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Healthcare was always poised to be a defining issue in the 2020 presidential election. It affects the lives and livelihoods of all Americans, and President Donald Trump and former Vice President Joe Biden have vastly different visions for the future of the healthcare industry. In the last several months, the COVID-19 pandemic has only served to amplify that focus on healthcare as November 3 approaches.

For many voters, this election has become a referendum on the nation’s response to COVID-19 and what that response should look like going forward. What’s more, the recent passing of Supreme Court Justice Ruth Bader Ginsburg has put extra focus on healthcare issues as the court prepares to weigh in on the Affordable Care Act (ACA), as well as long-term implications on fundamental and other longstanding healthcare debates. 

In breaking down the key differences in the healthcare landscape between a second term for the Trump administration and a Biden presidency, it’s important to consider the policies each will prioritize as well as how their leadership styles will impact their efforts to evolve the healthcare space over the next four years. With that context in mind, here’s a closer look at the healthcare industry under a re-elected President Trump or a newly elected President Biden.

President Trump

President Trump has not offered significant details on his healthcare policies and priorities if he were to win a second term. More than any other president, Trump has sought ways to accomplish his agenda without spending a lot of time on consensus building or legal handwringing. He’s prone to taking action and letting the courts vet the finer details of his policies. But the reality is, most sitting presidents don’t offer comprehensive details on proposed second term platforms for healthcare or other issues. They’re more focused on their record in their first term and shaping the narrative around the last four years.

For President Trump, no narrative in the healthcare space or beyond is more important to his re-election hopes than the COVID-19 pandemic. As the election nears, President Trump has pushed to reopen schools and businesses in an effort to reset key parts of society and the economy. Looking to the months ahead, the question is less about what will happen and more about how – and when – it will happen. Both President Trump and Biden obviously want to see an effective vaccine as quickly as possible. The president’s efforts to fast-track a vaccine are aligned from a political and public health perspective. His push to return the country to a state of normalcy will remain a key part of his COVID-19 messaging if he wins re-election in November.

President Trump has shown an eagerness to highlight his administration’s other healthcare efforts this election season. One key area of focus has been around drug pricing highlighted in his recent Executive Order on Lowering Drug Prices by Putting America First, which takes aim at lowering prescription drug costs by bringing Medicare drug pricing in line with what other developed nations pay. It’s likely President Trump will continue to focus on Medicare and value-based pricing and other payment models to further impact drug pricing and other healthcare costs. Additionally, President Trump will likely continue his focus on health information technology and healthcare data as tools to combat crises like COVID-19 and natural disasters.

Former Vice President Joe Biden

Like most presidential hopefuls, Biden offers a significantly more detailed healthcare plan than his incumbent rival. On the COVID-19 front, Biden also promises a fast push toward a vaccine with a greater focus on testing and stockpiling supplies to ensure a comprehensive response. While he also has made prescription drug pricing a key element of his platform, his healthcare focus centers on building on the Affordable Care Act and increasing the number of people insured by providing a public option. If elected, it’s sure to be a considerable hurdle for the Biden administration, with challenges from the right as well as from more progressive corners of the Democratic Party who supported Medicare for All during the primaries.

What’s more, with the confirmation of Amy Coney Barrett to the Supreme Court hanging in the balance, this may well impact the state of the ACA when Biden hopes to take office. With oral arguments on the case set for November 10, the fate of the ACA may rest with the lower court’s ruling in the event of an even 4-4 justice split. Or, the justices could agree to rehear oral arguments after a ninth justice is appointed.

Biden has also pledged to take a tougher stance on antitrust efforts and evaluate M&A activity in the healthcare sector. His platform commits to “aggressive” use of existing antitrust authority to keep market power from becoming too concentrated, so that it doesn’t drive down competition. This would be a reversal of an ongoing trend towards mergers and acquisitions in the nonprofit and for-profit healthcare space.

Access to Insights and Expertise is More Important than Ever

Political pundits and TV talking heads love to speculate and make broad predictions using the phrase “if the election was held today.” The reality is, that’s not a terribly useful device in the world of politics – and that’s never been truer than today. Politicians and their advisors structure campaigns as a deliberate build-up to election day. Every announcement and appearance is calculated to deliver maximum impact through strategic timing based on research and polling.

It’s impossible to predict exactly how an industry as far-reaching as healthcare will be impacted. However, there are some things we can say for certain. Donald Trump and Joe Biden have vastly different leadership styles and vastly different priorities for the healthcare industry. A Biden presidency would signal a return to more traditional governing practices and restore executive support for the ACA, among other things. A second term for President Trump would maintain his focus on aggressive actions and trying out big ideas. These differences in leadership can have a tremendous impact on policy. 

Looking toward the final weeks of this election and toward a 2021 Inauguration Day, the value of partnerships and experts on the inner workings of DC politics has never been more critical. Buchanan Ingersoll & Rooney’s healthcare and federal government relations teams are well-positioned to navigate the realities of a Biden administration or a second term for President Trump. Our bi-partisan team in Washington has decades of experience working with clients to advance their legislative and appropriations objectives in the healthcare space and beyond – regardless of which party controls the White House, the House or the Senate.