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How Trump can affect health

Online Niel November 13, 2024

Unlike immigration and the economy, health care has not been a major issue for Donald Trump during his 2024 campaign.

Still, experts say many health-related policies he has touched on at rallies, town halls and media interviews in recent months could reshape the U.S. public health system.

That’s if the new administration can figure out how to implement them, said Stephanie Kennan, a former member of Congress who has worked on health policy for more than 25 years.

“There are a lot of ideas,” said Kennan, senior vice president of federal public affairs at McGuireWoods Consulting. But she said none had “gelled” or been “resolved”.

Here are some of his proposed policies and how they could affect Americans over the next four years.

Reproductive health: abortion, in vitro fertilization

Although Trump frequently mentions his role in overturning Roe v. Wade, the president-elect has said he does not support a federal ban on abortion.

“Everyone knows that I would not under any circumstances support a federal ban on abortion, and in fact would veto it, because it is up to the states to decide based on the will of their voters (the will of the people!)” wrote on X, ex Twitter, on October 1st.

Trump has tried to distance himself from Project 2025, a policy model published by the Heritage Foundationa conservative think tank. The document says the Food and Drug Administration should revoke its approval of mifepristone, the drug used in nearly two-thirds of U.S. abortions. In AugustTrump said he would not rule out removing access.

Trump also said X social media platform that his administration will be “very good for women and their reproductive rights.”

He promised to protect in vitro fertilization, or IVF, a medical procedure that helps people with fertility problems.

During interviews, Trump made the reference a February ruling by the Alabama Supreme Court that said embryos created during IVF are “extrauterine children” and must be legally protected like any other child. The ruling sparked panic among families and institutions across the country, with some of them temporarily halting IVF procedures for fear of the implications of the decision.

At a town hall with Fox News moderator Harris Faulkner addressing women, Trump said he was the “parent of IVF” and wanted public and private insurance to cover the medical procedure.

But IVF is very expensive, Kennan said. While it would be nice to relieve families of this financial burden, which can cost up to $30,000 per test, the administration should answer two important questions: Who would pay for it and how?

“Someone’s going to have to cover it,” she said. Promising coverage is “a strange statement to make if you understand anything about insurance.”

The Affordable Care Act

Republicans have said they have no plans to eliminate the Affordable Care Act and would only change it if they could improve it to reduce costs and improve coverage.

“There are a lot of parts of the Affordable Care Act that the American public is quite positive about,” said Carri Chan, professor and faculty director of the Nursing and Pharmaceutical Management program at Columbia Business School.

Vice President Kamala Harris said during her only televised debate with Trump in September that she plans to protect the ACA. Trump said he has no specific policies for replacing it, but has “concepts about a plan.”

A few days later, in an interview with NBC NewsSenator JD Vance, Trump’s vice president-elect, said the new administration plans to reorganize the program based on individual health needs.

“We want to make sure everybody is covered,” he told NBC’s Kristen Welker. “But the best way to do that is to actually promote more choice in our health care system and not have a one-size-fits-all approach that puts a lot of people in the same insurance pools.”

That could mean cheaper options for healthy young people, experts say. But it could also mean more expensive plans for seniors and those with chronic illnesses.

The administration also may not renew the tax credit that helps low-income patients afford premiums, which may force some people to drop coverage, Keenan said.

The Affordable Care Act “is so embedded in our system now that it would be very difficult to completely rip it out and replace it,” she said. But the Trump administration can “spin out of it.”

Transgender, nonbinary health, and gender-affirming care

In the days leading up to the election, the Trump team released a series of ads attacking Harris for her support of the transgender community.

“Kamala backs taxpayer-funded sex changes for prisoners”, one of the mentioned ads. “Kamala is for them/them. President Trump is for you.”

The official platform of the 2024 Republican Party vowed to stop “taxpayer-funded schools from promoting gender transition,” under a section titled “Republicans Will End Left-Wing Gender Insanity.”

In a speech in SeptemberTrump has promised to issue an executive order instructing federal agencies to stop “promoting gender transition.” He said he would institute a ban on sex-affirming minors’ care and keep federal funding from health care facilities that violated it. would restore “Trump’s ban on transgenders in the military.”

On the topic of abortion access, there are laws in place that prevent federal dollars from funding abortions, according to Kennan, so extending that rule to gender-affirming care wouldn’t be a stretch.

However, Kennan worries about the mental health impact for people diagnosed with gender dysphoria, which is the distress caused by a mismatch between a person’s gender identity and the sex they were assigned at birth. Treatment plans for gender dysphoria typically include changes in gender expression and role, hormone therapy, surgery, and behavioral therapy. according to the Mayo Clinic.

Kennan said she’s also concerned about what will happen to patients without access to safe gender-affirming care who might try unproven alternative methods.

People could seek hormone therapy from disreputable sources and “get hurt because the substances aren’t what they’re supposed to be,” she said.

RFK Jr. wants to make America healthy again

Robert F. Kennedy Jr., a 2024 presidential candidate who still appears on some ballots even though he dropped out of the race in August, told supporters that Trump “promised” he would put him in charge of the agencies of public health.

Howard Lutnick, co-chair of Trump’s transition team, said in an interview with CNN that Kennedy would not have a job at the Department of Health and Human Services.

“That’s not what he wants to do. … He just wants data,” he told CNN’s Kaitlan Collins last week.

But Trump suggested in his victory speech that Kennedy might have a broader role than overseeing data collection.

“It will help make America healthy again. … He wants to do some things and we’re going to let him go at it,” Trump said at 2:30 a.m. Wednesday from his home state of Florida. “Go and have fun, Bobby.”

Kennedy has earned a reputation for criticizing vaccines and raising questionable claims about the origins of the COVID-19 virus. However, Kennedy said in an interview with NBC News On Wednesday he won’t “take anyone’s shots”.

Instead, Trump instructed him to “clean up the corruption” in federal health agencies — returning them to “standard science” — and “make America healthy again” by ending chronic disease.

Republican lawmakers have discussed the potential for restructuring federal health agencies such as the Centers for Disease Control and Prevention and the National Institutes of Health, according to media reports. Experts hope that any restructuring will not affect research.

“The devil will always be in the details,” said Chan, of Columbia Business School. “My hope is that in the restructuring there will still be core funding.”

Adrianna Rodriguez can be reached at [email protected].