Next Administration Scenarios: Implications for Healthcare

Pharmacy benefit managers     

While both parties have engaged in intense scrutiny of pharmacy benefit managers’ practices, it remains unclear whether either presidential candidate would prioritize reform. 

• While a Harris administration could increase pressure on PBMs, given the vice president’s legal background, the industry could remain relatively untouched because getting alignment on reform in Congress would continue to be challenging. 

• During his administration, Trump made PBMs and rebate reform a significant focus but was ultimately stymied by both Congress and the healthcare industry. It is unclear if he would make another attempt at reform. 

Pharma 

Lowering prices and increasing access to prescription drugs will remain a bipartisan issue. These discussions will be stoked by the rise of popular, though expensive, obesity medications along with Medicare price negotiations and insulin price caps. 

• It is unclear how a Trump administration would implement Medicare price negotiations, but his vice-presidential candidate, U.S. Sen. JD Vance, expressed support for the policy. Trump continues to support drug importation and international reference pricing, which the industry has long opposed. The 2024 GOP platform and Trump’s policy proposals also signal the party’s intent to reduce prescription drug costs and increase transparency.  

• Expect Harris to double down on implementing the Medicare drug price negotiations and insulin price caps included in the 2022 Inflation Reduction Act (IRA) – for which Harris cast the tie-breaking Senate vote. In her early weeks as the nominee, Harris consistently spoke about “big pharma” and her days as California’s attorney general, when she won record settlements against pharmaceutical companies. 

Health tech 

Recent breakthroughs in digital technology – particularly in generative artificial intelligence (AI) – have increased the already high level of government interest in the health technology space. Scrutiny of health tech companies, especially those that are primarily consumer-facing, is likely to play heavily in Washington. 

• As vice president, Harris has made the case for a strong government role in regulating AI and said in March that Americans have a right to know that when government agencies use AI tools, they do so in a responsible way. 

• While in recent months Trump has promised to cut back on AI regulations, and he courted support from Silicon Valley donors with a stake in AI, he has also called AI “maybe the most dangerous thing out there.” 

Implications for businesses 

While healthcare businesses have been strengthening their communications capabilities, especially in issues management, crisis response, and public affairs, they should continue to assess reputational vulnerabilities as well as related operational and geographical issues. 

Additionally, healthcare companies employing or developing AI technologies should accelerate their efforts to explain their positive public health impacts and the safeguards they are putting in place to ensure patient privacy protections, data security, and equitable results. 

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