In January, we will welcome a new administration, a new Republican-led U.S. Senate, and likely, the continued Republican majority in the U.S. House of Representatives all of which can impact the nation’s blood supply. This unified government will only be the second time in the last 15 years that we have seen power reside with one party in the administration, Senate, and House of Representatives, ushering in an era of significant policy change that presents both opportunities and challenges.
America’s Blood Centers (ABC) and our members are dedicated to working with the new administration and Congress to promote a safe and available blood supply as part of these efforts. The blood supply is generally non-partisan, and we are optimistic we will see the same level of support we have had in previous administrations. For instance, it is important to remember that President-elect Trump was supportive of community blood centers in their pandemic response, including the ramp up of convalescent plasma.
With changes in the leadership of federal agencies and more than 60 new members of Congress, ABC, our members, and our partner organizations must be active in engaging the new administration and in promoting education about the blood supply, providing common sense solutions to improve our healthcare system, and ensuring we are well placed to respond to any changes or proposals that are introduced.
Overall, we expect change in the new Administration and Congress to fall into several broad areas that will shape the work of ABC and community blood centers over the next four years.
Regulation & Federal Authority
We anticipate the administration will seek to limit the role and power of the federal government and identify opportunities to decrease regulation at the federal level. ABC’s Advocacy Agenda is well positioned in this area, with asks to reduce regulatory burdens on blood centers to support a safe and available blood supply. Our priorities include elimination of the HBsAG test, further streamlining of the licensure process, and implementing a rational, flexible approach to the regulation of plasma products. We anticipate continuing to work with the ABC Policy Council and members to identify additional areas of regulatory reform.
The likely impact of these efforts is increased regulatory efforts at the state level. ABC and its members are well positioned for this change with the creation of the Council of States and the efforts many of your centers have already undertaken to educate and build relationships at the state level.
Of note is last year’s Supreme Court decision that overturned the 40-year-old precedent known as the “Chevron deference,” changing the way a court will view the decision making of an agency. Now, courts will no longer defer to the expertise of the agency where there is ambiguity, but instead will undertake their own processes to interpret ambiguous information. While we will see the impact of this Supreme Court decision, it is less likely to be as impactful during this administration, as it would be utilized to restrain agency action. However, we anticipate the administrative agencies will likely be more restrained during the Trump Administration, meaning the Supreme Court ruling is less likely to be invoked.
Reduction in the Federal Workforce
It is often said that ‘personnel is policy,’ and it will be important to watch and see who takes over leadership in the various agencies and the impact of President-elect Trump’s promise to reduce the role of career civil servants. Furthermore, as we saw in the last Trump Administration, open positions are more likely to be allowed to remain open, meaning the agencies are more likely to be short-staffed, which impacts the amount of work they can get done. The impact of this may be uneven depending on the specific roles that are unfilled, and how work is redistributed within the agency. The result is the agencies will likely be restrained in their ability to engage in rulemaking for both ideological and practical reasons. As we identify who the key officials are, ABC will continue to work to develop and maintain relationships and provide necessary education on the role of the blood supply and how they can support a safe and available blood supply.
Public Health Agency Reforms
President-elect Trump has expressed consternation with the level of independence the scientific agencies have in following changing scientific knowledge, particularly with the Centers for Disease Control and Prevention (CDC). We will vigilantly watch how this could impact blood centers should there be similar skepticism of the scientific method and knowledge within the U.S. Food and Drug Administration (FDA). Cuts to public health, including potential cuts to the federal agencies, such as the National Institutes of Health (NIH) and CDC, are also likely. Cuts to these federal agencies could have ripple effects for blood centers that work with them on research and other public health efforts.
Congressional Agenda
The Congressional agenda is likely to mirror the President-elect’s agenda of reducing the size and scope of government, including cuts to multiple government programs. Any bills with a “score,” meaning they cost, rather than save money for the overall federal government, will be difficult to move.
One of the first major legislative efforts expected in the new Congress will come in the form of tax reform, with $4.6 trillion in tax relief set to sunset over the coming years. Congress is likely to try and pass a sweeping reform in the first 100 days of the new Congress to provide an early win to the new administration. Of note, major conservative think-tanks have proposed changing the exempt status of non-profits as a potential way to create additional revenue. ABC is actively monitoring developments in this space and will work as part of broader coalitions on this topic as needed. Of note, Republican control of the House and Senate also opens the opportunity for the use of budget reconciliation, a process that allows for the expedited advancement of tax, spending, and debt limit legislation, meaning ABC and other stakeholders must be vigilant and proactive in developing our positions and plans, because this process can allow for quick progress of the provisions of a reconciliation bill with fewer opportunities for opposition.
Overall
While there are always unknowns with a new administration and Congress, ABC is actively engaged in maintaining and building new relationships with the members of the administration and Congress to help educate them about the importance of the blood supply. We encourage you to begin reaching out to your members of Congress, both new and returning, and ensure they are aware of your blood center, the blood supply. ABC is returning to an in-person advocacy day on the Hill this year that we will integrate it into the ABC Advocacy Workshop where you can learn more about our advocacy priorities and positions, as well as how to engage with your members of Congress.