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.
However, the stocks of some of the largest U.S. insurers rose after news of Trump’s victory, signaling Wall Street believes his regime could prove friendlier than the Biden administration. Under Biden, regulators have taken steps to curb profiteering in federal programs — especially Medicare.
The Better Medicare Alliance, a lobby for insurers in the privatized Medicare Advantage program, said it “looked forward to partnering” with the Trump administration to ensure “sufficient funding and sensible policies” in MA.
Groups representing pharmacy benefit managers, drug middlemen oft-maligned by federal regulators in the Biden administration, and telehealth companies, which Trump allowed into Medicare during the COVID-19 pandemic, also sent their congratulations to the incoming administration.
The American Medical Association, the national lobby representing physicians, did not respond to a request for comment and had no statement on the election on their website.
Here’s how some of the industry’s most influential trade associations responded to news of Trump’s win.
American Hospital Association
“The AHA and America’s hospitals and health systems congratulate President-elect Trump and look forward to working with him and his incoming Administration to make progress on the many critical issues facing the health care field and the patients and communities we proudly serve. We also extend our congratulations to the new and returning Members of Congress on both sides of the aisle.
As we enter the final weeks of this session of Congress and look ahead to the next, our priorities remain the same: ensuring access to coverage and care, enhancing the quality and affordability of care, supporting our caregivers, and making sure that hospitals and health systems have the resources and support they need to remain cornerstones of their community.”
America’s Essential Hospitals
“We stand ready to work with the new administration and Congress to strengthen health care for all people by protecting Medicaid and other programs that help working families and others stay well and productive.
Good health and the financial security affordable health care access brings are vital to a strong economy and healthy communities. Our hospitals provide that, as well as lifesaving services for entire communities, such as trauma and burn care, transplant services, and behavioral health. Essential hospitals are economic engines and often a community’s largest employer.
We appreciate President-elect Trump’s stated commitment to unity for the good of all Americans. We also commit to working with all stakeholders to preserve and enhance our hospitals’ indispensable role in their communities.”
Federation of American Hospitals
“FAH congratulates President-elect Donald Trump, and we look forward to working with him, his Administration, and the new Congress to assure all Americans the health care they need and deserve. 24/7 lifesaving care is critical to the American people, and we’ll partner to ensure all Americans have access to needed hospital care in their communities. There are a lot of important issues on the line for patients across the country regarding health care coverage and protecting Medicare beneficiaries in managed care, and we look forward to addressing patient care together.”
Pharmaceutical Care Management Association
“PCMA congratulates President-elect Donald Trump, Vice President-elect JD Vance and newly elected Members of Congress on their victories in the 2024 election.
America’s pharmacy benefit managers (PBMs) look forward to working with the Trump Administration and Members on both sides of the aisle in the 119th Congress to achieve more affordable prescription drugs for all Americans.
To make progress on drug affordability, policymakers have to start by addressing the prices set by drug companies and misuse of the patent system that blocks market-based competition. Promoting greater competition, along with protecting critical choice and flexibility for employers, will lead to lower cost prescription drugs. We stand ready to partner with federal and state policymakers to deliver for American patients.”
Better Medicare Alliance
“President-elect Donald Trump and Vice President-elect JD Vance understand that protecting Medicare is a top priority for seniors, including Medicare Advantage. We congratulate them on their election victory, and we look forward to partnering with their administration and the new Congress.
Medicare Advantage delivers affordable, quality health care for nearly 34 million seniors and people with disabilities. With more than half of Medicare beneficiaries now choosing Medicare Advantage, it is crucial that we continue to ensure stability for seniors with sufficient funding and sensible policies.”
American Telemedicine Association
“President-elect Trump and his administration were strong proponents of telehealth during his first stay in the White House, creating important policy flexibilities that allowed for immediate and appropriate access to virtual care services early in the COVID-19 pandemic, for which we are grateful.
We are looking forward to working with Trump administration to ensure that access to needed care continues to be available to all Americans, and that telehealth services become a permanent part of healthcare delivery in our country.
Our thanks to the Biden-Harris administration, which also demonstrated unwavering support for telehealth over the past four years. It is our sincere hope that Congressional leaders on both sides of the aisle act swiftly to advance a bill extending telehealth flexibilities and get it to President Biden’s desk for signature before year-end. We cannot understate the urgency of extending these flexibilities in order to avoid interrupting needed and often life-saving care for millions of patients.”
Alliance for Connected Care
“There are few issues more bipartisan than access to health care through technology. The Alliance worked with the first Trump Administration to enable remote monitoring and then telehealth in the face of a global pandemic and we look forward to working with the incoming Administration and Congress to finally enshrine permanent access to telehealth into statute.”
