President Trump’s Remarks on Healthcare in the State of the Union

Though he was largely expected to step away from remarks on healthcare in his State of the Union address on Tuesday, President Trump made several remarks regarding his administration’s plans in 2018, which give us some insight into potential actions the administration may take this year.

Trump took the opportunity to declare his success in repealing the individual mandate, stating the GOP “repealed the core of the disastrous Obamacare.” The individual mandate is slated to be eliminated in 2019 under the new tax bill passed in December. More importantly than touting this success, however, was what was missing from the speech. The President made no mention of a renewed effort to repeal and replace Obamacare, meaning it’s possible the remaining aspects of the law such as the Medicaid expansion and tax credits will be safe from another repeal by reconciliation attempt this year.

President Trump also addressed the opioid crisis, citing the 64,000 Americans who died from opioid overdoses in 2016 alone. However, the administration already declared a state of emergency in 2017, with little to show in accomplishment or a potential pathway forward. Trump stated his commitment to get tougher on drug dealers, meaning we will most likely see tougher enforcement actions promoted by his administration. Trump did mention helping people get treatment they need as part of his agenda, however, no clear policy was outlined as to how the administration plans to move forward with the opioid crisis. As the emergency declaration was extended, and with the appointment of new Health and Human Services (HHS) Secretary Alex Azar, we could see some of Trump’s opioid commission recommendations be put forward, but we will first need to see some legitimate funding allocated for the epidemic.

Finally, Trump also focused on drug prices, vowing to bring costs down dramatically in 2018. Again, with no clear policies outlined, we will likely see a continuation of lowering prices through the Food and Drug Administration (FDA) approval of more generic drugs and medical devices. HHS Secretary Azar did state that tackling drug costs would be a drug priority, so this is definitely an area to watch in 2018. One area ripe for change in particular is how HHS decides to proceed with its Request for Information on the application of manufacturer rebates and pharmacy concessions to drug prices at the point of sale. Given that this would have a minimal effect on drug companies, and with Azar at the helm, this could very well be a new policy effectuated for 2019.

 

 

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