Brace for Impact: Trump's Next Moves in Healthcare

Emily Green-Conrad
Written By Emily Green

The Trump administration's return to the White House signals a period of potentially transformative shifts in U.S. healthcare policy, focusing on substantial deregulation, aggressive cost-reduction measures, and a restructuring of key federal healthcare programs. Among the top policy priorities are the potential expiration of ACA subsidies that currently support millions of Americans, anticipated adjustments to Medicare and Medicaid funding models aimed at privatization and cost containment, and the implementation of broad tariffs that could disrupt healthcare supply chains and increase costs for providers and patients alike. Additionally, the recent announcement of Robert F. Kennedy Jr. as Secretary of Health and Human Services (HHS) nominee highlight a dramatic shift in the administration’s vision for public health. The following analysis delves into these anticipated policy shifts, drawing on recent political reporting and insights to provide a comprehensive look at how these changes may shape the healthcare landscape and impact industry stakeholders.

Robert F. Kennedy Jr. as Secretary of HHS 

President-elect Trump’s selection of Robert F. Kennedy Jr., a vaccine skeptic and longtime critic of pharmaceutical companies, as HHS Secretary has sparked significant debate. If confirmed, Kennedy will oversee critical health agencies such as the FDA, CDC, NIH, and CMS, with a combined budget of over $1 trillion. His views often clash with mainstream science, particularly on vaccines, fluoride, and chronic disease management.

Kennedy has publicly criticized vaccine safety, claiming a lack of robust studies, though he denies being anti-vaccine. He has also proposed removing fluoride from public water systems and banning food additives prevalent in U.S. products but outlawed in Europe. His focus includes reducing the influence of pharmaceutical and food industries on public health, with promises of a sweeping overhaul of federal health agencies.

While these proposals resonate with a segment of voters who distrust large corporations, they have raised concerns among public health experts about potential disruptions to established health programs. Kennedy’s intent to fire hundreds of agency staff deemed “compromised by corporate interests” signals a contentious path forward. It remains uncertain how his leadership will balance regulatory reform with evidence-based public health practices.

Affordable Care Act (ACA) and Marketplace Subsidies

Expiration of Enhanced ACA Subsidies

Enhanced ACA subsidies, introduced under the Biden administration’s American Rescue Plan, are set to expire at the end of 2025. Without Congressional renewal, approximately 4 million Americans are projected to lose coverage in 2026 due to an inability to afford rising premiums. These subsidies, which have increased ACA enrollment to record highs, currently support over 20 million enrollees, with an outsized impact on middle-income Americans, especially those in rural states where premium costs are higher. The expiration would affect not only individual financial security but also healthcare providers, as higher uninsured rates increase patient medical debt and decrease financial stability for hospitals.

Potential Modifications to the ACA

While Trump has shifted from seeking a full repeal of the ACA, his administration has indicated interest in making technical modifications aimed at reducing costs. Trump has publicly expressed his desire to make the ACA “better” by lowering premiums and enhancing competition in ACA marketplaces, although specific plans remain limited. This strategy aligns with the administration’s deregulatory goals but may create political friction within the GOP, especially from conservative factions that continue to push for a full repeal or more comprehensive restructuring. Read more here.

Pre-existing Conditions and High-Risk Pools

Vice President-elect JD Vance has suggested reintroducing high-risk insurance pools as a method to cover individuals with pre-existing conditions. This model could lower premiums for healthier enrollees by segmenting risk, but it would increase premium costs significantly for those with chronic health conditions. Vance’s approach may appeal to conservative GOP members focused on reducing ACA costs but could face strong opposition from moderate Republicans and healthcare advocacy groups concerned about patient affordability. 

Medicare and Medicaid Adjustments

Shift Toward Medicare Advantage

The Trump administration has expressed a clear preference for Medicare Advantage, a privatized form of Medicare administered by commercial insurers. This shift aligns with its broader goal of streamlining costs while promoting market-driven solutions. By incentivizing Medicare Advantage enrollment, the administration aimsto make it the default option for seniors. While this approach may reduce federal expenditures in the short term, it raises concerns about limiting patient access to out-of-network providers and transferring additional financial burdens onto enrollees. Many lawmakers, especially those representing districts with substantial Medicare populations, have voiced bipartisan concerns over the potential loss of patient choice and accessibility.

Adding to the controversy, President Trump’s nomination of Dr. Mehmet Oz to oversee the Centers for Medicare and Medicaid Services (CMS) further underscores the administration’s intent to shake up the healthcare landscape. In a statement announcing his choice, Trump said Oz will “cut waste and fraud within our Country’s most expensive Government Agency, which is a third of our Nation’s Healthcare spend, and a quarter of our entire National Budget.” 

Dr. Oz’s background as a heart surgeon and his prominence as a television personality have drawn attention, with supporters citing his ability to communicate health priorities effectively. However, critics highlight his history of controversial medical advice and question his qualifications for managing a program with a $1.7 trillion budget. Dr. Oz’s potential policies may deepen resistance from healthcare providers worried about cuts to traditional Medicare reimbursements and from patient advocates concerned about maintaining equitable care access.

Medicaid Block Grants and Work Requirements

Returning to Medicaid block grants and reintroducing work requirements represents a core GOP strategy to decentralize Medicaid control, giving states more latitude in determining eligibility criteria. Trump’s administration has indicated that tying Medicaid eligibility to employment or volunteer hours will be a priority, and such policies would directly affect nearly 80 million Americans who rely on Medicaid. States with large low-income populations may face higher uninsured rates as a result. Republican governors may support these changes, but opposition is likely from Democratic-led states and advocacy groups who argue these measures will disproportionately impact vulnerable communities.

Reproductive Health and Public Health Initiatives

Abortion Access and FDA Oversight

Trump has pledged not to sign a federal abortion ban but may use FDA oversight to restrict access to abortion medications, particularly regarding the mailing of abortion pills. Reversing FDA guidance established under the Biden administration could limit abortion access for women in rural and underserved areas who rely on mail-order services. This potential policy shift could lead to legal battles and bipartisan debate, particularly as Senate and House members from both parties advocate for women’s healthcare rights. The administration may face resistance in courts and from state-level policymakers, which could limit the scope and impact of any such FDA-based restrictions.

Healthcare and Trade Policies

Tariffs and Healthcare Supply Chains

Trump’s planned tariffs, which include a 20% across-the-board tariff on imports, could significantly raise costs in the healthcare industry, impacting hospitals, medical device suppliers, and pharmaceutical companies. Industry leaders warn that these tariffs would exacerbate already high inflation and labor costs, potentially leading to service cutbacks and increased patient costs. Congress may see bipartisan advocacy from healthcare representatives and industry lobbyists pushing for exemptions on critical medical supplies. Such tariff policies may also face resistance from trade-focused committees, who are concerned about supply chain disruptions in essential healthcare goods.

Tariff Impact on Pharmaceuticals and Medical Devices

Specifically, the healthcare sector has voiced concerns about tariffs on pharmaceuticals and medical devices. Hospitals and health systems have arguedthat these tariffs could lead to reduced access to affordable medications and essential devices. Trade associations are advocating for medical supply exemptions to prevent patient care disruptions, a position that has garnered support from some bipartisan members of Congress who view healthcare as an exception within broader trade policies. The administration’s stance on these exemptions may impact Congressional action and could lead to further negotiations with trade policy committees to mitigate financial strain on the healthcare sector.

Conclusion

The Trump administration’s policies indicate a return to a deregulatory, cost-reduction-focused approach, impacting ACA subsidies, Medicare and Medicaid access, and public health regulations. Additionally, tariffs are expected to impose further cost pressures on the healthcare sector. Navigating these shifts will require active engagement with executive agencies, Congressional leaders, and bipartisan committees to address potential impacts on healthcare access, affordability, and supply chain stability. Regular updates on policy developments, Congressional responses, and agency regulations will be essential as stakeholders adapt to these anticipated changes. Rest assured, Constitution Partners is here to help you navigate this transitional period.

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Emily Green
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