State of the Union – State of Healthcare Uncertainty

The President’s State of the Union address to the country was long, 1 hour and 48 minutes long, but he only spent about 5 minutes on healthcare. However, in those 5 minutes, he did focus on three main topics - criticizing the Affordable Care Act (ACA), praising his administration’s drug-pricing initiatives and calling on the Congress to codify his Most Favored Nation (MFN) pricing policy.

What he didn’t touch on were the recent cuts and delays to health research funding, the controversial changes to vaccine recommendations, the downsizing of HHS, and the steep cuts to Medicaid in the One Big Beautiful Bill Act (OBBBA) passed last summer. It seems to me that many of the things he didn’t mention will have, or already have had, an impact on our healthcare. When you reduce health research funding, you reduce the chance for life changing or lifesaving scientific breakthroughs. Not to mention, the number of people getting vaccinated for measles and Hepatitis B has already gone down and many states are starting to wrestle with how to handle reduced Medicaid funding. I found it strange that these impactful decisions weren’t discussed.

He did take the time to criticize the ACA - he labeled it a rip-off and said it really didn’t make healthcare more affordable. His criticism of the ACA is certainly not new, but his party’s willingness to let the generous ACA COVID era subsidies expire is grabbing headlines and becoming an issue in the upcoming mid-term elections. The President did point to his Great Healthcare Plan which he released in January as a solution. Unfortunately, the lack of detail enveloped the plan in a cloud of uncertainty. However, it did offer one way to lessen the impact of the reduced subsidies – redirect money straight to consumers. There are still a lot of questions about how this would work and if it would be enough to help people afford proper coverage. We will keep you updated.

During the speech, the President also took the opportunity to praise his price cutting initiatives. One of these was the continued support for the drug price fixing aspects of the Inflation Reduction Act (IRA). When it passed in 2022, this bill only had two Republicans vote for it in the House, garnered no Republican support in the Senate, and it was vilified by President Trump. The law continues to freeze innovation through its price fixing scheme, and I had hoped the President would have found a way by now to lessen these negative impacts. He did highlight a new direct-to-consumer website, TrumpRx.gov, which he promised would offer lower drug prices. This website would be especially helpful for those who don’t have insurance, people with high deductibles (which this year has increased in number), and those whose plans don’t cover certain drugs, like the latest weight‑loss medications.

Finally, and most concerning, is the President’s call to codify his efforts to enact his Most Favored Nation (MFN) policies. He uses the word codify as a call for Congress to turn his varied MFN efforts into law. I released a statement right after the President’s address that focused on the dangerous aspects of turning the MFN policies into law. It outlines some of the pitfalls of this approach. I would like to go into a little more detail about why codifying this approach won’t work. Putting this approach into long term law would leave little room for undoing the terrible parts of MFN discussed in my statement. Another indicator of how this approach is bad for seniors is the fact that the Americans for Tax Reform (ATR) authored a letter signed by more than 50 organizational leaders urging Members of Congress to oppose codification. I think this is significant. Some naysayers would say that businesses and organizations would be against codifying the MFN for selfish monetary reasons, but they couldn’t deny that ATR, and those that signed the letter, would be doing it solely to highlight the harm it would do to the citizens of our country. I would hope that our lawmakers sit up and take notice of this fact.

While the State of the Union offered 5 minutes of uncertain healthcare approaches, it also offered some ideas that would give you and me more control over our healthcare costs and more choices that would fit our own specific needs. Additionally, it proposed cementing the terrible aspects of the MFN pricing approach into law, a move that would deter innovation, ration access to care, and have little impact on our final cost. Even those outside of the normal players in this arena can see the harm turning this mistake into law would have on all of us. The fight to make the right decisions is not over. We’ll keep you up to date on where things are headed and what each of us can do to make our voices heard.

Best, Thair