A number of weeks back I looked at what was known and could be divined about Kamala Harris’ health policy. Today, with the election getting close (less than 70 days out), it’s an opportune time to look at Donald Trump’s likely health policy positions. The Harris post is available here: https://rhislop3.com/2024/07/23/kamala-harris-likely-health-policy/
Both candidates have shared limited details about their health policies with neither candidate producing any position papers yet or posting position details on their respective websites. The GOP convention shed no new light on health policy. The upcoming Democrat convention promises no details from the Harris camp or the party. As Harris has been part of a governing administration, there is a bit more detail available, assuming she moves forward with Biden policy positions.
What we know from Trump’s positions is fundamentally, where he was between 2016 and 2020. Nothing right now, new or illustrative has come forward. The Trump campaign has not released the customary policy papers typically expected from presidential candidates, and his public statements often lack clarity and specificity.
Both Trump and Harris have been totally silent on Medicare or Medicaid reforms, instead pledging to not change benefit eligibility or program structures. Sadly, as both programs, especially Medicare, hurtle toward collapse or implosion, structural change is required and should be, a big part of an overall economic plan.
The Affordable Care Act: A hallmark position from the Trump’s 2016 campaign was a repeal of the ACA or Affordable Care Act. His Administration never produced plans to do so, and Congressional support was lacking. Instead, the Trump administration ceased payments to ACA insurers that were meant to offset the cost of providing reduced cost-sharing for low-income patients. President Trump predicted this would lead to the end of Obamacare. However, insurers countered by raising premiums, which subsequently led to an increase in federal premium subsidies and higher costs for the federal government.
President Trump’s 2020 budget proposals encompassed plans to transform the Affordable Care Act into a block grant for states, limit federal Medicaid funding, and permit states to ease the ACA’s protections for individuals with preexisting conditions. Had Congress sanctioned these plans, they would have slashed federal health care funding by over $1 trillion within ten years. What is Trumpcare? | Health Care Reform | JAMA Forum Archive | JAMA Network
Abortion and Reproductive Health: Trump faces a political dichotomy on this issue and in turn, he’s tried to take a King Solomon approach. On one hand, he openly takes credit for ending Rowe v. Wade via his Supreme Court judicial appointments. Not wanting however, to back any federal position that may further agitate pro-abortion voters (some legal freedoms similar to Rowe v. Wade), Trump’s policy has become a nebulous, “let the states decide”.
Comments he has made regarding state laws with significant restrictions suggest that he is not in favor of complete bans, but some forward position defined as a ban after so many weeks. Again, this would parallel most Rowe v Wade policies. Trump has said he would “sit down with both sides and I’d negotiate something.”
Prescription Drug Prices: While Trump has frequently criticized the high cost of prescription drugs, targeting both the pharmaceutical industry and pharmacy benefit managers for their roles in pricing, his previous administration did little to change the price landscape. The Trump administration established a demonstration program that limited monthly insulin co-pays to $35 for some Medicare recipients.
Toward the end of his term, the US Centers for Medicare & Medicaid Services announced a rule linking Medicare payments for certain physician-administered drugs to the prices in other countries, which was subsequently halted by the judiciary. Additionally, the Trump administration set forth regulations that would allow states to import less expensive drugs from Canada. Any further details are unknown other than Trump has said that he “will tell big pharma that we will only pay the best price they offer to foreign nations.”
Medical Freedom: Trump scored a legislative win for certain elements of the Republican Party signing into law the “Right to Try Act” The Act aimed to simplify the process for terminally ill patients to access drugs or treatments not yet approved by the FDA. However, the number of patients who have successfully obtained treatment under this law remains unclear, as the FDA has historically approved “compassionate use” requests for drugs pending approval. The law does not tackle the challenge of persuading drug companies to provide medicines that are under trial and may be limited in supply.
