The recent election of Donald Trump as President-elect is expected to have significant implications for the U.S. healthcare system. With Republicans in control of both the House of Representatives and the Senate, they are likely to pursue their agenda with fewer obstacles. This could result in disruptions for households relying on Medicaid or Affordable Care Act (ACA) marketplace plans, as Trump and Republican lawmakers aim to implement reforms that may redirect federal funds to other priorities, such as tax cuts.
Currently, the uninsured rate in the U.S. is at its lowest in history, standing at just under 8%. However, experts warn that this figure is likely to rise again as the incoming administration seeks changes that could undermine the progress made in expanding health coverage. Trump"s potential appointment of Robert F. Kennedy Jr. to lead the Department of Health and Human Services could further influence health policy, given Kennedy"s controversial views on vaccines and healthcare reform.
One immediate concern for consumers is the future of enhanced subsidies under the ACA, which are set to expire at the end of 2025. These subsidies have significantly reduced the cost of health insurance for many individuals and families. However, experts express skepticism about the likelihood of these subsidies being renewed, which could result in approximately 3.8 million people losing their health insurance. This raises concerns about affordability and access to healthcare, with potential higher premiums for those who manage to retain coverage.
Medicaid is also likely to face budget cuts as the Trump administration seeks to finance its broader policy agenda. With Trump promising not to cut Social Security and Medicare, Medicaid becomes a potential target for revenue generation. Experts predict that cuts to Medicaid could lead to fewer households receiving benefits, disproportionately affecting lower-income families, individuals with disabilities, and seniors in nursing homes. Proposed changes to Medicaid could include work requirements for recipients, capping federal spending allocated to states, or converting Medicaid into a block grant system.
During Trump"s previous administration, there was an increase in the availability of non-ACA compliant health insurance options, such as short-term plans. These plans, which offer limited coverage and often exclude pre-existing conditions, may see a resurgence as the new administration promotes their marketing and sale. While proponents argue that these plans provide lower premiums, they come with substantial limitations that can leave individuals vulnerable to high out-of-pocket expenses.
The Trump administration"s stance on drug pricing remains uncertain, particularly in light of the Inflation Reduction Act signed into law by President Biden in 2022. This legislation introduced reforms aimed at lowering prescription drug costs, including allowing the federal government to negotiate prices for certain medications covered by Medicare. The potential rollback of these reforms could have consequences for patients, especially those relying on costly medications. The fate of these critical reforms hangs in the balance as the new administration formulates its healthcare strategy.