THE ELECTION
Unlike immigration and economic issues (like tariffs and taxes), healthcare per se is not at the top of Trump’s to-do list; whom he appoints is more likely to influence policy. That said, below are a few thoughts about likely changes in the next few years.
1. Antitrust.
Efforts at controlling mergers and acquisitions will be minimized. We are more likely in the next 4 years to see more combinations of insurance companies and provider organizations.
2. Medicare.
While Trump denies connections with Project 2025, I believe he will adopt its suggestion to expand private Medicare options, like Advantage Plans. Today, shares of companies in that space have already soared.
3. Medicaid.
As with his last term, consideration again will be given to other payment forms, such as block grants or capitation. More likely will be a federal enactment of a work requirement as a condition to receive benefits.
4. Pharma
While Trump has vowed to repeal the IRA, he will continue to address drug prices. Previously, he said he wanted to implement a “most favored nations” program for pricing. Other possibilities include market basket calculations or even methods the Biden administration is currently using.
5. ACA
This issue is the biggest wildcard. During his debate with Harris, he says he is working on a plan. In his last term, tried to repeal it.
However, since his last term, the provision of health insurance through the ACA has become more popular; 62% of the population have a favorable opinion. It is therefore difficult to imagine a major change that would upset the electorate. The next national election is in 2 years and healthcare could be a major issue if the ACA is repealed or changed in a significant way.
6. Public health
As I mentioned in my Blog on Monday, the public health changes could be disastrous. Trump said he would let RFK, Jr “go wild.”
Deleterious changes could range from removal of fluoride in the water to weakening of vaccine policies.
7. Abortion
Trump promised there would not be a national abortion policy; rather, he said decisions should be left to the states. Republicans believed that many states would choose very strict rules or outright prohibition. However, most states, even conservative ones, have chosen more liberal legalization provisions. These actions might cause Trump to change his mind- especially with a Republican-controlled Congress.
8. The Supreme Court
While not strictly a healthcare topic, its decisions have significantly affected healthcare laws (even beyond Roe v. Wade). For example, yesterday the Court heard arguments concerning Disproportionate Share Hospital payments. In the next four years, it is unlikely any of the justices will retire. However, if there are health issues, a Republican Senate would approve a conservative justice to replace a more liberal one or a much younger conservative to replace Justices such as Thomas or Alito.
Here are a few ballot item updates: Which healthcare ballot measures passed?
About hospitals and healthcare systems
Intensity of the IV Fluid Shortage at US Hospitals Remains Very High “Baxter is posting regular updates on its website as North Cove recovers gradually. The latest update, dated Oct. 31, says a key production line has restarted and that the earliest shipments from the facility will happen in late November — ahead of original estimates.”