Beyond Obamacare: How Trump’s Cabinet Picks Could Affect Americans’ Health

December 14, 2016, 10:30 AM UTC
Republican National Convention: Day Two
CLEVELAND, OH - JULY 19: Former Republican presidential candidate Ben Carson delivers a speech on the second day of the Republican National Convention on July 19, 2016 at the Quicken Loans Arena in Cleveland, Ohio. Republican presidential candidate Donald Trump received the number of votes needed to secure the party's nomination. An estimated 50,000 people are expected in Cleveland, including hundreds of protesters and members of the media. The four-day Republican National Convention kicked off on July 18.. (Photo by Alex Wong/Getty Images)
Alex Wong — Getty Images

It’s hard to deny that President-elect Donald Trump and the incoming GOP Congress could change the face of American health care in significant ways. From Trump’s ardent opposition to Obamacare to House Speaker Paul Ryan’s—and Trump’s choice to lead the Department of Health and Human Services (HHS), Rep. Tom Price’s—support for both repealing the law and scaling back social safety net programs like Medicare and Medicaid, several of the nation’s largest entitlements may see major transformations.

But health is affected by plenty of factors beyond insurance coverage and the way that medical providers treat patients. And that’s why Trump’s choices to lead other critical, if less high-profile, organizations like the Department of Agriculture (USDA) and the Department of Housing and Urban Development (HUD) may also harbor consequences for Americans’ wellness.

That’s because access to basic social needs like heating, electricity, food, and medicine can play a significant role in health outcomes, according to a new study published in the journal JAMA Internal Medicine.

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The nonprofit group Health Leads—which screens patients for these very necessities and works to provide them with assistance through community organizations—teamed up with Massachusetts General Hospital to assess how much these factors could affect health. The results were striking: of 1,774 patients who visited various Massachusetts General primary care facilities over about a year and a half and were found to have unmet social needs, 1,021 wound up participating in Health Leads’ program—and these patients actually saw an improvement in both their blood pressure and cholesterol levels.

That suggests that major federal programs like food stamps and public housing can play a role in shaping these fundamental health indicators. The Health Leads participants’ improvement in blood pressure, for example, was nearly the equivalent of placing them on an additional BP medication.

So what do Trump’s cabinet picks portend for such far-reaching programs? For one, the president-elect’s pick to lead HUD, former presidential candidate and neurosurgeon Dr. Ben Carson, will have a big role in shaping housing policy that he has previously criticized.

“It really is not compassionate to pat people on the head and say, ‘There, there you poor little thing, I’m going to take care of all your needs, your healthcare, your food, and your housing, don’t you worry about anything,'” Carson said during the 2015 Conservative Political Action Conference (CPAC), according to PBS. He’s also slammed Obama administration-backed fair housing laws and an Iowa Section 8 housing voucher program that he compared to “what you see in communist countries.”

Trump still hasn’t announced his pick for USDA chief, who will oversee the federal food stamp program. But there have been early reports that he’s considering Democratic Sen. Heidi Heitkamp of North Dakota. Heitkamp, who is the daughter of a public school cook, has proposed legislation to help schools meet nutritional standards by boosting kitchen equipment.

Another big question is how adequately these various programs will be funded by the incoming Congress.

And Price, the likely next HHS Secretary, will also play a part when it comes to non-medical societal needs. HHS oversees, not just Obamacare, Medicare, and Medicaid, but also the LIHEAP program for low-income families. The organization also initiated a $157 million pilot project to test out whether or not the efforts of groups like Health Leads (which incorporate basic needs screening processes into medical care) can improve outcomes earlier this year.

Those kinds of projects could, theoretically, be scaled back under a new administration. In the meantime, outfits such as Health Leads say they’ll continue to push their more holistic approach to health care.

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