Because the second Trump administration begins to take form, prime well being officers should quickly allocate sources and choose coverage priorities. Whereas new administration officers will doubtless have a special method to well being coverage than these previous them, there may be one space the place President Trump, the Biden administration, and lawmakers from each events have agreed lately: growing shopper alternative and competitors within the healthcare market.
This dedication to pro-competition reforms was demonstrated within the first Trump administration, which took vital steps to decrease prescription drug prices, draw on untapped authorities within the Inexpensive Care Act to advertise price transparency, and defend customers from some unfair billing practices. President Trump’s first time period additionally introduced agency antitrust enforcement, because the FTC challenged a number of important health care mergers. In early 2024, the outgoing Biden administration continued this important work and promoted additional motion via the appointment of the Chief Competition Officer inside the Division of Well being and Human Providers (HHS). Complementary parallel appointments have been additionally made for well being care counsels and task forces on the Federal Commerce Fee (FTC) and the Antitrust Division inside the Division of Justice (DOJ-ATR). If President Trump goals to offer tangible advantages for employees and customers struggling to afford wanted well being care, then his second administration ought to keep these competition-focused positions and supply them higher sources to additional enhance pro-competition insurance policies.
Why Competitors Coverage Is and Ought to Stay a Bipartisan Precedence
Well being care prices in america have lengthy involved policymakers and constituents alike. With well being care prices accounting for roughly 17 percent ($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 year, U.S. per capita well being care spending far exceeds that of comparably developed nations. Repeatedly, researchers have demonstrated the reason for this excessive spending: high health care provider and drug prices, pushed in massive diploma by elevated vertical and horizontal consolidation and different anti-competitive enterprise practices. Individuals do not use more medical services than do individuals in different nations, they merely pay a lot more for companies.
In makes an attempt to decrease well being care prices and improve shopper alternative, policymakers on each side of the aisle have lengthy supported varied pro-competition reforms. Along with price containment alternatives, competitors also can enhance effectivity, as organizations should optimize their operations in an effort to keep forward of opponents. Moreover, competitors can incentivize innovation and enhance high quality, as opponents jockey to create higher worth companies and items for his or her clients. Competitors can also enhance entry to well being care companies, as stakeholders enter new markets and provide extra companies to draw further customers. All of those aggressive outcomes – decrease prices, elevated shopper 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 establish, coordinate, and elevate alternatives inside HHS and throughout companies to advertise competitors in well being care markets—in different phrases, to make well being care a “good deal for the American people.”
Since their appointment in January of 2024, the Chief Competitors Officer and the HHS competitors crew has gathered info and established cross-agency strains of communication to help future pro-competition coverage reforms, oversight, and enforcement. To raised perceive present boundaries to competitors and anticompetitive conduct within the well being care market, HHS and the FTC issued a request for info (RFI) in February 2024 on group purchasing organizations (GPOs) and drug wholesalers. These companies, together with DOJ-ATR, then launched a joint RFI on health care consolidation in March. These RFIs acquired immense public participation, with hundreds of particular person and group stakeholders submitting feedback. (These feedback can be found to the general public: comments on GPO RFI and comments 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 via a brand new portal, out there at HealthyCompetition.gov. The portal provides customers examples to assist establish anticompetitive conduct, together with contract phrases that block value transparency or prohibit competitors, completely different types of price-fixing, and collusive conduct amongst purported opponents.
Along with these public info assortment efforts, the HHS Competitors Officer has taken essential steps to determine data sharing agreements and processes between the three companies to facilitate efficient enforcement of antitrust legal guidelines within the well being care market. Past inside info sharing and pro-competition work, the HHS competitors crew additionally helps the training of employers, customers, and different stakeholders, and may weigh in on coverage growth inside the company to make sure aggressive results are thought of.
By Leveraging the HHS Competitors Officer and Fostering Collaboration Throughout Companies, the Trump Administration May Cut back Well being Care Prices and Empower Shoppers
The muse for pro-competition reform has been laid, and the incoming administration can and will 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 info and translate this data into evidence-based coverage reforms and enforcement actions to decrease costs for customers.
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 may additionally help collaboration with the Division of Labor (DOL). With oversight authority over the well being care purchasers for Individuals with employer-sponsored insurance, more than half of the US population, DOL is well-positioned to research boundaries employers and employees face in well being care markets. DOL may additionally assist educate employers about the right way to be higher consumers (according to their fiduciary duties), in addition to educate employers about the place to file suggestions and complaints after they encounter anticompetitive conduct or lack alternative resulting from consolidation.
A continued dedication to the HHS Competitors Officer and comparable engagement throughout different companies would align with President Trump’s earlier coverage agenda and will effectuate Republicans’ long-standing objective to decrease well being care prices and improve decisions for well being care customers.
