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The State of the Health Care Union

February 5, 2019, 11:50 PM UTC

President Donald Trump is slated to deliver the State of the Union address this evening at 9 PM Eastern time. The contents are anyone’s guess, although the White House has attempted to preface the speech by saying it will contain “a policy agenda both parties can rally behind.”

Hot button issues such as immigration, trade, and the economy at large are likely to serve as focus areas. But what might we expect of the health care discussion?

It seems unlikely that the Affordable Care Act will take much in the way of premium air time, especially since the individual mandate has been repealed and the administration has essentially declared regulatory victory through its various oblique cuts to the health law. (There may well be victory laps along those lines, though.)

Two items to definitely keep an eye out for? Drug pricing and HIV/AIDS.

On the former, the Trump administration recently announced some major proposed overhauls to Medicare’s prescription drug program that would target the middlemen known as pharmacy benefits managers (PBMs). The pharmaceutical industry is largely supportive of these measures; it’ll be interesting to see whether or not the president proposes additional ideas that take aim at drug makers themselves (Trump has previously endorsed direct Medicare price negotiations, which is heavily opposed by the sector).

And then there’s the public health front. Trump may well bring up the opioid crisis, as he has in the past, and the Right to Try law he signed that allows terminal patients to access experimental treatments while largely bypassing the FDA. But a number of outlets have also reported that the president will call for a total eradication of HIV in the United States by 2030—a goal which sounds fanciful but, given the current state of innovation in HIV prevention and treatment, is far from impossible.

We’ll find out how much heft health gets in the SOTU soon enough.