Navigating uncertainty: What’s keeping healthcare execs up at night in this new era

Uncertainty is anathema to the world of business and finance, and one need only look at the major stock indices to know that certainty is in short supply of late.

As the new administration in the United States sets about radically reshaping the size and scope of government, companies and investors are recalibrating their strategies amid a fast-changing and often unpredictable policy environment. In our recent webinar with Fierce Pharma, Stirred and Shaken: How a new administration will change the U.S. healthcare market, we polled the audience (n=400+) about what policy uncertainties were of most concern to them.

The covered lives question mark

The number one item, cited by more than a third of viewers (35%), was shifts in insurance coverage. With Elon Musk’s Department of Government Efficiency reportedly talking of rooting out fraud in entitlement programs like Social Security and Medicaid and Republicans in Congress eyeing those programs for $880 billion in savings, some states are moving to add work requirements to Medicaid. Critics worry that this could lead to a substantial increase in the number of uninsured Americans, adversely impacting access to care. A recent analysis by the Urban Institute and the Robert Wood Johnson Foundation estimated that as many as 5.2 million adults could lose Medicaid coverage due to difficulty navigating these rules.

For its part, The White House has said that “The Trump administration will not cut Social Security, Medicare or Medicaid benefits.”

Then there’s the Medicare picture. President Trump’s nominee to lead the Centers for Medicare and Medicaid Services (CMS), Dr. Mehmet Oz, has in the past advocated for privately-run Medicare Advantage plans. However, he recently criticized those plans for charging the government more than traditional Medicare.

Policy uncertainty

Equal numbers of respondents (15%) expressed concern about three critical policy areas:

Potential changes to the Affordable Care Act (ACA): Republicans narrowly failed to torpedo the law during President Trump’s first term and may not have appetite for another swing at the law, but might take aim at lower-hanging fruit, such as exchange plan subsidies – without which these plans might be unaffordable to many beneficiaries.
Adjustments to the Inflation Reduction Act: One of President Trump’s first executive orders instructed officials to freeze disbursement of IRA environmental funding, and Trump has revoked some healthcare-related executive orders issued under the Biden administration that are aimed at reforming healthcare payments and lowering prescription drug costs. So far, however, the Trump administration’s plans for the prescription drug provisions of the IRA remain unclear.
Impact on Vaccine Development and Guidelines: In his confirmation hearings, Department of Health and Human Services Secretary Robert F. Kennedy, Jr. said he had never been anti-vaccine and vowed not to change the nation’s vaccine schedule. However, shortly after his confirmation, he said the agency would investigate vaccine safety in children. Then the Centers for Disease Control nixed an ad campaign promoting vaccination and signaled a new approach emphasizing “informed consent,” while postponing a meeting of its vaccines advisory committee indefinitely. FDA Commissioner Dr. Martin Makary was an outspoken opponent of vaccine mandates for COVID-19, but has expressed interest in expediting drug approvals, particularly for generics, biosimilars and rare disease treatments.

The unknown unknowns

Sweeping cuts to National Institutes of Health grants wasn’t on our radar when we designed our poll but seems likely to have a substantial impact on drug R&D over the medium-to-long term. Similarly, enormous workforce reductions at federal health agencies could affect drug approval timelines and much else. We will be convening panel discussions on these and other topics in the coming months.

For healthcare businesses, staying informed and adaptable is crucial. Engaging with policymakers, participating in industry discussions, and leveraging data-driven insights can help organizations navigate these uncertainties and continue to deliver quality care.

Clarivate data, solutions and expertise can help companies stay ahead of the curve and mitigate the impact of uncertainty. Learn more about how Clarivate commercial consulting services help life science companies navigate a fast-changing landscape to deliver innovative treatments to patients.

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