Former President Donald Trump’s election victory and return to the White House will likely lead to changes that slash the nation’s public health insurance programs — increasing the uninsured rate, imposing new barriers to abortion and other reproductive care.
Repercussions will be felt far beyond Washington, DC, and could include the erosion of consumer protections in the Affordable Care Act, the imposition of Medicaid work requirements and cuts to social security funding and challenges to federal agencies that protect public health. Abortion restrictions could be tightened nationwide with a possible effort to limit the shipment of abortion drugs.
And Robert F. Kennedy Jr. With the rise of a vaccine skeptic to Trump’s inner circle of advisers, public health interventions with rigorous scientific backing — fluoridating the public water supply or inoculating children — could be under fire.
Trump defeated Vice President Kamala Harris by 277 Electoral College votes, the Associated Press reported Wednesday at 5:34 a.m. ET. He won 51 percent of the national vote to Harris’ 47.5 percent, the AP estimated.
Trump’s victory will give a much broader platform to skeptics and critics of health care programs and actions. Worst-case scenario, public health officials worry, the US could see a rise in preventable diseases; undermining public confidence in established science; and discredited ideas — such as the link between vaccines and autism — adopted as policy. said Trump An NBC News interview on Nov. 3 that he would “make a decision” about banning certain vaccines, saying he would consult with Kennedy and calling him “a very talented guy.”
Trump has said he will not try to repeal the Affordable Care Act again, but his administration will immediately decide whether to back an extension of enhanced premium subsidies for Obamacare insurance plans next year. Without improved financial aid, large premium increases it is expected to result in lower enrollment. Current rate without insurance, about 8%it would almost certainly go up.
The specifics of the policy have not gone beyond the “concepts of a plan” Trump said he had in his discussion with Harris, though Vice President JD Vance later said the administration wanted to introduce more competition into the ACA’s marketplaces.
Republicans were expected to claim a majority in the Senate, in addition to the White House, while control of the House was still unresolved early Wednesday.
Surveys show that the ACA has He got support from the citizensincluding provisions such as protecting pre-existing conditions and allowing youth to remain on family health plans until age 26.
Trump supporters and others who have worked in his administration say the former president wants to improve the law in a way that cuts costs. They say he has already shown he will be strong in bringing down high health care prices, and has touted his presidential efforts to pioneer price transparency in medical costs.
“In terms of comfort, I would see it built in the first term,” said Brian Blas, who served as Trump’s health adviser from 2017 to 2019. He said that in terms of a democratic administration, there will be “much more attention”. “decreasing fraud and waste”.
Efforts to undermine the ACA include cutting funding for enrollment disclosures, allowing consumers to buy more health plans that don’t meet ACA consumer protections, and forcing insurers to charge sicker people higher premiums.
Democrats say they expect the worst.
“We know what their agenda is,” said Leslie Dach, executive president of Protect Our Care, a Washington, D.C.-based health policy and advocacy organization. He worked in the Obama administration helping implement the ACA. “They will raise costs for millions of Americans and cut coverage from millions, while subsidizing the rich.”
Theo Merkel, director of the Private Health Reform Initiative at the right-leaning Paragon Health Institute, which Blase leads, said the ACA subsidies extended by the Inflation Reduction Act in 2022 will not improve plans or lower premiums. He said the small value of the plans is papered over with higher government subsidies.
Other Trump supporters say the president-elect should preserve Medicare’s authority to negotiate drug prices, another provision of the IRA. Trump has advocated reducing drug prices, and in 2020 he advanced a testing model that would link the prices of some Medicare drugs to lower overseas costs, said Merkel, who served in Trump’s first White House. The drug industry successfully sued to block the program.
Within Trump’s circles, some names have already been floated as possible heads of the Department of Health and Human Services. They include former Louisiana governor Bobby Jindal and Seema Verma, who led the Centers for Medicare and Medicaid Services in the Trump administration.
Kennedy, who dropped his independent presidential bid and endorsed Trump, has told supporters that Trump promised him control of HHS. Trump said publicly before Election Day that he would give Kennedy a big role in his administration, but he may have difficulty winning confirmation for the Senate cabinet post.
While Trump has vowed to protect Medicare and has said he supports funding home care benefits, he has been less specific about his plans for Medicaid, which provides coverage for lower-income and disabled people. Some health analysts expect the program to be particularly vulnerable to spending cuts, which could finance an extension of tax breaks that expire at the end of next year.
Among the possible changes is the introduction of work requirements for beneficiaries in some states. The administration and Republicans in Congress could try to overhaul the way Medicaid is funded. Now, the federal government pays states a variable percentage of the program’s costs. Conservatives have long sought to limit federal allocations to states, which critics say would lead to draconian cuts.
“Medicaid is going to be a big target in a Trump administration,” said Larry Levitt, executive vice president for health policy at KFF, the nonprofit that compiles KFF Health News.
The potential future of reproductive health rights is unclear.
Trump has said decisions on abortion restrictions should be left up to the states. Thirteen states prohibit abortion with few exceptions, while another 28 restrict the procedure based on the length of pregnancy. According to the Guttmacher Institutea research and policy organization to advance reproductive rights. Trump said before the election that he would not sign a national abortion ban.
State ballot measures to protect abortion rights passed in four states, including Missouri, which Trump won by about 18 points, according to early AP reports. Abortion rights measures were rejected by voters in Florida and South Dakota.
Trump could move to restrict access to abortion drugs used in more than half of abortions, either by withdrawing the FDA’s approval of the drugs or a 19th-century law, the Comstock Act, that abortion opponents say prohibits their delivery. Trump has said he generally would not use the law to ban drugs from being sent through the mail.
