December 4, 2024

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How the healthcare industry is reacting to a second Trump term

How the healthcare industry is reacting to a second Trump term

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On Wednesday, Republican candidate and former president Donald Trump was elected to the nation’s highest office for the second time, ushering in once again an administration that created notable upheaval for U.S. healthcare.

Trump’s first term as president, which ran from 2016 to 2020, was characterized by efforts to chip away at key tenets of the Affordable Care Act, curtail the Medicaid program and deregulate the healthcare industry.

Trump has been vague about his healthcare policy goals on the campaign trail, as polling showed healthcare lagged issues like the economy and immigration for voters. But his second term promises more of the same — but with a savvier, more willing political apparatus behind him, according to experts.

“The focus on healthcare is likely to be similar to that of Trump’s first term but will happen faster and go farther,” said Stephanie Kennan, senior vice president of federal public affairs at McGuireWoods Consulting, over email. 

It’s unlikely that Trump will again attempt to repeal the ACA, which is widely popular among Americans. However, his administration could move to cut costs stemming from the Obama-era law, including allowing more generous subsidies for plans on ACA exchanges to expire next year. That would save taxpayers money, while causing the U.S. uninsurance rate to rise sharply after record gains in coverage under President Biden, according to experts.

Incoming Vice President J.D. Vance has also floated plans to let insurers stratify patients based on their health conditions, which could cut costs for healthier people but lead to skyrocketing spending for older individuals or those with chronic health conditions. Under Trump, the HHS could also reintroduce skimpy short-term health insurance and other non-ACA-compliant coverage, which were rolled back during the Biden administration.

As for Medicaid, Trump was largely silent during his campaign regarding the massive safety-net program, which covers almost 80 million Americans. However, the president-elect could revive guidance allowing states to shrink Medicaid eligibility through work requirements, controversial programs tying coverage eligibility to work or volunteering hours, and to cap program funding through block grants.

Trump has also promised to give free rein to vaccine skeptic Robert F. Kennedy Jr. to pursue his “Make America Healthy Again” agenda for public health reforms, a move that could augur sweeping changes for the Food and Drug Administration and other federal agencies.

Kennedy told NPR he’d work to eliminate fluoride from U.S. drinking water, rolling back one of the biggest public health initiatives of the 20th century.

Meanwhile, Trump has pledged not to sign a nationwide abortion ban, but could lean on the FDA to make it more difficult to access the procedure. That could include revising guidance that allows abortion pills to be sent in the mail. Trump has also promised to roll back gender-affirming healthcare for transgender individuals.

Backed by a newly Republican Senate — and potentially a Republican House of Representatives — Trump could have carte blanche to pursue conservative healthcare policies in his second term, with real impacts on payers, doctors and patients, experts say.

Major trade associations for the hospital industry congratulated Trump on his win this week, while reiterating their priorities for lawmakers in Washington.

Insurer groups were quieter. AHIP, the largest lobby representing payers, told Healthcare Dive it had no statement to share. Other associations, including the Alliance of Community Health Plans, which represents nonprofit insurers, didn’t issue official statements on the election but posted blogs outlining their priorities for the incoming administration.

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