By Stephanie Jamison (Greenway Health), Chair, EHR Association Executive Committee

With a new administration poised to enter office and Republicans set to control both the House and Senate, the anticipated impact of the 2024 election on health IT policy is a question many in the industry are contemplating as they consider policy priorities for the year ahead. 

In assessing what to expect from the next four years, we can consider both the previous Trump Administration and those areas where Congress has been vocal in its desire to put forward legislation. While the assumption is that healthcare is unlikely to be the highest priority for either the incoming administration or Congress—the most urgent focus areas will likely be border security, tax, trade, energy, and environmental regulations—technology is top-of-mind in many areas. Legislation addressing AI, cybersecurity, and data privacy is expected to be a focal point of a new Congress.

Impacts on ASTP/ONC and its Policies and Regulations

Of importance to those that sell or use certified health IT technology is the future of the Office of the National Coordinator for Health IT, recently rebranded to the Assistant Secretary of Technology Policy (ASTP). 

While there is no indication that changes to ASTP would be an immediate priority, some in Congress have questioned its statutory authorities and role in reviewing AI safety testing. 

President-elect Trump has nominated Robert F. Kennedy Jr. to lead HHS. If confirmed, Kennedy could consider dismantling the new ASTP structure as part of Department of Government Efficiency (DOGE) efforts and move ONC under another agency to carry out its statutory authority to oversee the EHR certification program and ongoing CURES Act implementation. While there is no indication that changes to ASTP would be an immediate priority, some in Congress have questioned its statutory authorities and role in reviewing AI safety testing. 

Regardless of whether the group remains as ASTP or is changed, its leader does not require Senate confirmation and could be named even before the new HHS Secretary is confirmed. 

Regarding upcoming rulemaking from ASTP, neither the Trump campaign nor its surrogates have spoken about health IT priorities. The first Trump Administration’s support of digital health transformation has led some to predict that the incoming administration won’t substantially adjust health IT policy. However, Trump has said he will rescind President Joe Biden’s October 2023 AI executive order tasking federal agencies to establish AI guardrails. It is unclear what the administration would do in the area of AI regulation in its place.

As is customary, the incoming administration will likely freeze all rules currently at OMB. This places the future of the larger HTI-2 final rule in flux. Additionally, under the Congressional Review Act, federal agency rules can be overturned within 60 legislative days of issuance, meaning the new Congress could void any number of recently issued rules.

As is customary, the incoming administration will likely freeze all rules currently at OMB. This places the future of the larger HTI-2 final rule in flux. Additionally, under the Congressional Review Act, federal agency rules can be overturned within 60 legislative days of issuance, meaning the new Congress could void any number of recently issued rules.

Republican Control of the House and Senate

As for what Republican control of the House and Senate means for healthcare, there are early signals based on positions Republicans have taken thus far. Sen. Bill Cassidy (R-LA) and Sen. Mike Crapo (R-ID) are positioned to chair the Senate Health and Finance Committees, with Cassidy overseeing the confirmation process for the new administration’s picks to head the FDA, CDC, and NIH.

Focal points of the upcoming 119th Congress could include: 

• Passing a bipartisan bill introduced in the Senate by Sen. Cassidy with more stringent requirements related to cybersecurity.
• Introducing AI legislation following congressional requests for information earlier this year that solicited industry feedback on potential legislation. 
• Consideration of bills clarifying rights to patient data privacy outside of the HIPAA structure, such as data captured in apps.
• Increased momentum around prior authorization reform, as it has historically been a policy priority for incoming Senate Majority Leader John Thune (R-SD). 
• Making telehealth services permanent, as Vice President-Elect JD Vance has historically supported the CONNECT Act that sought to make FQHC and RHC telehealth services permanent. 
• Driving deregulation and decreasing healthcare spending, including potentially stripping pieces of the Affordable Care Act (ACA) and implementing Medicaid funding changes. 

For the HIMSS perspective on the potential impact of the 2024 elections on health IT, view their on-demand webinar, What’s Next for Health IT: Unpacking the 2024 Election.