An analyst has warned of likely instability in the US’ healthcare systems following the election of Donald Trump as the country’s President, in particular pointing to the possible appointment of anti-vaccine advocate Robert F. Kennedy Jr (RFK) to oversee health within the administration and changes to the Affordable Care Act (ACA).
GlobalData pharmaceuticals analyst Cyrus Fran commented: “During his first term, Trump attempted but failed to repeal ACA but he may consider revisiting it. However, in his 2024 campaign, he stated he would not pursue an ACA repeal in his second term, opting instead to propose an alternative plan – details of which remain unclear.
“Over the past four years, the ACA has gained widespread support under the Biden Administration, and any restructuring could significantly impact millions of Americans. Medicaid may also face changes, as Trump previously proposed adding work requirements; however, he has not addressed this during his recent campaign.”
ACA – often referred to as ‘Obamacare’ – provides subsidies to the 20 million Americans who rely on private health insurance. Under President Biden, enhanced subsidies were passed as part of the American Rescue Plan Act (ARPA) in March 2021, but these are set to expire in 2025. Currently, Trump has not indicated any intention to extend them.
Trump’s likely appointment of former Democrat RFK within healthcare has also raised eyebrows. He has suggested that RFK will be given the authority to carry out his plan to “make America healthy again.”
While the details of that plan are yet to emerge, it is likely to constitute significant changes for regulatory bodies in the US, hinted at in a tweet posted in October when RFK warned: “If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Preserve your records, and 2. Pack your bags.”
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Fan explained: “Appointing RFK the position as health secretary may have damaging implications for the US healthcare. Given his anti-vaccine rhetoric and negative comments towards the FDA, it raises questions for the future of US drug approvals and the FDA’s regulatory power.
“In addition, dismantling the Centres of Disease Control and Prevention (CDC) and other health agencies could jeopardize US public health and slow down all the work made during the Biden Administration. This includes addressing the opioid epidemic and the Cancer Moonshot program.”
Concerns about RFK’s historical attitude towards US healthcare issues have been exacerbated by Trump’s insinuation that he would give him free rein. In his victory speech on Wednesday (6 November), Trump said of RFK: “He wants to do some things, and we’re going to let him go to it. I just said, ‘But Bobby, leave the oil to me … Bobby, stay away from the liquid gold. Other than that, go have a good time, Bobby’.”
Despite concerns, there could be some positives for the pharmaceutical sector, including lower drug prices. Trump’s previous proposal to lower costs through international reference pricing appears to have gone quiet, but it has been suggested that he may seek to target other areas of the pharmaceutical industry, such as pharmacy benefit managers (PBMs), which have featured as a recent topic of interest for Republican lawmakers.
Fan concluded: “Trump provided limited details on healthcare policy during his 2024 campaign, leaving experts to speculate on potential changes in 2025. Many Americans may fear that their healthcare coverage through the ACA or Medicaid could be at risk. For the pharmaceutical industry, Trump appears less focused on imposing reforms this term, although he has expressed an interest in introducing drug cost-reduction measures – albeit less aggressively than the proposals by Democratic nominee Kamala Harris.”
