A second Donald Trump presidency could mean significant changes to health care.
On the campaign trail, President-elect Trump has touched on a variety of health care issues. But so far, he has provided few details on what he might do on several major issues in health care.
The Atlanta Journal-Constitution searched for his direct statements on these issues and spoke with local physicians and experts to get their reaction to what he proposes to do.
A greater focus on addressing chronic illness
Conservatives in Congress have proposed budget cuts for the Centers for Disease Control and Prevention to eliminate programs they say are not key to the agency’s mission of fighting infectious diseases.
The CDC’s failures during the COVID-19 pandemic, such as inadequate testing and flawed communication, are partly attributed to its lack of focus on infectious disease outbreaks, “having been distracted by its expanded mission,” said Joel Zinberg, a former health policy adviser in the first Trump administration. He cowrote a policy paper last year with Drew Keyes — senior policy adviser to House Speaker Mike Johnson (R-La.) — for the Paragon Health Institute and the Competitive Enterprise Institute, conservative think tanks.
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Noncommunicable disease programs, such as those for environmental issues and violence prevention, should be moved to other health agencies, they argue.
Meanwhile, eight former CDC directors who served in Democratic and Republican administrations warned in a recent letter published in STAT that restricting the agency’s efforts to only infectious diseases would cost lives and make little sense. The agency’s tobacco control program, for example, protects millions of people from addiction and cuts the need for expensive smoking-related medical care for lung disease, cancer, strokes and heart attacks, the former directors said.
Daniele Fallin, dean of the Rollins School of Public Health at Emory University, said it’s “definitely too early” to know how health priorities will be impacted by Trump’s administration. But she defended the role of the CDC to prevent, prepare and control chronic and noncommunicable diseases.
“The more that we work to prepare for and prevent diseases, the less we spend on them economically, emotionally and otherwise down the road,” she said. “So the broad mandate of the CDC, in addition to directly addressing health, is economically wise.”
Vaccine overload?
According to The New York Times, Mr. Trump has said at dozens of rallies this year, “I will not give one penny to any school that has a vaccine mandate or a mask mandate.”
It’s a line his campaign said was only referring to COVID vaccine requirements but that has not eased fears that his administration might discourage recommended vaccinations for children and adults. Trump has repeatedly said at campaign rallies that he wants to bring Robert F. Kennedy Jr. in as a health adviser, although he has not announced a cabinet position for Kennedy. Kennedy has been public about what he says are health threats posed by vaccines.
During a New York City campaign event last month, Trump said if he were to become the 47th president he would let Kennedy become more involved. “I’m going to let him go wild on health. I am going to let him go wild on food. I am going to let him go wild on medicine.”
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After Trump’s win, Kennedy said in an interview Wednesday with NBC News that he won’t take away people’s vaccines.
“If vaccines are working for somebody, I’m not going to take them away,” he said. “People ought to have choice, and that choice ought to be informed by the best information. So I’m going to make sure scientific safety studies and efficacy are out there and people can make individual assessments about whether that product is going to be good for them.”
Like other states, Georgia relies on the CDC for guidance on which vaccines should be given to children and when and on recommended adult vaccines. The Food and Drug Administration evaluates vaccines for safety.
The Affordable Care Act in Georgia
At the ABC News presidential debate in September, Trump said he was interested in replacing the Affordable Care Act, also known as “Obamacare.”
“Obamacare was lousy health care. Always was,” Trump said. “It’s not very good today and, what I said, that if we come up with something, we are working on things, we’re going to do it and we’re going to replace it.”
The ACA makes premiums affordable for a broad range of people by subsidizing the cost of their health insurance according to their income level. The program also requires insurers to provide basic types of coverage, including for drugs and preexisting conditions.
Trump said he had “concepts of a plan” to replace the ACA but provided no details.
“If we can come up with a plan that’s going to cost our people, our population, less money and be better health care than Obamacare, then I would absolutely do it,” Trump said during the debate.
Ariel Hart
Ariel Hart
About 1.3 million Georgians currently buy health insurance coverage through the Affordable Care Act.
Gov. Brian Kemp worked with the first Trump administration on an attempt to loosen the ACA’s rules for Georgia insurance shoppers. But under the Biden administration, new enrollment skyrocketed as additional or enhanced subsidies made the plans even more affordable. Kemp did not have an immediate comment on how Trump’s second term in office might impact the state’s ACA offerings.
Next year Congress must take action to renew the existing level of financial aid for Americans who buy their health plans through the ACA, or allow it to expire.
Tax relief for caregivers
President-elect Donald Trump has said he wants to help families address the financial burden of caregiving.
At an Oct. 27 Madison Square Garden appearance, Trump said, “I’m announcing a new policy today that I will support a tax credit for family caregivers who take care of a parent or a loved one. It’s about time that they were recognized, right?”
An estimated 41 million family caregivers in the United States provided 34 billion hours of unpaid care to adult loved ones in 2017, according to AARP’s 2019 “Valuing the Invaluable” report.
About 226,000 Georgia families are providing care for a loved one with developmental disabilities, and the Georgia Council on Developmental Disabilities has a long waiting list for services. There are roughly 374,000 caregivers for people in Georgia with Alzheimer’s disease or dementia
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Although help from Washington would be welcome, it’s hard to say exactly what that might look like because Trump’s proposal has had few details. A tax credit would allow caregivers who qualify to reduce their tax bill.
With the staggering costs of health care, “almost any kind of financial help is needed,” said Leslie Tripp Holland, a spokeswoman for the Georgia Chapter of the Alzheimer’s Association. “It can bankrupt a family.”
According to a statement from D’Arcy Robb, the Georgia Council on Development Disabilities executive director: “Over 7,000 people, the majority of whom have aged out of K-12 education, are on a list waiting for waiver services (in Georgia). It is common for caregivers to curtail their careers or even exit the workforce altogether, which can put the whole family in financial peril.”
Robb said the council and families welcome Trump’s interest in supporting caregivers and urge him and his team to go further into this issue, “so that all Georgians with developmental disabilities and their families have the support they need to live and thrive in their communities.”
