As a consumer-focused health information technology company dedicated to empowering individuals to access their healthcare data using Artificial Intelligence, we will refrain from commenting on specific market segments. Our mission is to benefit consumers, but given the magnitude of the national healthcare crisis, we will focus on broader policy implications. Stay tuned for more insights on Healthcare AI in our upcoming blog.
The recent election has brought President-Elect Trump back into office, securing 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 implement its agenda with greater decisiveness. As a result, healthcare policy is expected to undergo significant shifts.
Policy Landscape and Initial Actions
Congress is anticipated to align with Trump’s policy goals, though potential filibuster challenges in the Senate could slow progress. Executive orders could have a direct impact on healthcare and other sectors as early as January 20, 2025. Advisors such as Elon Musk and Robert F. Kennedy Jr. could play influential roles in shaping healthcare policy, particularly around transparency, regulatory reform, and technological innovation.
Healthcare Expectations and Regulatory Adjustments
- Tax Cuts and Healthcare Subsidies
An extension of the 2017 tax cuts is expected, with implications for healthcare policies, including potential Medicaid reforms. With the Affordable Care Act (ACA) subsidies set to expire in 2025, Trump may look to extend these with modifications. The administration may also review provisions in the 21st Century Cures Act and the Inflation Reduction Act, focusing on drug pricing reforms and necessary mandates. Additionally, a potential tax credit for home caregivers could be considered to support long-term care at home. - Regulatory Relief for Providers and Insurers
A rollback of regulations affecting healthcare providers and insurers is likely, aimed at reducing administrative burdens. Changes to Medicare Advantage plans— which have led to higher costs and reduced benefits for beneficiaries—could be reassessed. The Trump administration is expected to review regulations affecting long-term care, lab testing, and technology mandates, which often benefit technology companies over providers. - Flexibility in Benefit Design
Expect more flexibility in benefit structures, such as expanded gap benefits and enhanced health savings accounts (HSAs). Medicaid waivers are likely to be a focus, and there may be an expansion of Medicaid in non-expansion states, potentially coupled with work requirements. - Value-Based Care and Price Transparency
Value-based care initiatives are expected to continue, with the potential for acceleration through increased flexibility for insurers and providers. Hospital price transparency will likely become a key priority, with facilities potentially required to provide more upfront pricing information. - Drug Pricing and Regulatory Agency Changes
While the Inflation Reduction Act’s provisions on drug pricing may remain intact, modifications and potential expansions are likely. With the influence of Robert F. Kennedy Jr., we could see significant restructuring within agencies like the FDA, CDC, and NIH, with an emphasis on faster approval processes and greater efficiency in drug development and regulation. - Hospital Site-Neutral Payments and Medicare Physician Payments
Reforms aimed at site-neutral payments—ensuring equitable reimbursement across different care settings—are likely to move forward. The Trump administration will also need to address a 2.9% cut to Medicare physician payments scheduled for 2025, which could become a key issue in future negotiations to prevent further reductions.
A Trump 2.0 administration is poised to pursue bold healthcare policy changes, including tax reforms, regulatory rollbacks, and enhancements to Medicaid and Medicare structures. With the backing of Congress, we could see significant shifts in drug pricing, provider reimbursements, and the continued evolution of value-based care models. These changes will likely reshape the healthcare landscape, with far-reaching consequences for providers, insurers, and patients alike.
-Noel J. Guillama, Chairman