Congressional Healthcare Reform Priorities Under Trump’s Second Term

Republicans are likely to pursue ACA repeal and replacement, focusing on market-driven solutions and increased state flexibility12.

Medicaid reform may include block grants to states and increased flexibility in program management12.

Price transparency initiatives are expected to be expanded and strengthened through legislation23.

Medicare Advantage plans may see a more favorable regulatory environment, potentially becoming the default enrollment option for new Medicare beneficiaries2.

Drug pricing reform could involve reinstating the Most Favored Nation model and potentially modifying parts of the Inflation Reduction Act3.

Value-based care models may be expanded, focusing on population health management and risk-sharing arrangements2.

The 340B Drug Pricing Program is likely to face increased scrutiny and potential reforms2.

Site-neutral payment policies may be expanded to reduce costs and encourage care delivery in lower-cost settings2.

Changes to ACA subsidies and Medicaid expansion could impact employer-sponsored health insurance and individual market dynamics4.

Efforts to strengthen health savings accounts (HSAs) and health reimbursement arrangements (HRAs) are anticipated3.

Sources:

1. https://www.commonwealthfund.org/sites/default/files/documents/_mediafilespublicationsissuebrief2016sep1903saltzmantrumphltcarereformproposalsib_v2.pdf

2. https://www.forvismazars.us/forsights/2024/11/2024-election-implications-healthcare-organizations-health-policy

3. https://jamanetwork.com/journals/jama-health-forum/fullarticle/2825024

4. https://www.wtwco.com/en-us/insights/2025/01/9-federal-health-policies-that-may-change-with-new-administration