Immigration, the economy, and the candidate's personality dominated the presidential election that former President Donald Trump won in a landslide yesterday. Medical issues remained largely in the background, except for abortion and a few remarks by Robert F. Kennedy Jr. on fluoridation during his final weekend.
Drew Altman, president and CEO of KFF, said in mid-October, “There is no discussion of major health care reform that would attract national attention, and there are no major health care proposals from either candidate.'' “This is not a 'medical election,'” he wrote.
But now that Trump has won and Republicans have gained a majority in the Senate (the fate of the House remains in doubt), we will explore how the new administration will reorganize federal health care policy and programs and improve public health priorities and public health outcomes. Attention is now focused on ways to reconsider long-standing rules regarding priorities. policy.
The future of the Obama administration's signature achievement, the Affordable Care Act (ACA), and the Biden administration's signature healthcare achievement, the Inflation Control Act (IRA), is now more uncertain than it was during the Harris administration. , this may not be as true for IRAs as it is for ACAs. One issue on the horizon is the enhancement of the ACA premium subsidy, which has significantly reduced premium costs for individual insurance purchased on ACA exchanges. Congress must decide whether to continue them next year. forever
In the final weeks of the campaign, Republican House Speaker Mike Johnson appeared to be in favor of replacing the ACA during an exchange at a campaign event. In an interview a few days later, he said it was a misunderstanding. “We are focused on improving health care, as we are in every sector. We need better quality care in many parts of the country, we need more access, we need lower costs. We need them,” Johnson said.
Johnson, R-Louisiana, cited the Republican Physicians Association as a source of health care ideas. In the current Congress, the caucus is made up of 16 Republican doctors, pharmacists, and dentists, and is chaired by Rep. Andrew Harris, Maryland's only Republican and an obstetric anesthesiologist. .
In the Senate, Sen. Bill Cassidy, a gastroenterologist, is expected to play a key role in enacting the health care law. He will become chairman of the Committee on Health, Education, Labor, and Pensions (HELP), a position currently held by Sen. Bernie Sanders, an independent progressive from Vermont.
Lindsay Beeler Greenleaf, JD, MBA, vice president of ADVI Health and an expert on state and federal health policy, said in an interview today that Republicans have moved on from completely repealing the ACA. “It’s so ingrained,” she said. But she anticipates cuts to federal spending on the program, including cuts to premium subsidies and more flexible benefit designs.
Cassidy and Harris' influence on the Trump administration's ACA changes may pale in comparison to Kennedy's disruptive and high-profile role, if Trump follows through on his campaign promises. . “I'm going to let him rant about health. I'm going to let him go crazy about food,” Trump said of Kennedy at a rally at Madison Square Garden on Oct. 27. Ta.
In a video call with supporters early last week, Kennedy promised that Trump would “take control of the public health agencies (HHS and its subdivisions, CDC, FDA, NIH, and several other agencies) and the Department of Agriculture.” He said he did. Trump campaign officials objected to Kennedy's promises and cabinet positions.
In a town hall-style interview on the cable television network's NewsNation Town Hall, President Kennedy said President Trump has called for a “reorganization” of federal agencies involved in human health, including the CDC, NIH and FDA. . Some agencies of the USDA. ”
Regardless of his exact role, Kennedy appears to be positioned as a high-profile figure in the Trump administration. Kennedy said in a NewsNation town hall that Trump will root out corruption, end conflicts of interest and “return these institutions to a rich tradition of gold standards, empirical, evidence-based science.” “We have called for a visible reduction in chronic problems,” he said. Children will be sick within two years. ”
“I think it's a hot topic that deserves attention,” Greenleaf said of Kennedy's role in the administration. The relationship between Trump and Kennedy is new, and one that medical interest groups and policy experts are still trying to figure out. Even having a role in Kennedy's presidency could be important, she noted, although holding a position that requires Senate confirmation may be out of the question. She said Mr. Kennedy could be appointed to head a commission or commission that would investigate the causes of chronic disease, especially in children.
Kennedy endorsed Trump in August after canceling his own independent bid for the presidency, announcing his “Make America Healthy Again” campaign, which mimics Trump's “Make America Great Again” slogan and movement. (MAHA) campaign. Kennedy says on MAHA's website that the goal is to remove the influence of the pharmaceutical industry from public health agencies, ban food additives, and change policies to reduce ultra-processed foods. The website sells items such as $35 embroidered baseball caps that say “Make America Healthy Again.”
On November 2nd, President Kennedy caused a stir with a social media post reviving public water fluoridation as a controversial issue. On the first day of the Trump administration, the White House will advise the United States. Kennedy wrote that he has installed a water system to remove fluoride from public water supplies. “Fluoride is an industrial waste product linked to arthritis, bone fractures, bone cancer, lower IQ, neurodevelopmental disorders, and thyroid disease,” his post reads.
Public health and dental organizations have championed fluoridation as important for oral health.
Federal Group's Patrick Cooney, who has decades of experience as a lobbyist in Washington, D.C., and as a Congressional staffer earlier in his career, has seen power swing back and forth between Democrats and Republicans in several elections. He pointed out that there was. Cooney said the 2024 results highlight that “the public continues to want significant economic changes that impact their daily lives.”
“Over the next few months, the new Trump administration and the 119th Congress will continue to navigate governance business,” Cooney said. It will happen,” he said. Problems will come. ”
