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- President Donald Trump has released a seven-point agenda on healthcare for his second term, and a four-point list of goals for ending the coronavirus pandemic by 2021.
- During his presidency he has leaned on several players to craft the details of healthcare policy, whether it be in Congress, within his administration, or outside of it.
- Democrats think they have the edge on healthcare, and are running against Trump’s record on handling the coronavirus pandemic — and his attacks on the Affordable Care Act — heading into Election Day.
- For more stories like this, sign up here for our healthcare newsletter, Dispensed.
President Donald Trump’s healthcare agenda for a second term is laid out in just seven bullet points.
It’s a contrast to the detailed policy proposals put out by his Democratic rival, Joe Biden. If elected to the White House for another four years, among Trump’s promises are to end surprise medical bills, cut prescription drug prices, and lower premiums for health insurance.
Left out of the list is a promise he made in 2016 to repeal and replace the Affordable Care Act, commonly known as “Obamacare.”
Trump hasn’t been able to keep that promise, though the ACA looks different than it once did. Trump signed a bill into law that zeroed out a fine for going without insurance, and his administration allowed people to sign up for cheaper plans outside of the ACA’s rules.
Still, the threat to the healthcare law isn’t gone. The Trump administration is siding with GOP states in a lawsuit that threatens to unravel the healthcare law — a lawsuit that will head before the Supreme Court only one week after Election Day. Democrats, including Biden, frequently raise the president’s attacks on the ACA when trying to make their own case to voters.
But perhaps the biggest threat to the president’s reelection is the coronavirus pandemic. More than 189,000 Americans have died from COVID-19, the disease caused by the coronavirus, and 6.3 million people have been infected. The latest Kaiser Family Foundation Tracking Poll finds that 61% of voters disapprove of Trump’s handling of the pandemic and 35% approve.
In his public remarks, the president has shifted the blame for the outbreak to China, where the virus started. He has pressured agencies to quickly create and authorize treatments and a vaccine. In his agenda document, he says he wants to bring the US back to normal by 2021.
As Trump strives toward that goal, there are people in and outside his administration who are shaping his thinking and actions. It’s been widely reported that the president is influenced by whoever he talks to last, but there are also close allies he has allowed to take the lead on certain healthcare policies, including his vice president, Mike Pence.
Influential Trump administration officials, such as Health and Human Services Secretary Alex Azar, frequently urge the public to pay attention to the president’s initiatives outside of the ACA: those to combat the spread of HIV, to reduce opioid overdose, and to help people on dialysis.
During his presidency, Trump has leaned on Republicans in Congress to craft policies on ACA replacements and on prescription drugs, and many members of his administration have close ties to conservative think tanks like the Heritage Foundation and the Galen Institute.
Business Insider has assembled a list of people who’ve helped to shape the president’s policies during his time in office and who are likely to continue having influence if he wins a second term. We did a look back at the policies he has passed during the last few years and also spoke with people close to the White House and the Trump campaign.
The list is in alphabetical order.
As the nation’s top doctor, Dr. Jerome Adams raised awareness about the opioid crisis.
Before the coronavirus pandemic, Surgeon General Jerome Adams was primarily focused on reducing the stigma of addiction.
As the nation’s top doctor, he urged the public to view addiction as a disease and has openly shared that his brother has a drug addiction. He advised more Americans to stock the opioid overdose-reversal drug, naloxone.
When Trump came to office, the drug-overdose crisis — driven by opioid use — was considered the largest public health threat facing the US. It had a death toll of more than 63,600 people in 2016.
Now, Adams is one of the members of the coronavirus task force. He has come under fire for initially saying people shouldn’t wear masks, and then reversing course when more evidence showed masks were helpful in reducing coronavirus transmission.
In a recent interview with Business Insider, Adams said that structural racism and social determinants of health, including poverty, were to blame for why communities of color had been hard hit by the coronavirus. In the coming months he plans to raise awareness about hypertension and maternal mortality, both issues that disproportionately affect the Black community.
Alex Azar, Health and Human Services secretary, has shaped the president’s drug pricing executive orders.
Alex Azar oversees the Department of Health and Human Services, the agency that includes the government’s medical research, healthcare, and public health institutions.
Azar led initiatives from the administration in areas including drug pricing, expanding health insurance options for workers at small businesses, and eliminating HIV transmission within a decade. He’s also overseeing an initiative to improve care for people on dialysis, which received widespread praise when it was announced.
Azar championed the executive order Trump signed in July to eliminate drug rebates negotiated by insurance middlemen known as pharmacy benefit managers. He also pushed for drug companies to post their prices in TV ads, but that’s facing legal challenges.
Azar’s feud over health policy with Seema Verma, who oversees the Centers for Medicare and Medicaid, was part of a lengthy series of reporting by Politico. Despite the infighting, both have stayed on with the administration.
Azar is a member of the Coronavirus Task Force and was initially leading it. In February, Trump handed over the authority to Vice President Mike Pence, saying Azar had many other responsibilities at HHS.
Azar is a lawyer who previously worked at HHS under former President George W. Bush. From 2007 to 2017, Azar was a senior executive at pharmaceutical giant Eli Lilly.