2025 – A year of Changes

As this year comes to a close, we find ourselves getting ready for the holidays, after hopefully spending time with our families during Thanksgiving. We may even be looking forward to the new year, thinking of resolutions that we need to make. I’m a big fan of looking forward, a wise man once said, “you can’t plow a straight furrow if you’re looking behind you.” I also know that Patrick Henry said, in his “give me liberty or give me death” speech, “I have but one lamp by which my feet are guided, and that is the lamp of experience. I know of no way of judging the future but by the past.” So here I am trying to decide what the end of the year blog(s) should be focused on, and, since I’m a fan of compromise, I decided to stay true to both of these words of wisdom and do two blogs, one looking back to how our healthcare was changed in 2025 and one looking forward to what we might expect in 2026.

I’ve written 48 blogs so far this year, and if you read all of them you should get some sort of award! They covered all sorts of things that impacted our healthcare - proposed and enacted legislation, changes in rules and guidance by federal health agencies, new Presidential Executive Orders and tariffs, even actions taken by different states. It seems that there are many different government entities that have their hands on the levers that control the healthcare for older Americans and how these levers are manipulated have an impact on all or, more often, certain groups of us. The election of a new President, especially one of a different party than his predecessor, has added to the number and impact of proposed and implemented changes to our healthcare.

I think it’s important to step back and discuss some themes that presented themselves as the new administration took over. The biggest was the Make America Healthy Again (MAHA) movement. It was based on the premise that Americans eat unhealthy food and are exposed to unhealthy chemicals. I think most people believed the basic premise was correct, I certainly did. I haven’t written a blog yet on MAHA because there hasn’t very much that has happened on this front yet. The President spent one minute talking about it in his State of the Union speech and I talked a little bit about it in my blog on his address to Congress, but the Administration seems to be picking up momentum on this theme. Another topic in his State of the Union speech was that the government was bloated and needed to be streamlined. This is another point that I think is correct. Many haven’t been too pleased, however, with the manner that it was done. Remember the Department of Government Efficiency (DOGE) and Elon Musk? Those were turbulent times and I’ve argued throughout the year that it seemed we were throwing the baby out with the bath water. I wrote periodically about these cuts, and they continue, not so much from DOGE, but from the heads of the different government health departments - HHS, CMS, CDC, and FDA. Time will tell how these cuts will affect our healthcare.

Another area that the President has focused on is tariffs. Now you wouldn’t think that tariffs would have that big an impact on our healthcare, but there are three areas where they have. First, there has been national security concerns with sourcing raw ingredients from foreign countries. Certain tariffs and restrictions have been put on some countries, primarily China, to try to regulate and reduce our dependence on nations that aren’t deemed to be our allies. This has already caused some shortages. Second, closely related to this is, the President’s desire to bring manufacturing back to the U.S. The threat of tariffs has caused some drug manufacturers to make significant pledges to move some production back to America. The downside is that it will take several years to develop these new manufacturing capabilities.

The President issued an Executive Order that said that the drug manufacturers needed to propose ways that they would lower the price of some drugs in the U.S. to match those in some foreign countries. It’s a complicated issue and it might help to read my earlier blog on this subject. There has been some movement in this area, and a few drug manufacturers have committed to lowering some prices. All the details of these agreements have not been revealed but the President has rescinded some tariffs. Again, this could also result in some shortages, we’ll just have to wait and see.

The One Big Beautiful Bill (OBBB) was passed and, as I wrote in this blog, the biggest impact was Medicaid cuts. Those cuts will be felt next year as the states try to fill the void in their individual Medicaid budgets.

I do want to mention the Administration’s and the head of HHS’s stance on vaccines. There have already been changes to the recommendations - and even to who will sit on the Advisory Committee on Immunization Practices (ACIP). I believe that 2025 has seen a reduction in the trust of the government entities that make healthcare recommendations and especially at the ACIP. As I wrote here, I think vaccines are safe and save lives. I hope we don’t let the white noise and sound bites drown out the medical facts about how important and safe vaccines are.

Lastly, one big thing that will happen very quickly, either in the next few weeks or at the beginning of next year, is the decision on whether the ACA’s enhanced premium tax credits will be continued or will expire. These subsidies will not affect those in Medicare, but it could impact our kids and grandkids. If they are allowed to expire it would raise the ACA premiums of 22 million people significantly. We will keep you informed as this plays out.

This year has been a roller coaster for changes in our healthcare. Some effects won’t be felt until next year or beyond, but the legislation, rules and Executive Orders have been implemented and 2026 is shaping up to be another wild ride. I’ll try to predict what next year will look like in my blog coming out on December 29th.

Best, Thair