Donald Trump and Diabetes Policy: What We Know Right Now

Donald Trump’s electoral college win has already had a ripple effect within diabetes care circles. As he’s been putting together an administration, it’s still been hard to predict where his administration will land on issues that affect people with diabetes. His positions have often been subject to change, and it’s still unclear how much success he will have getting his somewhat-populist agenda passed in a Congress controlled by more traditional Republicans.

This means there still are more questions than answers, but those questions are provocative. Here’s a rundown of the signs we’re seeing in the week after his victory:

-Over the weekend, Donald Trump has signaled that he would like to keep two popular provisions of the Affordable Care Act – that insurance companies are barred from denying coverage based on preexisting conditions and that adults up to age 26 can stay on their parents’ health insurance plans. However, one Washington Post economics writer argues that coverage for preexisting conditions might become catastrophically unaffordable unless you keep the provision of the ACA that mandates individual health insurance, and that provision is probably a non-starter with the Republican-controlled Congress.

-Donald Trump has put out a list of what he intends to do in his first 100 days in office. Within a bullet point about Obamacare is this sentence: “Reforms will also include cutting the red tape at the FDA: there are over 4,000 drugs awaiting approval, and we especially want to speed the approval of life-saving medications.”

Could this mean that there will be a streamlined pipeline for diabetes drug development? It’s unclear. That’s because while a president has control of the hiring and firing of the leaders of federal agencies, he or she cannot simply change regulations with the stroke of a pen on Day 1. According to a 2011 law review of presidential authority, presidents can propose streamlined regulations, but agencies still must go through a public process to establish the harm vs. benefit of changed regulations. That hasn’t always worked out in favor of the kind of deregulation Trump is proposing

-It appears that Trump no longer is backing the importation of cheaper drugs from abroad, as he did in his campaign. According to a ARS Technica report, that part of his list for health care reform has disappeared.

-The post-election bounce in stock prices for insulin-makers Sanofi and Lilly has continued, but not for Novo Nordisk. That bounce was fueled most likely by investor belief that those who had wanted to curb drug prices were defeated at the ballot box. (Also defeated was a ballot measure in California that attempted to curb drug prices.)

However, as a report in BioSpace indicates, the pharmaceutical industry as a whole is beginning to sober up to the fact that there is a lot of regulatory uncertainty that comes with the incoming Trump administration. Like so many, they are taking a wait-and-see approach.

The bottom line is this: Trump has no track record in public office, and he has not fleshed out many of his proposals. Never in recent history has a president-elect come in with so many question marks about his stances on policy and his effectiveness in advocating for his legislation. All this is to say that the regulatory picture for diabetes care, as with much else, will remain extremely fluid.

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Craig Idlebrook is a past editor for Insulin Nation, Type 2 Nation, and Información Sobre Diabetes. He is now the community engagement and content manager for T1D Exchange.

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