Since the inauguration of Donald Trump as the 45th U.S. president on January 20, 2017, new policies around immigration, trade, energy, and the federal government have been put in place. Although a repeal of the Affordable Care Act (ACA), or Obamacare, took center stage in Trump’s campaigning, no policies directly impacting health have been implemented by his administration, and the fate of health care under Trump is still unknown. To provide a recap of what we do know, we outline what has taken place on the health front in his first two weeks. In addition, based on campaign rhetoric, we outline what a Trump administration will likely mean for digital health moving forward.
A recap of the first 15 days
On the first day of his presidency, President Trump signed an executive order indicating that the administration would seek “the prompt repeal” of the ACA. The order also asked all federal agencies – “to the maximum extent of the law” – to “minimize the economic burden” of the ACA. The impact of this order is still uncertain.
What to expect in the future
Even though Trump has offered few details of his health care proposal, he made a pledge to “come up with a new plan that’s going to be better healthcare for more people at a lesser cost.” This trade-off reinforces the Republican’s party pursuit of a more lightly regulated system that, while more affordable, would cover less than Obamacare (i.e., only catastrophic events would be covered, leading to high copays and deductibles, but lower premiums). Moving forward, this approach means that:
- Policies will provide less support for ongoing and preventative care, at least for poorer consumers. This will likely halt development and adoption of behavior augmentation technologies, such as activity trackers and personalized nutrition solutions, which help consumers change their behavior to remain well. This could ultimately increase the prevalence of lifestyle-dependent diseases like obesity, cardiovascular disease, and diabetes.
- Insurers will face price pressures, to the advantage of technologies that promise to cut costs. This means that it will be easier for cost-saving digital health solutions to get buy-in from these stakeholders, while also creating a bigger push for digital health players to adopt value-based revenue models.
- Food and Drug Administration (FDA) approval process will be relaxed, potentially shortening time to market for some products. In addition, a more relaxed FDA approval process may mean that we will see more technologies from adjacent industries (consumer, industrial, military), such as consumer stress and fatigue management solutions, and artificial intelligence and blockchain-based solutions making their way to the health space.
- Hospital infrastructure will improve, while efforts to innovate on remote care will suffer. Health care will be more centralized around the hospital, and will be less readily available outside its four walls. As a result, patients will have a harder time receiving care in their own homes – or altogether, if they reside in rural areas. In this paradigm, products for disease management in the smart home, for example, will be less applicable.
We will continue to closely monitor developments and their impact on digital health in what will continue to be a contentious and unpredictable policy landscape.
By: Noa Ghersin