What Does a Second Trump Administration Mean for Health Care?
The election of Donald Trump for a second term as President of the United States signals a significant shift in health policy priorities for 2025 and beyond. While specific details remain uncertain, several key changes are anticipated based on campaign promises and policy proposals:
Affordable Care Act (ACA) and Health Insurance
Trump has indicated he does not intend to fully repeal the ACA, but aims to make it “better” and “less expensive”[2]. However, some changes are likely:
• The administration may seek to reduce federal oversight and empower states to implement their own healthcare solutions[5].
• Enhanced ACA premium subsidies are set to expire at the end of 2025, which could lead to increased premiums and reduced enrollment if not extended[3].
• There may be efforts to expand alternative coverage options like Health Savings Accounts, Individual Coverage Health Reimbursement Arrangements, and Short-Term Limited Duration Insurance plans[3].
Medicare and Medicaid
Several changes to Medicare and Medicaid are possible:
• The administration is expected to promote Medicare Advantage plans run by commercial insurers[2].
• There may be attempts to reduce Medicaid spending, potentially through changes to the enhanced match rate for ACA expansion populations[1].
• CMS is likely to provide states more flexibility in managing Medicaid costs, possibly including work requirements and copayments[1].
Drug Pricing and Healthcare Costs
Trump has pledged to cut prescription drug prices and lower healthcare insurance premiums[9]. Specific proposals include:
• Potentially reviving previous proposals like the Most Favored Nations policy for drug pricing[3].
• Implementing site-neutral payments to reduce costs for outpatient procedures[8].
• Addressing surprise billing practices[9].
Public Health and Agencies
Significant changes to public health agencies and policies are anticipated:
• Trump has suggested giving Robert F. Kennedy Jr., a noted vaccine skeptic, a major role in shaping public health policy[7].
• There may be efforts to restructure agencies like the NIH, CDC, and FDA[3].
• The administration could reverse some Biden-era healthcare regulations and policies[6].
Reproductive Rights
While Trump has distanced himself from calls for a national abortion ban, his administration may still pursue policies to restrict access to reproductive care:
• Potential narrowing of abortion access through insurance coverage exemptions for religiously affiliated employers[7].
• Possible restrictions on access to in vitro fertilization and abortion services[3].
Healthcare Innovation and Deregulation
The administration is expected to focus on deregulation and market-driven solutions:
• Restoring the Medicare Coverage of Innovative Technologies rule to provide faster access to “breakthrough” medical devices[8].
• Reducing regulatory burdens on healthcare providers[5].
In conclusion, a second Trump administration is likely to prioritize market-driven solutions, deregulation, and state flexibility in healthcare policy, while potentially scaling back some public health initiatives and seeking to reduce federal healthcare expenditures.
Citations:
[1] https://www.forvismazars.us/forsights/2024/11/2024-election-implications-healthcare-organizations-health-policy
[2] https://abcnews.go.com/Health/2nd-trump-term-health-care-issues-including-aca/story?id=115560059
[3] https://avalere.com/insights/what-the-election-results-mean-for-health-policy-in-the-year-ahead
[4] https://www.milbank.org/quarterly/opinions/medicaid-and-a-second-trump-administration/
[5] https://www.pwc.com/us/en/industries/health-industries/library/election-2024-trump-health-agenda.html
[6] https://www.fiercehealthcare.com/regulatory/how-trump-could-roll-back-biden-era-healthcare-regulations
[7] https://www.advisory.com/daily-briefing/2024/11/06/trump-healthcare
[8] https://www.investopedia.com/what-project-2025-s-potential-medicare-changes-mean-for-you-8759509
[9] https://www.mercer.com/en-us/insights/us-health-news/trump-campaign-lists-second-term-healthcare-priorities/
[10] https://www.npr.org/sections/shots-health-news/2024/11/06/nx-s1-5181861/2024-election-trump-kennedy-health-care
