The Trump administration has recently announced what it’s calling a “digital health ecosystem” that will allow for millions of Americans to upload personal health data as well as medical records into an easily managed interoperability framework run by private tech companies. The announcement also included plans for patient-facing digital tools for chronic disease management, digital insurance cards, and a Fast Healthcare Interoperability Resources (FHIR)-based national provider directory.
In the same week, the Centers for Medicare & Medicaid Services (CMS) published updated guidance that allows payors to utilize older Qualifying Payment Amount (QPA) calculation methodologies in balance billing disputes as the Texas Medical Association (TMA III) case continues making its way through the legal system (one of several healthcare-related cases the Trump administration is defending in courts across the country). A bipartisan group of senators also introduced a comprehensive price transparency bill – a one of two introduced just this month – that essentially codifies transparency in coverage requirements and includes provisions that would modify certain aspects of the No Surprises Act (NSA), like the good-faith estimate. Frequent readers may recall that the U.S. Supreme Court recently ruled on the Patient Protection and Affordable Care Act (PPACA) mandate related to preventive services that will allow continued operation of the related task force.
If this update gives you the impression that the entire administration is suddenly all about healthcare, all the time, that’s because right now, it really feels like it is!
While this wasn’t entirely uncommon during his first term, it is in stark contrast to what we saw throughout President Trump’s campaign last year – and the first several months of his second administration.
The president most recently campaigned on many issues, but healthcare was not really at the forefront. While his promises on health mirrored his more general promises – to reshape, reorganize, and refinance federal institutions and programs – most of it was under the general umbrella of the “Make America Healthy Again” agenda.
When he entered office for the second time, executive orders (EOs) were the name of the game for several months. We saw renewed orders on transparency, digital payments, and drug pricing, and several others were mostly focused on rescinding or withdrawing previous EOs on topics like the PPACA, artificial intelligence (AI), and healthcare funding grants. Congress and agencies, however, were unusually quiet on healthcare issues as they focused on other priorities for the Trump administration.
But that appears to be over…for right now at least.
If you imagine the Trump administration’s focus on healthcare on a graph, it would be what we call a bimodal graph with two bell curves (if you too went to law school and benefited greatly from one of those).
His first administration focused on numerous comprehensive healthcare issues: the failed push to repeal the PPACA, the emphasis on telehealth, short-term, limited-duration health plans, and of course, the signing of the No Surprises Act. It dipped over the last year as other priorities were spotlit, until discussions about Medicaid work requirements and potential funding cuts for both Medicaid and Medicare in the One Big Beautiful Bill slowly crept into the news.
The question then is: what’s next? Will we continue to see renewed focus on a variety of healthcare issues, or are we due for another valley? There is certainly no shortage of issues to which the administration could switch its focus.
But August is a strange month in politics, generally considered the doldrums of political and legislative activity. You might think you have time to relax and consider this question as Congress is on break and most Americans are focused on end-of-summer activities. There are indeed many, many variables here to ponder: lawsuits to decide, the impact of tariffs, and it remains to be seen how successful some of these proposed bills and initiatives will be, in reality.
However, what we know is that this time of year is famously unpredictable across the board, and the Trump administration likes to move fast. With that in mind, I’ll leave you with my favorite quote about what to expect this month: “beware the ides of August.”