2020 State of the Union – A Peek into the Murky Future of Healthcare

Last week, President Trump held his 2020 State of the Union Address.

And, as in years past, healthcare was a key topic. The evening held all the political drama and partisan showmanship that we have come to expect of these events. What made this address different was its proximity to the upcoming elections. It provided additional insight into the president’s position on the healthcare topic and hinted at some of his goals during a possible second term. And, as usual, the reactions from the legislators in attendance served as a barometer of how those policies might be received should the current balance of power remain the same in 2020.

The future of healthcare in the United States will continue to be a dividing topic within the election year despite several aspects of healthcare policy that are receiving bipartisan support.

Here are some key observations and takeaways from President Trump’s 2020 State of the Union Address, specific to healthcare:

Details: Not surprisingly, details were scarce. The SOTU address is not a place to get into the weeds of an issue. While many topics were raised, specifics were absent.
Border Security: President Trump positioned healthcare as a key argument in his border security policy. The ability of undocumented immigrants to receive government-funded healthcare was a point that was raised several times.
The Affordable Care Act: Surprisingly, there was no discussion of repealing the Affordable Care Act. Although it’s important to note, that the Trump Administration is arguing in court that it should be tossed out. Instead, the president spoke of, ‘an ironclad pledge to American families, we will always protect patients with preexisting conditions.’ Again, no details were provided on plans to keep these protections in place. However, it’s significant that this popular component of the Affordable Care Act was called out along with a pledge that this protection will remain.
Medicare for All: The president countered some Democratic candidates’ call for ‘Medicare for All’ with the promise that, ‘we will never let socialism destroy American healthcare.’
Prescription Drug Costs: Prescription drug costs are likely to be a frequent and contentious debate point going forward despite both parties claiming to seek lower drug prices. During the speech, the president called for bipartisan legislation to lower drug prices. This had the Democrats chanting ‘H.R.3!! H.R.3!!’ in reference to the House bill on drug pricing reform that passed the House but is unlikely to pass the Senate.
Limited Bi-Partisanship: There were some bipartisan moments with healthcare including the pledge to spend $50 million on neonatal research, calling out commitments to fight HIV, cancer and kidney diseases and some success in battling the opioid epidemic.
Family Services: The president also called for a ban on late term abortions.

While the State of the Union Address will undoubtedly be fact-checked and analyzed, the reality is that it is largely political theatre and offers only limited insights into the policies and positions being adopted by the competing parties. Healthcare, however, continues to grab a lion’s share of the conversation and indicates that we can expect differences in healthcare policy and the future of the Affordable Care Act to be hot topics in the coming months—both on and off the debate stages. And, if the State of the Union is any indication, a big fight is brewing over prescription drug pricing reform.

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