Gregg's Top Four Health Policy Articles: Post-Election Edition

Well, it was a big week and hard to narrow down the health policy news. That said, if you can only read four things about health policy this week, I suggest...

The Top Three...

KFF Health News: Trump’s White House Return Poised To Tangle Health Care Safety Net Former President Donald Trump’s election victory and looming return to the White House will likely bring changes that scale back the nation’s public health insurance programs — increasing the uninsured rate, while imposing new barriers to abortion and other reproductive care. The reverberations will be felt far beyond Washington, D.C., and could include an erosion of the Affordable Care Act’s consumer protections, the imposition of work requirements in Medicaid and funding cuts to the safety net insurance, and challenges to federal agencies that safeguard public health. Abortion restrictions may tighten nationwide with a possible effort to restrict the mailing of abortion medications. (Armour, 11/6)

ABC News: What A 2nd Trump Term May Look Like For Health Care Issues Including ACA, Abortion Donald Trump has been inconsistent on what his plans are regarding the Affordable Care Act (ACA), the landmark law signed in 2010 by then-President Barack Obama. During his first term, Trump tried several times to repeal the ACA but was unsuccessful. In November 2023, he also vowed to replace it in a post on his social media platform, Truth Social. Since then, he has shifted course. In March, Trump said is "not running to terminate" the ACA but said he wanted to make it "better" and "less expensive," in a post on Truth Social. There could also be changes to Medicare, a federal health insurance program for people aged 65 or older and younger people with disabilities. (Kekatos, 11/6)

Roll Call: A Look At Those Who Could Be On Trump’s Health Team Short List President-elect Donald Trump has pledged to involve anti-vaccine activist and conspiracy theorist Robert F. Kennedy Jr. in his next administration in some capacity, but whoever else he picks to run the major health agencies will have a major impact on the GOP health agenda of the next four years. Top posts require Senate confirmation, meaning Trump will need Senate buy-in too. Positions include Health and Human Services secretary, which requires Senate confirmation; Centers for Disease Control and Prevention director, which will require Senate confirmation beginning in January 2025; Food and Drug Administration commissioner and National Institutes of Health director, which also require Senate confirmation. (Cohen, 11/7)

Healthcare Dive: How The Healthcare Industry Is Reacting To A Second Trump Term Major trade associations for the hospital industry congratulated Trump on his win this week, while reiterating their priorities for lawmakers in Washington. Insurer groups were quieter. AHIP, the largest lobby representing payers, told Healthcare Dive it had no statement to share. Other associations, including the Alliance of Community Health Plans, which represents nonprofit insurers, didn’t issue official statements on the election but posted blogs outlining their priorities for the incoming administration. (Pifer, 11/7)

For a Deeper Dive...

The Wall Street Journal: Trump Will Create New Winners And Losers In Healthcare For healthcare companies, Donald Trump’s victory means very different things depending on which part of the sector they operate in. For firms offering plans in the exchanges created by the Affordable Care Act (aka Obamacare), as well as Medicaid plans, it could be bad news. That explains why Oscar Health, which derives most of its business from Obamacare marketplaces, was down 8% Wednesday morning while Centene, a big Medicaid operator, was down 5%. But for businesses operating in Medicare Advantage, the privately run system that mainly serves seniors, a Republican victory is expected to provide major regulatory benefits. (Wainer, 11/6)

The New York Times: Robert F. Kennedy Jr., Foe Of Drug Makers And Regulators, Is Poised To Wield New Power As an independent presidential candidate and as a surrogate for Mr. Trump, Robert F. Kennedy Jr. pledged to upend the nation’s agriculture system and public health bureaucracy, effectively gutting whole swaths of the regulatory state, under the rubric of rooting out “cronyism” and corruption. Some have speculated that Mr. Trump will make him a “health czar” inside the White House, to guide the president on public health matters; a person familiar with the transition said Mr. Kennedy was at Mar-a-Lago on Wednesday and spoke with Trump insiders about the public health agenda. (Stolberg and O'Brien, 11/6)

The New York Times: How Ballot Measures Will Change Abortion Access The 2024 election broke a ballot measure winning streak for abortion rights advocates. Voters in seven states, including Republican-led ones, had previously sided with abortion rights in every contest since the Supreme Court overturned Roe in 2022. Advocates for abortion rights caution that opportunities to protect those rights through ballot measures may be dwindling. Most remaining states with abortion bans do not allow citizen-initiated measures to be placed on the ballot, and their Republican leaders are unlikely to put the issue to voters. (McCann and Schoenfeld Walker, 11/6)

Stat: Who To Know In The 'Make America Healthy Again' Movement MAGA, meet MAHA. The sweeping election victory for President-elect Donald Trump this week also marks the start of an ambitious anti-chronic disease campaign, “Make America Healthy Again,” that has become central to Trump’s health agenda. (Cueto, 11/7)

Common Dreams: Trump's Chief Of Staff Pick Worked As A Tobacco Lobbyist While Running 2024 Campaign Trump's team didn't mention in its announcement that Wiles worked as a lobbyist for the tobacco company Swisher International while running the former president's 2024 bid. Citing disclosure forms filed earlier this year, the investigative outlet Sludge reported Thursday that Wiles "worked to influence Congress on 'FDA regulations.' ""Wiles has not filed a termination report for her work with Swisher, but she has not reported lobbying for the company since the first quarter of the year, when the company paid her firm Mercury Public Affairs $30,000 in fees," Sludge noted. The outlet pointed out that Mercury—which lists Wiles as a co-chair on its website—has "large lobbying contracts with several junk food companies that will be working to oppose" Trump's stated objective to "Make America Healthy Again" by, among other changes, working to remove processed foods from school meals. (Jake Johnson, 11/8)

Bloomberg: UnitedHealth, Humana Soar On Trump Election Victory Donald Trump’s re-election rippled through the health-care landscape as the new administration is expected to pull back on Biden-era measures affecting US health insurers, drug prices and public-health leadership. Insurers focused on the Medicare market jumped on the expectation that the government will pay higher rates to companies that provide private versions of the US health program for seniors. (Tozzi, Mufarech, and Smith, 11/6)

Stat: What Trump's Win Means For Biotech And Pharma With Donald Trump now poised to become U.S. president for the second time in January, biotech and pharmaceutical leaders are preparing for the shift to an administration with a complicated history. Trump has positioned himself as business-friendly, but has criticized “Big Pharma” over high drug costs. During the course of the Covid-19 pandemic, he was supportive of the pharmaceutical industry’s efforts to develop vaccines, but his campaign has more recently embraced vaccine skeptic Robert F. Kennedy Jr. (DeAngelis, Herper, Joseph, Mast and Silverman, 11/6)

BBC Washington: Who Will Win Control Of The House? The Outstanding Races To Watch The party that will control the US House of Representatives for the next two years is not yet decided - but the Republicans look to be inching towards a majority that would hand them full control of the US government. On Friday morning, the party was a handful of seats short of the 218 needed to take control of the lower chamber of Congress. (Looker, 11/8)

The New York Times: Will Trump Have A New Opening To Repeal The ACA? The fact that Republicans have gained control of the Senate — and possibly the House — could give Mr. Trump an opening to try and transform the 2010 health law and remake the nation’s health care system. Key to that strategy, health policy experts said, is simple inaction. Major subsidies that lawmakers approved during President Biden’s term that have lowered the cost of plans are set to expire next year. Republicans could allow them to sunset, a move that could deprive roughly 20 million Americans of extra financial help for coverage on the Affordable Care Act’s marketplaces. (Weiland, 11/7)

Roll Call: A Look At The Health Priorities Of Incoming Senate Democrats Republicans took control of the Senate with Tuesday’s elections, but a handful of new Democrats will also be going to the Senate in January. The tight races between Republican Kari Lake and Democratic Rep. Ruben Gallego in Arizona and between Democrat Jacky Rosen and Republican Sam Brown in Nevada had not yet been called by Thursday evening. Here’s a look at the health care portfolios of incoming Democratic senators so far. (Hellmann, 11/7)

Healthcare Dive: Physicians, Hospitals Decry 2025 Medicare Payment Rates Despite their payments rising, hospitals decried the update as inadequate. Powerful lobby the American Hospital Association argued the rates will make it harder for hospitals to invest in patient care, cybersecurity and their workforce. “Medicare’s sustained and substantial underpayment of hospitals has stretched for almost two decades, and today’s final outpatient rule only worsens this chronic problem,” Ashley Thompson, the AHA’s senior vice president of public policy analysis and development, said in a statement. (Pifer, 11/4)

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CBS News: Taking A Break From Social Media Can Help With Post-Election Emotions, Expert Says
No matter who you voted for, election fallout has many voters still feeling a wide array of emotions, and social media has been busy with many people voicing their opinions on the election results. Social media has transformed politics and how we discuss them. It's where many folks air their political opinion. On days like today, the day after the presidential election, the internet can be a place of rage and resignation. (Guidotti, 11/6)

NEJM: Implication of the 2024 Election Outcomes for US Health Policy. RJ Blendon, JM Benson, NB Le

A few years ago I started a weekly e-mail for friends and colleagues who want to keep up on major federal health policy developments but did not have time to plod through all the minutiae--they were busy doing important things like running organizations and taking care of patients! Much to my surprise, it became pretty popular. I have now converted to a weekly newsletter format so you can manage your own subscription preferences and forward to others that might be interested.

These summaries represent my judgement on health policy issues that may not on the front pages, but are relevant to clinicians, administrators, and educators. I monitor many news sources and clipping services to identify content for this newsletter and I try hard to be as factual, balanced, and non-partisan as possible. While the articles are written by others (with credit attributed), the choice of what to include is entirely mine. If you are interested in receiving a daily summary of health policy news, you might consider signing up for the KHN Morning Briefing. If you enjoy podcasts, I suggest What the Health? and Tradeoffs.

-Gregg S. Margolis, PhD