10 Health Policy Options for the Incoming Trump Administration

Howdy folks. With the second (non-consecutive) Trump administration taking office in a few days and Congress providing rumblings of one big reconciliation bill to rule them all, Danny and I sat down to talk about the health policies we’d like to see adopted.

Ten health policies to adopt in 2025:

1. Allow the Temporary Expanded Premium Tax Credits to Expire at the End of 2025.

2. Make High-Deductible Plans on the ACA Marketplaces Exchanges HSA-Eligible

3. Remove the ACA Restriction on New Physician-Owned Hospitals

4. Allow HSAs to Pay for Direct Primary Care Memberships

5. Bring Back Short-Term Limited Duration Plans

6. Bring Back Association Health Plans and Make Them Stick This Time

7. Direct CMS to Vastly Expand Permissions via 1115 and 1332 State Waivers

8. Revise Federal Medicaid Cost-Sharing Amounts for the ACA Expansion Population

9. Walk Back the Inflation Reduction Act’s Direct Negotiations on Prescription Drug Prices

10. Embrace Medicare Site-Neutral Payments

I also threw out a few later-down-the-line big picture ideas:

1. Give states an incentive to drop their CON laws if they still have them

2. Restructure Medicaid FMAP percentages

3. Restructure GME payments to increase the number of residency slots

4. Create Individual Health Accounts so that more people have dedicated savings set aside for health care expenses

Time Stamps for the Episode

[3:30] - Allow the temporary expansion of federal premium subsidies for ACA enrollees up above 400 percent of the federal poverty line to expire at the end of 2025

[5:39] - Danny’s dog Chesterton says hello

[10:48] - Make high-deductible health plans on the ACA exchanges eligible for HSAs by granting an exemption for their maximum allowable out-of-pocket limits

[15:54] - Allow new physician-owned hospitals by removing ACA-imposed limitation

[17:24] - Allow HSA dollars to be used to pay for Direct Primary Care memberships

[18:40] - Bring back short-term limited duration plans

[19:36] - Revise and improve previous push to allow greater use of Association Health Plans (AHPs)

[21:30] - Expand state access to Section 1115 and 1332 waivers

[25:01] - Revise Medicaid cost-sharing amounts for the ACA expansion population (able bodied adults without dependents - ABAWDS)

[20:06] - Revisit drug price negotiations put in place by the Inflation Reduction Act

[30:49] - Site neutral payments in Medicare

[31:54] - Out there idea: Incentivize states to drop their CON laws with the promise of temporary boosts to FMAP payments

[33:24] - Long-term idea: Restructure Medicaid FMAP percentages

[34:56] - Restructure GME payments to increase the number of residency slots

[37:42] - Create Individual Health Accounts, our clever idea to get more people to have dedicated savings for health care expenses

[38:42] - Veto of the week: “I return without my approval House bill No. 1471, entitled ‘An act increasing the pension of Andrew J. Hill.’”

[39:51] - Send us your feedback or policy questions by emailing feedback@584vetoes.com or finding me on Twitter @TomVChurch