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6 Healthcare Topics to Watch in Trump's State of the Union

By Jack O'Brien  
   February 04, 2019

The president's second State of the Union address is likely to focus on healthcare policy.

President Donald Trump will deliver his second State of the Union address Tuesday night, a speech that is likely to focus on healthcare policies the administration is pursuing in 2019. 

Last year, Trump discussed the fate of the individual mandate penalty, which was repealed in the tax reform bill passed in late 2017, along with the possibility of pursuing bipartisan reinsurance bills in the Senate, among several other healthcare-related items.

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

This year, Trump no longer has a Republican majority in the House of Representatives but is still positioned to pursue regulatory reform through the actions of HHS Secretary Alex Azar and CMS Administrator Seema Verma. 

The State of the Union presents Trump with an opportunity to discuss what approaches the administration is considering and how the healthcare industry could be affected as a result.

Below are six topics to keep an eye on during Tuesday's speech:

1. Surprise medical bills:

Late last month, Trump turned his attention to one of the nation's most expensive and growing problems: surprise medical bills that patients often cannot afford to pay.

Trump instructed his health officials to look into how reduce the amount and frequency of surprise medical bills, a move that is in line with his recent actions requiring hospitals to publicly post their list prices for consumers.

“The health care system too often harms people with some unfair surprises ... medical bills and the like,” Trump said at a White House roundtable, according to The Hill. 

Additionally, Sen. Maggie Hassan, D-N.H., is expected to bring a woman who received a bill exceeding $1,600 for an in-network ER visit as her guest of honor. 

2. Prescription drug prices:

This is an area that has garnered rare bipartisan support on Capitol Hill, as both Democrats and Republicans have expressed a shared rhetoric for holding pharmaceutical giants accountable for rising prescription drug prices.

Trump stated last year that reducing the price of prescription drugs was one of his "greatest priorities," and ordered the FDA and HHS to take steps to accomplish those goals throughout 2018.

The recent HHS proposal to eliminate PBM rebates has generated significant coversation and analysis over the past week and could be a prominent element of the State of the Union address.

3. Ongoing Obamacare lawsuit:

In an interview Friday with The New York Times, Trump expressed his hope that the ACA would be terminated pending the appeal of the Fifth Circuit's ruling in December that the landmark healthcare legislation was unconstitutional. 

The process is still ongoing, delayed in part by the most recent federal government shutdown, but the case is being closely followed as it could have major ramifications for healthcare in America. 

Trump stated during last year's address that removing the individual mandate penalty did away with the “the core of disastrous Obamacare," which is likely to receive a mention during this year's speech. 

Related: Former HHS Secretary Kathleen Sebelius Details How to Make State of the Union Response Stand Out

4. Campaign to end HIV by 2030:

During the speech, Trump is expected to announce an effort to end HIV transmissions in the U.S. by 2030, according to Politico.

Details of the plan are scant as it has not been fully unveiled but the public health campaign is expected to mirror the administration's approach to ending the opioid epidemic.

The 10-year strategy will be helmed by HHS Secretary Azar and CDC Director Robert Redfield with an aim to stem the nearly 40,000 new infections that occur annually across the nation. 


5. Combating the opioid crisis:

Speaking of the opioid epidemic, Trump is likely to provide an update on the administration's efforts to curb the effects of widespread opioid abuse.

In the midst of the midterm election cycle, Trump managed a bipartisan legislative victory by signing a major anti-opioids package into law. 

Public attention has once again returned to the deadly crisis as Massachusetts leads a lawsuit against Purdue Pharmaceuticals and the Sackler family for propagating the powerful opioid Oxycontin despite knowing about its highly addictive qualities.


6. Longest shutdown over but another looms: 

For the second year in a row, Trump's State of the Union address follows shortly after the federal government reopened following a multiday shutdown.

February 15 is the deadline for the current continuing resolution that ended the longest government shutdown in U.S. history, which had impacted some federal health programs for more than a month.

Expect Trump to discuss where negotiations stand with Democratic congressional leaders and if he is prepared to issue a national emergency to fund the southern border wall should those negotiations fail. 

Jack O'Brien is the finance editor at HealthLeaders, a Simplify Compliance brand.

Photo credit: Washington, DC – March 17, 2017: US President Donald Trump hold a joint press conference with German Chancellor Angela Merkel at the White House after their first in-person meeting. - Image / Editorial credit: Nicole S Glass /

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