With a new U.S. president taking office, along with a shift in both houses of Congress, business owners are wondering if they’ll get some relief from burdensome health care insurance costs – or if premiums will spiral even higher. We asked some experts to weigh in on the question.
Unlike some previous election years, health care “was not a big issue in the debates,” observed Joel Cantor, director of the Rutgers Center for State Health Policy. “But we can look to the past as a prelude to what we can expect from a second Trump administration.”
The last time he held office, Donald Trump “was one vote away from repealing the Affordable Care Act,” said Cantor. “So, it’s likely that he will, at the very least, seek to reduce funding for subsidies in the ACA coverage exchanges and make other changes likely to undermine affordability and market stability in the exchanges.”
ACA subsidies were significantly increased during the pandemic, but those enhancements are set to expire at the end of 2025.
Some 4 million people would likely lose coverage if the subsidies expire, according to a 2017 report by the Congressional Budget Office. But that same report also estimated that if the ACA mandate had been repealed [at the end of 2017] it would reduce federal deficits by about $338 billion through 2027.
Cantor, though, fears that Trump’s policies could drive increases in health care insurance premiums for everyone. “In recent years, a big driver of health care cost increases has been M&A activity among hospitals,” he said. “Biden was a strong enforcer of antitrust laws, but I don’t think that’s likely under Trump. More M&A among hospitals means more monopoly power, which is likely to lift costs for employers and individuals. And although Trump has said he is in favor of re-importing drugs from lower-cost countries like Canada, he also wants to slap more tariffs on imports, which could lead to cost increases on drug and medical equipment imports.”
Cantor also believes Trump’s decision to nominate Robert F. Kennedy Jr. to lead the federal Department of Health and Human Services could further drive-up costs. “RFK Jr.’s opposition to vaccine mandates and fluoride in our water could lead to more illness, greater hospital use, and could lead to dental issues with children,” he said. “This could lead to even higher health care costs.”