
President Donald Trump’s plan to repeal American healthcare legislation could present challenges for Indian start-ups.
Trump’s effect on Indian healthcare is a topic Health Issues India has explored before. In November 2016, we wrote that Indian pharma experts were emboldened by his upset election victory. His “pro-industry” leanings and calls for “barriers to entry into free markets for drug providers” to be removed were cited as cause for optimism. This was seemingly reflected in the Bombay Stock Exchange (BSE) health index, which gained 1.5 percent, as pharma companies saw their stocks rise.
Some sang a different tune by the time Trump was sworn in on January 20th, however. There were some suggestions that Trump would be more bane than boon for Indian drugmakers, given his protectionist trade views. It even led to the BSE health index closing at 0.73 percent down.
It is clear that Trump is causing a lot of uncertainty, both at home and abroad. A big part of this is what he intends to do with the Patient Protection and Affordable Care Act (PPACA). Popularly known as Obamacare, the PPACA was the flagship social policy of Trump’s predecessor, Barack Obama. Trump made repealing the law one of his key promises on the campaign trail. Since taking office, he is wasting no time in acting upon that pledge. An executive order to begin the rollback was signed within hours of his inauguration.
At the moment, media coverage is understandably concentrated on the effects rescinding Obamacare will have on the many Americans who could be left without health insurance. There is also a question, however, concerning how it might impact other countries – India being one of them.
Repealing Obamacare: “A lot of uncertainty”
A recent report by The Times of India says, as well as pharma, “IT majors…smaller cloud-based startups and the virtual medical scribe industry in India…are facing a lot of uncertainty” as a result of plans to repeal Obamacare. HII has written about the importance of start-ups to healthcare in India before – highlighting the likes of Practo and YourDost.

The ToI goes on to say that some companies “are already seeing an adverse impact.” It quotes Harsneh Prett, chief compliance officer (CCO) of digital health start-up IDS Infotech, as reporting “a definite slowdown in business this quarter.”
The reason why Trump repealing Obamacare could be so problematic for Indian start-ups is because of how the bill has led to healthcare records in the U.S. being digitised. This is providing opportunities for Indian companies, many of which are being awarded contracts by U.S. companies. IDS Infotech, for one, acquired a million-dollar contract from American firm Augmedix two years ago.
On the surface level, this may seem more detrimental to Americans than Indians. India is said to be poised to be the world’s leader in digital health. However, if startups are losing U.S. contracts, their profits will inevitably take a hit. This would prove costly and could lead to downsizing or even closures. This would be an obstruction to Indians who are in dire need of the benefits digital health has to offer.