The US healthcare system faces persistent challenges of high costs and limited access. However, new opportunities for reform emerge in 2025 as key policies sunset, including Tax Cuts and Jobs Act provisions, expanded Affordable Care Act subsidies, and temporary telehealth waivers. Congressional action is required on decisions about Medicare spending, drug pricing negotiations, physician payment reforms, and tax policy changes. These deadlines create unique opportunities for meaningful healthcare system improvements.

Key Takeaways

  • Major healthcare policy decisions can't be delayed past 2025: Expiring provisions in the Tax Cuts and Jobs Act, Affordable Care Act subsidies, and telehealth waivers force Congress to act now.
  • Medicare expenditures have risen dramatically, from 2.2% of GDP in 2000 to 3.7% in 2023, with projections showing further growth to 5% by 2034.
  • The expiration of the Tax Cuts and Jobs Act in 2025 will significantly impact health-related tax expenditures, with Treasury estimating a 16% increase ($51 billion) between 2025 and 2026.
  • Telehealth expansions during COVID-19 showed promising benefits, including reduced no-shows and improved rural access, suggesting that permanent adoption could enhance care delivery.

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An Introduction to 2025 and Beyond: Looming Health Policy Challenges by Hoover Institution

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