Donald Trump has been elected 47th president of the US after the 5 November election having won more than the 270-seat threshold needed. Despite his victory, what a second Trump presidency will mean for the healthcare industry remains unclear.

During his campaign, the Republican spoke little about healthcare policy but did make some declarations, including that he would let Robert F Kennedy Jr “go wild” on healthcare and that RFK Jr would be able to “do what he wants” with women’s healthcare.

Despite Trump’s reluctance to declare an official cabinet role for his one-time third-party rival, RFK Jr said that Trump had “promised” him control over public health agencies, including the Centers for Disease Control and Prevention (CDC) and US Food and Drug Administration (FDA).

RFK Jr has already questioned the Prescription Drug User Fee Act in a Washington Post op-ed and is known to be an anti-vaccine activist. It is unclear at this stage quite how much control RFK Jr will have in healthcare.

Before the election, it was predicted that Trump would look to take a second pass at policies which were introduced but did not come to fruition during his first term. One of these is international reference pricing, more commonly known as the Most Favored Nation (MFN) rule. Trump’s 2020 version stated it would establish a mandatory seven-year demonstration to tie prices for drugs under Medicare Part B to the lower prices given to other countries.

During his campaign, Trump said he intends to repeal Biden’s Artificial Intelligence Executive Order (EO), which he states “hinders innovation” and looks to support AI development “rooted in free speech and human flourishing”. The 2019 Trump EO, which is expected to be a springboard, focused on R&D in the AI field.

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In his first term, Trump was unable to overturn Obamacare, also known as the Affordable Care Act. He has said he would be looking to put in a new system, calling the act “lousy healthcare”. When asked in the ABC News debate in September what his plan would be, Trump said he had “concepts of a plan” to replace the ACA but provided no details.

Trump attempted to partially repeal the ACA by passing the American Health Care Act (ACHA), which would have repealed the individual and employer mandate, amended Medicaid eligibility, and weakened protections for patients with pre-existing conditions.

A new chair of the US Federal Trade Commission (FTC) will be assigned under the Trump administration, despite Trump’s vice-presidential candidate JD Vance complimenting the current Democratic chair Lina Khan on her tenure, including praising her work challenging certain FDA orange book patents.

A central part of Harris’ campaign for abortion rights, however, this may not have had the impact she may have hoped as the 5 November ballot included abortion rights voted for ten states. Despite being a Republican-leaning state, Montana voted to retain the right to abortion. Although Floridians voted to protect abortion rights, due to the ballot needing a super majority, the swing was not enough.

It has already been declared that the Republicans have gained control of the Senate after taking more than the 50-seat threshold needed, with more seats still to be counted.