Because the second Trump administration begins to take form, prime well being officers should quickly allocate assets and choose coverage priorities. Whereas new administration officers will probably have a special strategy to well being coverage than these previous them, there’s one space the place President Trump, the Biden administration, and lawmakers from each events have agreed in recent times: growing client alternative and competitors within the healthcare market.
This dedication to pro-competition reforms was demonstrated within the first Trump administration, which took necessary steps to decrease prescription drug costs, draw on untapped authorities within the Reasonably priced Care Act to advertise value transparency, and defend shoppers from some unfair billing practices. President Trump’s first time period additionally introduced agency antitrust enforcement, because the FTC challenged a number of vital well being care mergers. In early 2024, the outgoing Biden administration continued this necessary work and promoted additional motion by way of the appointment of the Chief Competitors Officer throughout the Division of Well being and Human Companies (HHS). Complementary parallel appointments have been additionally made for well being care counsels and process forces on the Federal Commerce Fee (FTC) and the Antitrust Division throughout the Division of Justice (DOJ-ATR). If President Trump goals to offer tangible advantages for employees and shoppers struggling to afford wanted well being care, then his second administration ought to preserve these competition-focused positions and supply them higher assets to additional enhance pro-competition insurance policies.
Why Competitors Coverage Is and Ought to Stay a Bipartisan Precedence
Well being care prices in the USA have lengthy involved policymakers and constituents alike. With well being care prices accounting for roughly 17 % ($4.5 billion) of whole gross home product, and with the typical household premium for an employer group well being plan costing $25,572 a yr, U.S. per capita well being care spending far exceeds that of comparably developed international locations. Repeatedly, researchers have demonstrated the reason for this excessive spending: excessive well being care supplier and drug costs, pushed in giant diploma by elevated vertical and horizontal consolidation and different anti-competitive enterprise practices. Individuals don’t use extra medical providers than do individuals in different international locations, they merely pay much more for providers.
In makes an attempt to decrease well being care prices and improve client alternative, policymakers on each side of the aisle have lengthy supported numerous pro-competition reforms. Along with price containment alternatives, competitors also can enhance effectivity, as organizations should optimize their operations to be able to keep forward of opponents. Moreover, competitors can incentivize innovation and enhance high quality, as opponents jockey to create higher worth providers and items for his or her prospects. Competitors may additionally enhance entry to well being care providers, as stakeholders enter new markets and provide extra providers to draw extra shoppers. All of those aggressive outcomes – decrease prices, elevated client alternative, improved effectivity, higher innovation, and expanded entry – align with the well being care agenda of President Trump’s first time period.
The Chief Competitors Officer Has Laid a Basis for Professional-Competitors Reform
The Chief Competitors Officer’s mandate is to determine, coordinate, and elevate alternatives inside HHS and throughout businesses to advertise competitors in well being care markets—in different phrases, to make well being care a “whole lot for the American individuals.”
Since their appointment in January of 2024, the Chief Competitors Officer and the HHS competitors group has gathered data and established cross-agency traces of communication to assist future pro-competition coverage reforms, oversight, and enforcement. To higher perceive present boundaries to competitors and anticompetitive conduct within the well being care market, HHS and the FTC issued a request for data (RFI) in February 2024 on group buying organizations (GPOs) and drug wholesalers. These businesses, together with DOJ-ATR, then launched a joint RFI on well being care consolidation in March. These RFIs obtained immense public participation, with hundreds of particular person and group stakeholders submitting feedback. (These feedback can be found to the general public: feedback on GPO RFI and feedback on consolidation RFI).
The well being care competitors tri-agencies – HHS, DOJ-ATR, and FTC – additionally solicited complaints and tips on well being care competitors and equity by way of a brand new portal, obtainable at HealthyCompetition.gov. The portal affords customers examples to assist determine anticompetitive conduct, together with contract phrases that block value transparency or limit competitors, completely different types of price-fixing, and collusive habits amongst purported opponents.
Along with these public data assortment efforts, the HHS Competitors Officer has taken crucial steps to determine information sharing agreements and processes between the three businesses to facilitate efficient enforcement of antitrust legal guidelines within the well being care market. Past inner data sharing and pro-competition work, the HHS competitors group additionally helps the training of employers, shoppers, and different stakeholders, and might weigh in on coverage improvement throughout the company to make sure aggressive results are thought-about.
By Leveraging the HHS Competitors Officer and Fostering Collaboration Throughout Companies, the Trump Administration May Scale back Well being Care Prices and Empower Shoppers
The muse for pro-competition reform has been laid, and the incoming administration can and may leverage this basis. The Trump administration ought to proceed to function and fund the HHS Competitors Officer, in addition to the well being care leads inside DOJ-ATR and FTC, to deploy the collected data and translate this data into evidence-based coverage reforms and enforcement actions to decrease costs for shoppers.
To additional spur pro-competition reform within the business well being care market and profit tens of millions of employees and their households nationwide, the administration might additionally assist collaboration with the Division of Labor (DOL). With oversight authority over the well being care purchasers for Individuals with employer-sponsored insurance coverage, greater than half of the US inhabitants, DOL is well-positioned to research boundaries employers and employees face in well being care markets. DOL might additionally assist educate employers about methods to be higher consumers (per their fiduciary duties), in addition to educate employers about the place to file suggestions and complaints after they encounter anticompetitive conduct or lack alternative attributable to consolidation.
A continued dedication to the HHS Competitors Officer and related engagement throughout different businesses would align with President Trump’s earlier coverage agenda and will effectuate Republicans’ long-standing goal to decrease well being care prices and improve selections for well being care shoppers.
