What Healthcare Policies Will President Trump Highlight at the State of the Union?

President Trump is likely to focus his message on several healthcare policy objectives as he aims for reelection in November.

As the third impeachment trial in U.S. history comes to an end, President Donald Trump will deliver his third State of the Union address Tuesday night. 

Taking place one night after the Democratic presidential caucuses in Iowa, Trump is likely to target his message on several policy objectives as he aims for reelection in November.

Healthcare remains a top priority for American voters and will likely garner significant focus during the speech, as it has in Trump's previous two State of the Union addresses.

Last year, amid a partisan fight over federal funding for a southern border wall, Trump discussed several healthcare initiatives like lowering prescription drug costs and ending the HIV epidemic by 2030.

Related: 6 Healthcare Takeaways from Trump's Second State of the Union

Below are six healthcare policies, ranging from health insurance coverage modifications to lowering prescription drug costs, that Trump might discuss at his annual speech.

1. ACA lawsuit and protecting pre-existing conditions

The future of the Affordable Care Act (ACA) remains uncertain and is likely to receive some attention from Trump, who said in 2017 that the tax reform bill "essentially repealed Obamacare."

The law eliminated the individual mandate penalty and ultimately led to a district court judge to rule that the entire ACA was invalid in December 2018.

The Fifth Circuit Court of Appeals ruled in December 2019 that the individual mandate is unconstitutional but did not strike down the entire law, instead remanding it back to the lower court. 

California Attorney General Xavier Becerra, who led a coalition of states defending the ACA, filed a petition for certiorari to have the U.S. Supreme Court conduct an expedited review of the case.

In mid-January, the Supreme Court denied the motion to fast-track the case, meaning there is unlikely to be a ruling by election day. 

Recently, Trump has been tweeting about the need to protect patients with pre-existing conditions, according to The Hill, which could be a talking point during the address. 

2. Medicaid block grants

Last week, the Centers for Medicare & Medicaid Services (CMS) announced the Health Adult Opportunity (HAO) initiative, which will allow participating states to transition their Medicaid programs into block grant programs.

While the introduction of block grants has been a Republican healthcare policy goal for years, the HAO has been panned by both payer and provider organizations in recent days.

Trump might take the opportunity to detail specific aspects related to the HAO and defend the programs from critics.

3. Price transparency proposal

In November, Trump unveiled the administration's long-awaited price transparency rule that would require hospitals to provide patients with easily accessible information about charges for items and medical procedures.

The rule, which would take effect on January 1, 2021, was accompanied by a separate rule which also applied price transparency measures to insurers.

Hospital groups sued the administration over the rule in early December, seeking preliminary and permanent injunctions ahead of 2021.

Trump might revisit the policy in his speech, specifically as it affects the consumer healthcare experience. 

He might also approach the pushback from the provider community, which he acknowledged at the White House event to announce the rule.

"I don't know if the hospitals are going to like me too much anymore with this, but that's OK," Trump said in November. 

4. Lowering prescription drug prices

Prior to the impeachment trial proceedings, the House passed the Elijah E. Cummings Lower Drug Costs Now Act, first introduced by Speaker Nancy Pelosi, D-Calif.

The plan would allow the Department of Health and Human Services (HHS) Secretary to negotiate prescription drug prices with manufacturers and introduce a cap on out-of-pocket costs associated with drugs available under Medicare Part D.

Despite passing the House, the proposal received a polarized response from the pharmaceutical industry and resistance from Senate Majority Leader Mitch McConnell, R-Ky., who stated that the upper chamber was "not going to be calling up a bill like that."

Related: 5 Key Healthcare Points From Trump's First State of the Union

Still, Trump has made lowering prescription drug prices one of the administration's primary healthcare initiatives and might revisit the topic during the speech.

This could also be an opportunity to respond to recent criticism from Senate Finance Chairman Chuck Grassley, R-Iowa, who told Stat News that Trump has not advocated enough for a bipartisan drug pricing bill he coauthored with Ranking Member Sen. Ron Wyden, D-Ore. 

Additionally, in late November Trump promised that HHS Secretary Azar would deliver a drug importation plan, which could be highlighted during the speech.

5. Revisiting surprise billing legislation

Trump might look to revive interest in tackling out-of-network billing practices, which has been a major cost concern among consumers.

Much like lowering prescription drug prices, surprise billing is also a healthcare topic that has generated bipartisan interest but has not turned into signed legislation yet.

In early summer, both the Senate Health, Education, Labor and Pensions (HELP) Committee and the House Energy and Commerce (HEC) Committee passed surprise billing solutions.

However, when lawmakers returned from summer recess, the momentum behind the proposals stalled in the face of multimillion-dollar efforts to stifle the plans.

In mid-December, congressional leaders announced the expansion of a bipartisan investigation into surprise billing practices.

The probe, led by leaders from the Senate HELP Committee and the HEC Committee, is focused on Envision Healthcare, TeamHealth, Anthem Inc., Cigna Corp., CVS Health, Health Care Service Corporation, Highmark, and UnitedHealth Group.

6. Ending HIV epidemic  

During last year's address, Trump announced plans to end transmissions of HIV in America by 2030. 

The campaign's benchmarks include a 75% reduction in new HIV infections by 2025 and at least a 90% reduction in transmissions by 2030.

HHS Secretary Azar discussed the additional funding for the initiative while testifying on the department's budget proposal for fiscal year 2020.

However, Kaiser Health News reported that the proposal found a challenging audience in rural states, especially those that have not expanded Medicaid through the ACA.