Trump’s broad executive order mandates that the cost of new and repealed regulations be net neutral or negative for fiscal 2025. In healthcare, that means we could see a push to roll back policies such as Biden’s 80/20 rule, which dictates that at least 80% of Medicaid payments to home-health agencies go toward caregiver wages, with the remainder allocated to administrative expenses and profit.
This introduces uncertainty. Home-health providers may see improved margins if the rule is rescinded, but it could also invite political and legal battles that stretch out timelines for clarity. If the 80/20 rule is repealed, we may see a reallocation of capital, with firms in the space reevaluating their cost structures.
For healthcare companies, particularly those in home health and skilled nursing, regulatory unpredictability means strategic flexibility is essential. Will they reinvest freed-up capital into expansion? Or will they prioritize share buybacks and debt restructuring?
This raises critical questions about care quality. Fewer wage restrictions could mean providers have more discretion, but will this translate into better services or exacerbate workforce shortages?
One of the biggest targets is the Biden administration’s minimum staffing rule for nursing homes, set to take effect in 2026. The rule mandates specific nurse-to-patient ratios, which the Congressional Budget Office estimates would cost the federal government $22 billion over a decade. With Republicans seeking offsets to extend tax cuts, this regulation is on thin ice.
This is a key watchpoint. Companies like Omega Healthcare Investors and Ensign Group are already preparing for compliance, but a rollback could shift their capital allocation strategies.
The stakes are high. If the rule remains, compliance costs will bite into margins, likely leading to consolidation as smaller operators struggle to meet new requirements.
The question is whether a staffing mandate actually improves care outcomes. Evidence suggests better-staffed facilities lead to lower mortality rates, but at what cost to access and affordability?
A repeal could benefit diagnostic firms by reducing compliance costs and speeding up market access for new tests.
Deregulation means a return to rapid innovation cycles but also a heightened need for internal quality controls.
Faster test approvals could improve access to innovative diagnostics, but the absence of stringent oversight raises concerns about test accuracy and reliability.
The healthcare regulatory landscape is poised for another major shake-up. For investors, this presents both risks and asymmetric opportunities, depending on sector exposure.
For companies, adaptability will be the key to navigating shifting policies. And for patients, the fundamental question remains: do these changes ultimately lead to better or worse health outcomes?