Here are few links on Trump Administration and health policy:
- Fierce Healthcare: Where do Harris and Trump stand on health policy?
- Here.
- STAT: Donald Trump returns with big ambitions to shake up health care.
- NPR on Trump health policy, November 6.
- Here.
- HealthCareDive - How health industry reacts, November 7.
- Here.
- Healthcare Finance - What election means; November 7.
- Here.
- BioPharma Dive - Biotech, Trump, FTC may relax on mergers, etc.
- Here.
- NYTimes - What could Trump do to Obamacare?
- Here.
- Speaker Mike Johnson, who would likely continue in his role in a Republican majority, said that his caucus would seek “massive reform”[of ACA].
- The Guardian [UK]: Trump's queasy prescription to 'make America health again' takes shape.
- Here.
- WSJ reviews Trump economics more generally - e.g. the balance of pro's and con's re tariffs, tax cuts, potential inflation, etc.
- Here.
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Court Postures
One topic not mentioned above that could affect a few issues is how the Trump administration fights, or doesn't fight, the government side of some legal battles. For example, from the Obama to Trump to Biden administration, there were several 180 degree flip flops on whether to include "transgender" under the heading of "sex discrimination." ANother grand flip flop was from MCIT (Medicare Coverage for Innovative Technology) to TCET (Transitional Coverage for Emerging Technology) between Trump 2020 and Biden 2021.
Current legal cases include Braidwood v Becerra, where the moving party would like to eliminate USPTF recommendations as requirements for preventive services, an issue it is up to the government to defend in the way it chooses. Similarly the government could opt to take one of various responses to the FDA LDT litigation being pushed forward by ACLA.
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Leadership Nominations
Leadership of HHS, CMS, FDA, etc., will be up for grabs, and we may not know more until mid-spring.
My blog of January 25, 2017, just after the inauguration, contained several then-contemporary links to news report about Dr. Shiong-Soon (a biotech billionaire who owns the LA Times) and potential positions in the administration.
Returns?
One senior health policy executive in the Trump administration is Joe Grogan, who has remained active and public on health policy topics. E.g., he was interviewed at length on a second Trump administration in Stat Plus on October 16. He was one of just three Trump administration interviewed in a panel at the IOP (Institute of Politics) on October 15. See also his 30-minute interview on health policy at Andreessen-Horowitz (January 2024). He's also been outspoken on drug pricing policy and innovation (here). Another active figure in the Trump HHS was Eric Hargan, deputy secretary and acting secretary. See Hargan Group / Hargan Strategies.
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Executive Order 13957 & Schedule F
The fact we have a huge government employee apparatus, with just a tiny cap of rotating and politically appointed positions, has been recognized for many decades (see "Government of Strangers," 1977.) In the last days before the 2020 election, the Trump administration issued Executive Order 13957, which created a new Schedule F for exempted federal jobs when they had policy-making potential. Large numbers of mid-level and mid-career employees shifted to Schedule F would be much easier to replace for politics or performance. A roll-out calendar was given, through CY2021, but the plan was halted by a Biden executive order on January 22, 2021.
Much was written about this. There's a detailed, vintage-2022, 60-page GAO report on the topic here.
If rebooted in January 2025, the E.O. for Scedule F would take most of a year to implement (if kept in its original form and timeline). Schedule F seemed to have some overlap with existing Schedule C and exemptions for senior-level scientific jobs (here).
See 13957 at Wikipedia here. A November 2024 second-look at 13597 at Fedscoop, here.
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The Guardian article cites some "Project 2025" policies that the Trump campaign disavowed.
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AI Corner
This is a Chat GPT summary of recent health policy news. There are many different ways to summarize this news, and I only offer this as "if of interest" or "FYI."
Chat GPT 4o:
The recent election of Donald Trump for a second presidential term is anticipated to impact U.S. healthcare policy, with significant shifts in areas like Medicaid, telehealth, and Medicare Advantage. Industry experts foresee a continuation of Trump's earlier priorities, focusing on healthcare cost reduction, deregulation, and possibly more market-driven reforms.
Healthcare Legislation and Data Privacy: Trump's administration, supported by a Republican-majority Senate, is likely to fast-track changes in AI and cybersecurity regulations within healthcare. HIMSS, a major health information group, anticipates new policies aimed at interoperability and data-sharing, which were pivotal in the previous administration. Telehealth, expanded during the COVID-19 pandemic, could see a legislative push to make its benefits permanent, while maintaining remote patient monitoring services.
Medicare Advantage and Pharma: Stocks in Medicare Advantage insurers surged post-election, as expectations rise for a friendlier regulatory environment. Pharma representatives, like PhRMA’s Stephen J. Ubl, are optimistic about partnering with the administration to reduce regulatory constraints on drug innovation. Trump’s previous policies included initiatives aimed at lowering drug costs by tackling pharmacy benefit manager (PBM) practices, which could continue in his new term.
Medicaid and the ACA: Medicaid could face restrictions, with possible reintroductions of work requirements and spending caps through block grants, potentially limiting coverage. The ACA may remain, but Trump’s administration could scale back financial supports, such as enhanced subsidies, which were recently extended. Experts predict this would likely result in premium increases and a potential rise in uninsured rates.
Public Health and Health Agencies: Trump’s focus on lowering healthcare costs may extend to public health reforms, with Robert F. Kennedy Jr., a known vaccine skeptic, positioned to influence regulatory approaches. This could potentially shift long-standing public health policies and introduce more scrutiny on vaccine mandates.
Overall, Trump’s healthcare agenda seems aimed at reducing federal spending and emphasizing free-market principles, with potential effects across Medicare, Medicaid, and public health sectors. Industry stakeholders, including hospital and pharmaceutical groups, have expressed both optimism and caution as they prepare for possible regulatory changes that could reshape healthcare delivery and access in the coming years. [END CHAT GPT]