What to Expect from a Trump Presidency in Public Health

by Jon Scaccia November 13, 2024

As Donald Trump prepares for his second term as President, public health experts are assessing the potential impact of his proposed policies on healthcare access and delivery across the United States. Although healthcare was not a central focus of his campaign, Trump has made several promises and statements that suggest a shift in how the government might address key health issues. Here’s what we might expect from his presidency in terms of public health policies.

Reproductive Health and Abortion Rights

Trump’s stance on reproductive health is likely to reflect a conservative approach. He has reiterated his opposition to a federal abortion ban, emphasizing that abortion policy should be determined at the state level. Additionally, he has shown support for in-vitro fertilization (IVF), indicating a potential push for broader insurance coverage, although the high costs associated with IVF raise questions about implementation. Any movement on IVF coverage would likely require a careful examination of insurance mechanisms and funding sources to avoid placing a burden on individuals or insurers.

Affordable Care Act Adjustments

While Trump and his team have expressed no plans to eliminate the Affordable Care Act (ACA), they have suggested reorganizing it. The administration may explore reforms aimed at increasing options for younger, healthier individuals while likely reducing support for high-cost coverage options that benefit older adults and those with chronic conditions. Experts warn this could create disparities, where certain groups face higher premiums, leading to reduced access for lower-income individuals. Moreover, the administration’s potential removal of tax credits for low-income patients could jeopardize coverage for millions.

Gender-Affirming Care and LGBTQ+ Policies

Trump has promised executive actions to limit gender-affirming care, especially for minors, which may have implications for mental health and healthcare access among transgender individuals. Restricting federal funding for institutions providing gender-affirming care could lead some patients to seek unsafe alternatives, potentially worsening health outcomes. Such policies could reduce the availability of medically approved treatments for gender dysphoria, a concern that public health advocates have raised in terms of safety and mental health impacts.

Federal Health Agency Reforms

Trump has hinted at a desire to “clean up” federal health agencies like the CDC and NIH, a task he seems interested in assigning to Robert F. Kennedy Jr. Known for his controversial [backward?] views on vaccines and chronic disease, Kennedy’s leadership could lead to restructuring federal health bodies. While Trump’s team aims for increased transparency and “gold-standard science,” experts remain cautious about the potential impacts on research funding and the integrity of scientific work within these agencies. Ensuring stability and core funding will be essential to maintaining public trust and research efficacy.

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