American healthcare will likely undergo dramatic changes in the second Trump Administration. While their exact contours may not yet be completely clear, there are strong indications that millions of people will be impacted. 

Regardless of what the changes turn out to be, people will need guidance as to what exactly they mean. There isn’t really a playbook for the scope of change that may be coming, so many healthcare providers will be looking to their peers and the broader industry for guidance and what may net out in many cases to a new set of best practices. 

The responsibility for communicating all this will fall largely on healthcare leaders, and their communications strategies will need to address both patients and peers. While communications must be thoughtful and grounded in strategy, now is not the time for providers to retreat or shy away from their commitment to educate and shepherd patients along their care journey – whatever it may look like.  

Exactly what the administration is ultimately able to accomplish will be anyone’s guess, but here are some key policy and market shifts healthcare leaders and their PR teams should watch closely and be prepared to communicate around.      

Medicare and Medicaid adjustments: The potential changes here are enormous. Medicaid currently covers around 20% of the U.S. population, including 40% of all children, nearly 80% of children in poverty, and 60% of non-elderly adults in poverty. It also covers 41% of all births in the United States, nearly half of children with special healthcare needs, and more than 60% of nursing home residents. Proposed reforms, which include spending caps and work requirements for Medicaid, would almost surely result in reduced coverage for some of our most vulnerable patient populations. 

Changes to the Affordable Care Act (ACA):  Trump has signaled intentions to modify or replace the ACA to reduce costs and enhance market competition. ACA subsidies expire at the end of 2025 and a Republican controlled congress could elect to simply not renew them. If that happens, the Congressional Business Office (CBO) estimates that four million people will become uninsured by 2026, doubling by 2030.  

The ripple effects of this would be far reaching. The most direct impact would be to reduce access for already underserved populations; others would likely see higher premiums as a result. Restrictions around pre-existing conditions could also be reinstituted, hindering many with chronic conditions from accessing necessary care, and leading to the need for more acute (expensive) care down the road. 

Immigration: Like in other domestic industries, many healthcare providers rely on immigrant labor to function. The administration’s deportation efforts will likely increase labor scarcity, even if the majority of those employed by health care companies are here legally. This applies even more pressure to a workforce that is already stretched increasingly thin and quickly approaching a cliff of unsustainability. 

DEI: Efforts to scale back or even eliminate DEI programs at the federal level will leave many in healthcare wondering about the legality of their own programs, and whether to stay the course, modify, or eliminate them altogether. Hospitals and health systems that receive federal reimbursement are considered to be government subcontractors, leaving questions whether mandated rollbacks of federal DEI programs and contracts will extend to these provider organizations. 

General funding cuts: Many provider organizations rely on grant money to support critical programs. Amidst ongoing cuts, several notable systems have already expressed concerns about potential impacts to programs focused on substance use, maternal care, rural care, and diagnostics, just to name a few.

Beyond the direct impact to care services, cuts to NIH funding also have significant potential for downstream effect on things like clinical trials. Delaying or diluting this kind of research and innovation ultimately makes it harder to compete and keep patients from accessing breakthrough procedures or therapies. 

Price transparency and deregulation: The administration has indicated it would like hospitals and insurers to make their negotiated prices for most health care services clearly available to the public. This is already required, but it is extremely complicated to enforce and communicate in a consumer-friendly way. Moving forward, focus will likely be on the quality of data and enforcement.   

Reproductive health: Following the reversal of Roe v. Wade, Trump will likely continue to promote policies that lean pro-life. The new administration could remove protections under the Emergency Medical Treatment and Labor Act (EMTALA), which requires hospitals to provide emergency abortion care. Additionally, the administration seems open to supporting conscience exceptions that would allow medical professionals and even administrative staff to deny procedures — from gender-affirming care to abortion — based on personal beliefs. 

Telehealth expansion: Medicare coverage for telehealth and ‘hospital at home’ (continuous hospital care provided where you live) has been extended through the end of March 2025. While this is good news, and telehealth has historically enjoyed bipartisan support across both the Trump and Biden administrations, what happens after March is unclear. 

It is true that telehealth usage has dropped off significantly since the pandemic. But it still has very real use cases, including reaching people in care deserts, mental health patients, or those managing chronic conditions. Market leader Hims & Hers has recently enjoyed a significant bump in share prices on the heels of its Super Bowl advertised expansion into compounded GLP-1s, and its recent expansion into diagnostics, signaling that there is an appetite for the right kinds of care.   

Each of these potential changes, let alone their combination, would have significant implications for providers, many of which are just getting back to pre-pandemic patient volumes and profitability.  But the financial implications – which, make no mistake, are real – pale before the very serious human consequences. Some of our most vulnerable people stand to be hardest hit. When people encounter hurdles to access, many simply disengage or defer care, exacerbating their conditions. Some may also seek out care in less-than-ideal settings, putting themselves at potentially greater risk. 

Generally, very sick people are unable to work or contribute in meaningful ways to their communities and families. This can be measured in dollars and has detrimental impacts to already underrepresented people and neighborhoods. Showing empathy and understanding will go a long way for providers, particularly in these markets.   

All of this makes trust and strategic comms critical to helping patients understand what’s happening and guiding them to what they need. Here are some ways healthcare providers can prepare and respond. 

Understand your patient population’s unique challenges. Consider bringing together your comms, clinical, and data professionals to share insight into your patient population. Once you really understand the unique issues across your patient community, you can craft a communications strategy that helps to address their unique challenges, making you a trusted partner in their health and wellbeing. This will increase patient engagement, recruitment, retention, and drive better outcomes.  

Communicate proactively with patients. Reaching out with messages that are grounded in reality, that show genuine understanding, and that guide patients forward will be essential. Knowing the Social Determinants of Health (SDOH) across your patient populations is an incredibly powerful compass to guide communications that will not only reach the right people but educate and influence behaviors in a positive way. 

The messenger matters. The best way to gain patient trust, particularly in underserved communities, is ensuring that the message is delivered by people who look like them and, ideally, have a tie to the community. If the right people don’t already exist within your organization, consider changing that or engaging third party spokespeople.  

Openly share your perspective with other providers. Since many of these policies touch on cultural issues, or can be divisive, hospitals and health systems might be tempted to keep quiet, or worse point fingers at competitors. They should fight that urge. With changes of this scale come challenges across virtually all provider organizations. This will increase the appetite for genuine thought leadership and will present a substantial opportunity for those who take initiative and share their POV, experiences, and or best practices. This advances awareness and credibility within an organization’s community and can also help to drive more destination care.   

A final note: It is easy to get caught up in the complexity of the political landscape and business of care and lose sight of the fact that what truly matters is people. Make sure your communications are accurate, impactful, and inherently human. With these core ingredients steeped in your brand and subsequent communications – your efforts will help drive better results across your organization and the entire healthcare ecosystem.   

Photo by Alex Wong/Getty Images

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