Health care was not a major focus of Donald Trump’s 2024 campaign, unlike topics like immigration and the economy.

Nonetheless, experts believe that some of the health policies mentioned by Trump during his rallies, town halls, and media appearances could significantly alter the U.S. public health landscape.

Implementing these policies may be a challenge for the new administration, according to Stephanie Kennan, a veteran health policy expert and former congressional staff member.

“There are many ideas being considered,” Kennan, senior vice president of federal public affairs at McGuireWoods Consulting, stated. However, she pointed out that none of these ideas have been fully developed or detailed.

Here are some of Trump’s proposed health policies and their potential impacts over the next four years.

Reproductive Health: Abortion and In-Vitro Fertilization

While Trump often discusses his involvement in overturning Roe v. Wade, he has claimed that he does not support a federal ban on abortion.

“It’s known that I would not support a federal ban on abortion in any circumstances, and I would veto it, as the decision should rest with the states and their voters,” he posted on X, formerly Twitter, on October 1.

Trump has distanced himself from Project 2025, a policy proposal from the conservative Heritage Foundation which suggests that the FDA should revoke its approval of mifepristone, a medication used in approximately two-thirds of U.S. abortions. Trump stated in August that he wouldn’t dismiss the possibility of restricting access to the drug.

Trump also mentioned on X that his administration would support women and their reproductive rights.

He promised to safeguard in-vitro fertilization (IVF), a procedure that assists individuals facing fertility challenges.

In interviews, Trump highlighted a ruling from the Alabama Supreme Court which classified embryos created during IVF as “extrauterine children” deserving of legal protection. This decision raised concerns among families and IVF clinics nationwide, leading some to temporarily halt procedures out of worry for its consequences.

During a town hall session focused on women, Trump claimed to be the “father of IVF” and expressed a desire for both public and private health insurance to cover this treatment.

However, Kennan pointed out that IVF can be quite costly, sometimes reaching $30,000 per attempt. The administration needs to clarify two crucial points: Who would cover these costs, and how would that be feasible?

“Someone must finance it,” she remarked. She added that promising coverage raises complex issues related to insurance practices.

Affordable Care Act

Republicans have stated they do not intend to eliminate the Affordable Care Act (ACA), indicating they will only modify it to enhance cost-efficiency and coverage improvements.

“Many aspects of the Affordable Care Act enjoy public support,” noted Carri Chan, a professor at Columbia Business School specializing in healthcare and pharmaceutical management.

During a debate with Trump, Vice President Kamala Harris asserted her commitment to safeguarding the ACA. Trump acknowledged he did not have specific replacement plans but mentioned he had some “concepts” in mind.

In a follow-up NBC News interview, Trump’s vice president-elect, Sen. JD Vance, stated that the incoming administration aims to restructure ACA to align with individual healthcare needs.

“We want to ensure everyone has coverage,” he told NBC’s Kristen Welker. “The best way to achieve this is to encourage more choices in the healthcare system rather than a one-size-fits-all approach that groups everyone into the same insurance pools.”

This shift could potentially lead to affordable insurance options for younger, healthier individuals, but it might also result in higher costs for older adults and those with pre-existing health conditions.

Moreover, the administration might not extend the tax credits designed to aid low-income individuals with their premium payments, which could lead some to forfeit coverage, Kennan expressed.

“The Affordable Care Act has become so ingrained in our system that completely dismantling it would be quite challenging,” she said. However, the Trump administration could still “tweak it.”

Transgender, Nonbinary Health, and Gender-Affirming Care

Leading up to the election, the Trump campaign released a series of advertisements criticizing Harris for her support of transgender rights.

“Kamala advocates for taxpayer-funded gender changes for incarcerated individuals,” stated one of the advertisements. “Kamala is for they/them. President Trump is for you.”

The Republican Party’s official 2024 platform promises to prevent “taxpayer-funded schools from endorsing gender transition,” under a heading titled “Republicans will end left-wing gender insanity.”

In a September address, Trump committed to issuing an executive order that would instruct federal agencies to stop “promoting gender transition.” He also pledged to implement a ban on gender-affirming healthcare for minors and to withhold federal funding from healthcare facilities that do not comply. Furthermore, he mentioned reinstating the “Trump ban on transgender individuals serving in the military.”

Regarding abortion access, Kennan noted that current laws restrict federal funding for abortions, implying that extending similar restrictions to gender-affirming care would be manageable.

Kennan has expressed concerns regarding the psychological effects on individuals diagnosed with gender dysphoria, which refers to the discomfort experienced when a person’s gender identity does not align with their sex at birth. According to the Mayo Clinic, typical treatment strategies for gender dysphoria may involve adjustments in gender expression and role, hormone therapy, surgical procedures, and behavioral therapy.

Kennan additionally worries about the situation for patients who lack access to safe, gender-affirming healthcare and may resort to dubious alternative methods.

She noted that individuals might seek hormone therapy from untrustworthy sources and could end up causing harm to themselves because the substances they receive might not be legitimate.

RFK Jr. aims to ‘Make America Healthy Again’

Robert F. Kennedy Jr., who is running for president in 2024 and still appeared on some ballots despite his withdrawal from the race in August, informed his supporters that Trump “promised” to appoint him to lead public health agencies.

In an interview with CNN, Howard Lutnick, co-chair of Trump’s transition team, clarified that Kennedy will not get a position at the Department of Health and Human Services.

“That’s not what he’s looking for. … He’s interested in data,” Lutnick told CNN’s Kaitlan Collins last week.

However, Trump hinted in his victory speech that Kennedy might have a more extensive role beyond just data management.

“He’s going to help make America healthy again. … He has some initiatives in mind, and we’re going to let him pursue those,” Trump stated around 2:30 a.m. Wednesday from Florida. “Enjoy yourself, Bobby.”

Kennedy is well-known for his critical stance on vaccines and for sharing dubious claims regarding the origins of the COVID-19 virus. Nevertheless, he mentioned in an NBC News interview on Wednesday that he wouldn’t “take anyone’s vaccines away.”

Instead, Trump has tasked him with “eliminating corruption” in federal health agencies – bringing them back to “gold-standard science” – and to “restore health to America” by tackling chronic illnesses.

According to media reports, Republicans are contemplating a reorganization of federal health agencies such as the Centers for Disease Control and Prevention and the National Institutes of Health. Experts hope that this reorganization does not compromise research efforts.

“The specifics will be crucial,” mentioned Chan from Columbia Business School. “I hope that there will still be essential funding in the restructuring process.”