Health and the SOTU

Last night, U.S. President Donald Trump delivered his first State of the Union address to reflect on his first year in office. Here’s a quick look at how healthcare fared in the president’s remarks and some of the key issues leading the discussion today:

  1. Healthcare Took a Backseat to Immigration (& Other Issues) – Despite the prominence of health issues in the current national dialogue, healthcare wasn’t as front and center as many thought it would be, given its importance in debates over the past year, from “repeal and replace” to drug pricing to opioids. Healthcare did get some decent airtime, but immigration, crime, foreign policy and infrastructure took center stage. Although the reform of the Affordable Care Act was a top priority in his policy agenda during his first year in office, in the speech Trump was silent on policies to strengthen healthcare coverage and the system overall. Instead, he simply highlighted the repeal of the individual mandate; he declared that the “core of the disastrous part of Obamacare” is gone.
  2. Drug Pricing: “One of My Greatest Priorities” – Trump said one of his “greatest priorities is to reduce the price of prescription drugs.” He noted that “in many other countries, these drugs cost far less than what we pay.” This priority has also been reaffirmed by Alex Azar, the newly confirmed Secretary of Health & Human Services. Yet while the Administration’s commitment to lowering drug prices has come up time and again, the President’s speech did not outline a specific agenda or policy to bring this to fruition. Pressure is on industry to deliver solutions, try new approaches and work collaboratively across the sector, but many feel it’s unlikely that the federal government will actually take dramatic policy steps, given the Administration’s emphasis on reducing regulation. Trump calling out the high number of FDA approvals for drugs, generics and medical devices in 2017 shows the level to which innovation remains a marker of success for him. Action at the state level may be a more significant policy area to watch.
  3. Opioids: “We Must Get Tougher on Drug Dealers” – Trump emphasized a law enforcement approach to the opioid epidemic, over health interventions, for addressing prevention, addiction and recovery. He shared a moving story about a police officer and his wife from New Mexico who adopted a baby from a heroin-addicted mother, but many voiced that this was a missed opportunity to lay out how exactly the White House will lead on the public health emergency they declared last October, one they have yet to launch efforts or provide funding around. Specifically, Trump used this part of the speech to call on lawmakers to get tougher on drug dealers, a move he said would help get a hold on this national epidemic. He also reaffirmed his commitment to helping people get access to the treatment they need, but without any clear legislative or public health call-to-action. 
  4. Right to Try, Right at Home – There was a strong call from Trump to Congress to pass Right-to-Try legislation, giving access to experimental treatments to terminally ill patients. While many patient groups support this legislation, there is concern from many in industry and the medical research community that the bill will remove key patient protections in the clinical research process, and that experimental access is already available through the FDA’s compassionate use program and in states with right-to-try policies. FDA Commissioner Dr. Scott Gottlieb has cautioned that the current bill being considered would broaden access to experimental therapies so much that it might weaken the FDA’s drug approval process. However, Trump stated that he wanted “brave” patients to “have a chance to try right at home.” He followed-up by saying, “Congress needs to give them the right to try.” 
  5. Bezos Scooped Trump – The biggest health news of the day wasn’t anything the President called out. It was Amazon, Berkshire Hathaway and JP Morgan’s announcement that they are entering a new joint venture  to “provide U.S. employees and their families with simplified, high quality and transparent healthcare at a reasonable cost.” Analysis of what this means for the healthcare system and the potential impact on data, privacy and outcomes moving forward continues to lead today’s coverage.

Courtney Gray Haupt is executive vice president & group head, Health, Washington, D.C.

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