As a consumer-focused health information technology company working on empowering consumers to access their data using Artificial Intelligence, we will refrain from commenting on our segment. Our company is designed to benefit consumers, but the healthcare issue is a national crisis so we will only share our opinion on the broad issues. More on Healthcare AI in our next blog.
The recent election has placed President-Elect Trump back in office, achieving a Republican popular vote victory for the first time in 20 years. With expanded control in the U.S. Senate and a hold on the House of Representatives, the Trump administration is positioned to act decisively. Healthcare is likely to see considerable policy shifts.
Policy Landscape and Initial Actions
Congress is expected to align with Trump’s agenda, aside from potential filibuster issues in the Senate. Anticipated executive orders could impact healthcare and other sectors as early as January 20, 2025. Influential advisors, such as Elon Musk and Robert F. Kennedy Jr., could steer policy toward increased transparency, regulatory reform, and technological advancement in healthcare.
Healthcare Expectations and Regulatory Adjustments
Tax Cuts and Healthcare Subsidies
Extension of the 2017 tax cuts is anticipated, potentially affecting healthcare provisions, including Medicaid reform. With ACA subsidies set to expire in 2025, Trump may look to extend these with modifications. Additional initiatives may include reviewing the 21st Century Cures Act and the Inflation Reduction Act, specifically targeting drug pricing reform and necessary mandates. A potential tax credit for home caregivers may also be considered to support long-term care at home.
Regulatory Relief for Providers and Insurers
Significant regulatory rollback is likely, aiming to reduce administrative burdens on providers and insurers. Medicare Advantage plan changes, which have resulted in increased costs and reduced benefits for beneficiaries, may be reassessed. The Trump administration is expected to review recent healthcare regulations, including those affecting long-term care, lab testing, and technology mandates, the latter disproportionately benefit technology companies over providers.
Flexibility in Benefit Design
Trump’s administration may introduce more flexibility in benefit structures, expanding gap benefits and enhancing health savings accounts. Medicaid waivers are likely to gain attention, with a possible expansion of Medicaid in non-expansion states that could include work requirements.
Value-Based Care and Price Transparency
Value-based care initiatives will likely continue, with potential acceleration through increased flexibility for insurers and providers. Hospital price transparency could become a priority, requiring facilities to provide more upfront pricing information.
Drug Pricing and Regulatory Agency Changes
While the Inflation Reduction Act’s provisions on drug pricing may remain, modifications and possible expansions are expected. With Kennedy’s influence, we could see rapid restructuring in agencies like the FDA, CDC, and NIH, emphasizing faster approvals and greater efficiency.
Hospital Site-Neutral Payments and Medicare Physician Payments
Site-neutral payment reforms may advance, creating more equitable reimbursement across care settings. Medicare physician payments are set for a 2.9% cut in 2025, a critical issue needing a permanent solution to prevent further annual reductions.
A Trump 2.0 administration is poised to aggressively pursue healthcare policy changes, including tax reforms, regulatory rollbacks, and enhancements to Medicaid and Medicare structures. With the backing of Congress, significant shifts in drug pricing, provider reimbursements, and value-based care could reshape the healthcare landscape, impacting providers, insurers, and patients alike.
Noel J. Guillama-Álvarez
Chairman of the Board
OXIO Health, Inc.
