TL/DR –
During his first term, President-elect Trump aimed to repeal the Affordable Care Act (ACA) but now plans to improve it and reduce costs. Robert F. Kennedy Jr., an environmental attorney known for fighting vaccine mandates, has been chosen to lead the Department of Health and Human Services. The health care industry continues dealing with the U.S. Supreme Court’s ruling in Loper Bright Enterprises v. Raimondo, which overturned a 40-year-old precedent and has significantly impacted administrative law interpretation and the legislative branch, posing challenges for efforts to replace existing regulations.
Trump’s Shift in Health Care Focus
President-elect Trump, who initially aimed at repealing the Affordable Care Act (ACA), now projects a plan to enhance and reduce costs of the ACA.
Key Highlights
- The extended enhanced marketplace subsidies from the 2021 American Rescue Plan Act and the 2022 Inflation Reduction Act will expire by end of 2025, potentially increasing premiums in 2026.
- The health care industry faces challenges with the Supreme Court’s landmark decision in Loper Bright Enterprises v. Raimondo, reversing the 40-year-old “Chevron deference” principle.
Environmental attorney, Robert F. Kennedy Jr., known for opposing vaccine mandates via his nonprofit, Children’s Heath Defense, has been named by Trump to head the Department of Health and Human Services (HHS).
Uncertain Future for Health Care Industry
While the healthcare industry’s future remains vague, changes in healthcare policy are expected under the Trump administration. These include the appointment of Kennedy to lead HHS, deregulation initiatives, and the impact of the Supreme Court’s Loper Bright Enterprises v. Raimondo decision and the ACA.
Public Health Changes Under Kennedy
If confirmed as the nation’s top public health authority, Kennedy, who would oversee 13 agencies, intends to focus on transparency and chronic diseases, marking a shift from infectious diseases. Additional Trump nominations include Dr. Mehmet Oz for Centers for Medicare and Medicaid Services, Dr. Dave Weldon for the CDC, Dr. Marty Makary for the FDA, and Dr. Janette Nesheiwat as U.S. surgeon general.
Effects of SCOTUS’ Loper Bright Decision and Deregulation
The Supreme Court’s Loper Bright Enterprises v. Raimondo decision, which overthrows the “Chevron deference,” significantly changes administrative law interpretation. This may influence both the incoming Trump administration and the legislature. As a result, federal agencies may face challenges when attempting to replace existing statutes with those supporting their agenda.
The Trump administration is expected to focus on deregulation, primarily in public health and anticipated rollbacks on Biden-era policies. These include the HIPAA Privacy Rule to Support Reproductive Health Care Privacy and the updated nondiscrimination rules under Section 1557 of the ACA.
The ACA’s Future
Despite unsuccessful attempts to repeal the ACA during his first term, Trump has now suggested plans to enhance the ACA and lessen costs. Focus will need to be on the ACA marketplace subsidies, due to expire at the end of 2025, possibly causing a sharp increase in premiums in 2026.
The following analysis is part of a broader examination of the anticipated challenges and opportunities created by the changes in administration.
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