for the healthcare and senior living design industry during the new administration. The two healthcare issues I think are most important when it comes to design and construction are access to care and public health.

1. Access to Care

The Affordable Care Act passed by the Obama Administration in 2010 has expanded health coverage to millions of people, including expanding Medicaid and allowing young adults to stay on their parents' plans until age 26. It has also improved health equity for all Americans.

Trump favors changes to the ACA that would weaken pre-existing protections and reduce funding through a block grant to states. Also says he wants to repeal the ACA and replace it with "much better healthcare," but has provided no specific plans.

Possible impacts on healthcare facility design and construction:

  • Smaller, More Flexible Spaces: Efforts to repeal or modify the ACA would probably reduce the number of insured individuals. Fewer would seek elective procedures or preventive care. So, instead of building more large hospitals, the focus might shift toward building or renovating smaller, more flexible spaces that can adapt to fluctuating patient volumes.
  • Cost-Effective Renovations: Changes to the ACA could also affect funding for safety-net hospitals, which serve many uninsured and underinsured patients. They might not have the resources for facility upgrades or new construction projects, instead opting for cost-effective renovations and optimizing existing spaces.
  • Modest Facility Designs: Modifications to the ACA affecting Medicaid and Medicare could affect seniors' ability to afford assisted living or skilled nursing care. They'll want more affordable options, which could result in more modest facility designs that prioritize essential services.

I feel like some of these trends are already happening, but for different reasons.

Also, the president-elect has proposed tax incentives so that family caregivers can keep their loved ones at home instead of going to a senior living community or residential care facility. This could have a negative effect on occupancy and demand, as well as construction of new or renovation of existing residential senior housing and care facilities.

2. Public Health

Climate change is considered the biggest threat to public health worldwide. It threatens our air, food, water, shelter, and security.

What's more, according to the Pew Research Center, a majority of Americans think climate change is causing harm to people in the United States and 63% expect things to get worse in their lifetime.

It's a scientific fact that greenhouse gas emissions are a major cause of climate change. Globally, the healthcare industry emits 4.4% of greenhouse gas emissions, primarily carbon dioxide.

Trump doesn't believe in climate change. He's not likely to prioritize emissions cuts and favors economic growth, fossil fuel development, and deregulation. He's also probably withdraw from or renegotiate involvement in international efforts on climate action.

Possible impacts on healthcare facility design and construction:

  • Less Resilient Facilities: Reversal of Biden's climate policies, like building codes to enhance resilience to extreme weather events, could lead to a relaxation of standards that support designing climate-resilient facilities. Safety and structural integrity of healthcare and residential care facilities would be at risk once again.
  • Decreased Construction Costs: Deregulation might ease environmental standards for low-carbon materials and construction practices. Maybe this would lower construction costs, but at what price? Use of materials and methods that are less sustainable or energy-efficient could impact the long-term operational costs and environmental footprint of healthcare facilities and senior living communities.
  • Sustainable Design: Reduction in federal support for climate initiatives could also decrease funding opportunities for sustainable building projects, which could discourage the incorporation of low-carbon materials and energy-efficient designs in new healthcare facilities and senior living communities. Which would be a shame, since we were just starting to make progress in this area.

Despite these predictions, I have faith that the healthcare and senior living industry will continue to make strides in reducing their environmental impact, which will not only make them more operationally efficient, but better corporate citizens. Which will help them attract and patients and residents, as well as staff.

Human Impact

It occurs to me that the new administration's changes to the ACA and climate action could have greater impact on humans than on healthcare and senior living design and construction.

If people don't have health insurance, they will be less likely to seek care and will have more trouble managing their chronic conditions. If not slowed, climate change will continue to take increasing toll on our health and well-being.

Public health suffers in both these scenarios. And while public health may not be foremost on the minds of most Americans who voted in this last election (including me), I believe it is essential if we are to survive and thrive as a nation, and as a world.

P.S. Please do me a favor -- if you liked this post and like this blog, please share it with others by sending them the link or posting it on your LinkedIn, X, or Facebook. Also, don't forget to subscribe, so you'll get emails when new content is posted. Thanks!

Photo: ID 132344517 | Election © Ginettigino | Dreamstime.com

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Patrick Leahy, AIA, ACHA, EDAC, LEED AP

4 weeks ago

Thank you for the great summary. And for continuing to keep all of us in the healthcare planning design industry informed.

Deborah Seitz, AIA, LEED AP Homes

3 weeks ago

Always great summaries, Sara. This one is a great outline of the effects of public policy which affects everyone.

Sara Marberry_013-Retouched-New copy

What's my story? I'm a healthcare and senior living design knowledge expert who writes and speaks frequently about trends and issues affecting these two industries. I'm also a strategic marketing consultant and content creator, working with companies and organizations who want to improve the quality of healthcare and senior living through the design of the physical environment. You can reach me at .

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