As the political landscape has shifted with the 2024 election, health care policies are among the most significant issues that could be upended when the new Trump administration takes control in January. Under President Joe Biden, the Department of Health and Human Services (HHS) finalized several health care rules, that from their perspective, expand access to care, reduce drug costs, and protect vulnerable populations. However, many of these regulations may be on the chopping block come January.
Here’s a closer look at three key Biden health care rules that could be changed with President Donald Trump’s return to office:
The Skilled Nursing Facility (SNF) Staffing Rule
One of the major, and most controversial, health care initiatives from the Biden administration was a push to improve staffing standards in SNFs. The Centers for Medicare and Medicaid Services (CMS) finalized a rule in April 2024 that raised minimum staffing requirements for nursing homes, The rule set higher minimum standards for direct-care staff—such as registered nurses (RNs), licensed practical nurses (LPNs), and nurse aides— including that nursing homes must provide a minimum of 3.5 hours of care per resident per day from certified nurse aides (CNAs), including 0.5 hours from a direct registered nurse (RN). The rule also requires SNFs to have an RN onsite 24 hours a day, seven days a week.
Nursing home associations argued that the increased staffing requirements would lead to higher operational costs and potentially force some facilities to close or reduce services.
With Trump’s returns to office, he may direct his administration to roll back or rescind this rule. Trump’s 1st administration was known pulling back rules that increases operational costs for health care facilities – and this rule fits that category.
Medicare Drug Pricing Negotiations
One of the signature achievements of the Biden administration was the passage of the Inflation Reduction Act (IRA), which included provisions to allow the federal government to negotiate the prices of certain prescription drugs under Medicare. The law empowered Medicare to negotiate prices for a limited set of high-cost drugs. Under the IRA, the government negotiated the price of the ten most expensive drugs to Medicare, and proposed to expand this list further. This policy was touted as a major step to curbing the out-of-control growth of prescription drug costs for America’s seniors and those with disabilities.
However, the incoming Trump administration likely views these reforms as a step too far, potentially undermining free-market principles in the pharmaceutical industry. Trump’s administration previously opposed similar drug pricing negotiations. HHS, under Trump, could push to dismantle the provisions of the IRA, either by defunding the program, limiting its scope, or repealing the law entirely.
ACA Coverage for Dreamers
One of the more controversial aspects of the Biden administration’s health care policies has been its expansion of coverage under the Affordable Care Act (ACA) to include undocumented immigrants brought to the U.S. as children, also known as “Dreamers.” The Biden administration opened up health insurance marketplaces to DACA (Deferred Action for Childhood Arrivals) recipients, allowing them to access subsidies and qualify for Medicaid in some states. The policy was designed to ensure that Dreamers, many of whom are essential workers, have access to affordable health care.
Even with a lot of support from immigrant advocates, this policy has been the subject of heated debate. Critics argue that it represents a costly expansion of government programs that could incentivize illegal immigration and further strain public health resources. The Trump administration will almost certainly reverse this policy, pushing to end ACA coverage for Dreamers and restoring stricter immigration-related requirements for health insurance. Given Trump’s stance on immigration during his first term, a rollback of health coverage access for undocumented immigrants would likely be a priority.
You can be sure we are closely tracking all the incoming policy decisions of the Trump Administration. With health care being one of the most important and personal issues to millions of Americans, the policies adopted in the coming years will continue to shape the future of health care in the U.S.