The future of U.S. healthcare could see some big changes under a unified Republican government. With President-elect Donald Trump returning for a second, non-consecutive term and Republicans holding majorities in both the House and Senate, healthcare reform is high on the agenda.
For years, Republicans have promised to repeal Obamacare. But after their failed attempt back in 2017, it’s unlikely they’ll try again, especially with such a narrow majority in the House this time. In fact, the GOP only has a slim edge of 220-215 after upcoming special elections. So, sweeping changes are probably off the table.
Instead of going after Obamacare entirely, Trump and his Republican allies are likely to tweak the law, using agencies like the FDA and CDC to make adjustments in other areas. One area of focus could be Medicaid funding. Since Medicaid expansion has proven expensive, Republicans are considering changes to reduce the federal government’s burden, particularly for higher-income adults without children.
There’s also talk of allowing Obamacare subsidies to cover health plans that don’t fully align with the law. The idea is to offer younger, healthier people cheaper plans that have lower premiums but also offer less coverage. Another possibility is boosting health savings accounts (HSAs). These accounts allow individuals with high-deductible plans to set aside money for medical expenses, tax-free.
Expanding HSAs has potential for bipartisan support. The Bipartisan HSA Improvement Act of 2023, co-sponsored by Rep. Lloyd Smucker (R-PA) and retired Rep. Earl Blumenauer (D-OR), would let people roll over funds from flexible spending accounts and health reimbursement accounts into HSAs. The HSA Modernization Act could also double contribution limits, making it easier to save for future healthcare expenses.
And yes, short-term health plans are likely to make a comeback. Under the Trump administration, these plans could last up to three years, whereas President Biden’s administration limited them to four months. Critics of Biden’s rule argue that short-term plans offer a more affordable option, even if they don’t meet all of Obamacare’s requirements. These plans are designed for temporary coverage, like when someone is between jobs, and aren’t meant to be long-term solutions.
Despite these changes, it’s important to know that they won’t come without opposition. Democrats, who now hold the minority in both the House and Senate, will likely block any new healthcare legislation. This means Trump will likely rely on executive orders and smaller tweaks to Obamacare and other Biden-era policies to push his agenda forward.
While major healthcare reform may be unlikely, expect some changes on the horizon. It’s going to be a tough fight, but Trump and the Republicans will certainly try to make it happen.
