Three Major Health Care Policy Issues to Watch in 2025
Stat News / By John Wilkerson
WASHINGTON — Health care did not play a big role in the election that’s sending President Trump back to the White House and giving Republicans control of Congress. That doesn’t mean Congress will avoid the topic next year.
Trump mostly avoided talking about health care during his 2024 campaign, a contrast from 2016, when he ran on the promise of repealing and replacing the Affordable Care Act. But he did promise to “not cut one penny” from Medicare, and he said he’d give prominent vaccine critic Robert F. Kennedy Jr., now his pick to run the Department of Health and Human Services, broad rein to reshape health care.
However, Trump did promise to extend individual tax cuts that Republicans passed in 2017 and that are set to expire at the end of next year. He also wants to further cut corporate tax rates.
That tax plan would significantly increase the already ballooning deficit, so Republicans will likely need to rely on health care policy changes to help offset it, according to three former government health care officials, all of whom ran the agency overseeing Medicare and Medicaid.
“It was not a health care election,” said Nancy-Ann Min DeParle, who ran the Obama White House Office of Health Reform. “But no, health care will not take a back seat.”
DeParle, Mark McClellan, and Tom Scully spoke at an American Bar Association conference on Dec. 9. Here are the major policy issues they expect to surface next year.
Medicaid cuts
DeParle predicted that Republicans will target Medicaid for cuts because Trump has promised not to cut spending for Medicare, Social Security, and defense,leaving Medicaid as one of the only big programs to pay for tax cuts. DeParle ran Medicare during the Clinton administration and is now a partner at the private equity firm Consonance Capital Partners, which she cofounded.
Medicaid is especially vulnerable because Republicans control the White House and both chambers of Congress. That enables them to avoid the Senate filibuster by using a budget process that requires only a simple majority to pass.
Federal Medicaid spending increased significantly under the Biden administration as enrollment in the health insurance program for the poor swelled, thanks to pandemic-era legislation that prohibited states from disenrolling people. Enrollment began falling after states were allowed to trim their rolls last year.
Republicans are expected to pursue policies, such as work requirements and capped Medicaid funding levels, that could further reduce enrollment…
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