If Kamala Harris had won the 2024 election, Carmel Shachar, an assistant clinical professor at Harvard Law and health policy expert, expected that her work would have continued to be technocratic, focusing on “the nitty-gritty regulations we need” to fine-tune health care.
But a Trump win, she told me on this episode of the “First Opinion Podcast,” means something different altogether. Now, her work will become “a little bit defensive,” focusing on keeping the Affordable Care Act alive, protecting physicians from government interference in their work (a topic she also recently addressed in a First Opinion essay), and more, particularly around reproductive rights.
However, she said, a new Trump administration also “opens avenues of creativity to say, ‘OK, well, what issue is not overly politicized, such that we can make progress there?’ ” She said, “During the first Trump administration came some really good thinking around value-based care and how to get it unstuck, particularly from the fraud and abuse rules that simply didn’t actually address any problems in value-based care, but just kept people from adopting it.” She is hopeful that there will be opportunities for such innovation in a second administration, too, particularly around chronic illness.
We discussed how the second Trump term might differ from the first, how the health policy world is preparing, and her work on reproductive health, telehealth, and vaccines.
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