Unlike 4 years ago, we aren鈥檛 facing days of vote counting, post-election challenges and electoral uncertainty. Former President Donald J. Trump has been re-elected and will be inaugurated on Monday, Jan. 20, 2025.
Based on Trump鈥檚 previous term and the campaign trail promises from Trump and his surrogates, it is worth considering what a second Trump presidency means for EMS. The centerpieces of Trump鈥檚 campaign were tariffs, immigration, taxes and crime, issues that touch every aspect of daily life, in and out of the workplace.
Tariffs
Trump believes tariffs will boost manufacturing in the U.S. EMS should also expect tariffs to increase the cost of imported goods, from ambulance parts, to exam gloves, to computer chips and everything in between. Perhaps American manufacturers, with reduced international competition, will fill the void of foreign imports with affordable and reliable products.
Immigration
Trump has promised to forcibly remove millions of immigrants, starting with a million or more known criminals living illegally in our country. There will be an obvious societal and EMS benefit from the deportation of those who are causing injury, property damage and suffering of others.
This effort to remove known criminals, as well as millions of other illegal immigrants, will require significant federal, state and local law enforcement funding and resources. Expect billions of dollars for personnel and equipment to flow into law enforcement to complete this herculean task.
If illegal immigrants are high EMS utilizers in your community, you may experience call volume reductions as immigrants are either forcibly removed or self-relocate. As they are unlikely to be paying EMS customers, your agency may also lose less money than it already is losing.
Federal funding
EMS has never been adequately funded and should not expect that to change. Trump supporter Elon Musk believes he can help Trump from the federal budget. To reach that level of budget reduction, Trump will need deliver huge cuts to Medicare and Medicaid, and slash spending to infrastructure, like roads and bridges, public health services, nutrition programs, food and drug safety, vocational training and much more. EMS, which is not even a rounding error on $2 trillion, should expect massive reductions in its federal funding and other programs that support EMS and reduce injury and illness.
Astute EMS agencies will find a way to connect to the funding that is about to flow into law enforcement. Much like the post-9/11 period, EMS may be able to ride the coattails of law enforcement on community-wide funding for communication systems, training facilities and patient care equipment to support the mass deportation effort.
Taxes
Tax cuts, through a continuation of the first Trump tax cuts and promised additional tax cuts, have the potential to reduce the federal income tax burden of the citizens your community serves. Perhaps your constituents will be more willing to support statewide taxes or a local levy to financially support EMS as an essential service.
Fentanyl
Even though the rate of opioid overdoses has begun to drop, far too many people are still dying of opioid overdose. Trump has made it a fixture of his campaign to secure our borders to prevent entry of people and illegal drugs, like fentanyl. Reducing the supply, while hopefully also supporting programs to reduce demand and treat addiction, may lead to a continuing drop in deaths, and the family- and community-destroying impacts of the opioid crisis.
Affordable Care Act
In the debate, Trump told America that he has 鈥渃oncepts of a plan鈥� to replace the Affordable Care Act, also known as Obamacare. If Trump鈥檚 plan doesn鈥檛 equal or exceed the current program more than are using, EMS will feel the impact of caring for even more people who are uninsured or underinsured.
Pediatric emergencies
In return for his endorsement, Trump campaigned that he will let Robert F. Kennedy, Jr. 鈥済o wild鈥� on health. RFK believes he will have , including Health and Human Services, the Centers for Disease Control and Prevention, the National Institutes of Health, and the Food and Drug Administration. Childhood vaccination rates, already in decline, are likely to continue that trend in a second Trump term. Reducing rates of vaccination increases the likelihood EMS providers will encounter infants and children sick with pertussis, chickenpox, measles, mumps, pneumonia, influenza, hepatitis and other rarely encountered diseases.
Performance metrics
On the cusp of a second Trump administration, here are service metrics to consider monitoring:
- Opioid overdoses treated
- Uninsured patients assessed, treated and transported
- Pediatric emergencies caused by preventable diseases
- Being funded as an essential service
If in the next 4 years, your EMS agency achieves sustainable funding as an essential service and treats fewer opioid overdoses patients, fewer uninsured patients and fewer sick kids, President Trump will have fulfilled his campaign promises and your community will be healthy and prosperous.
Conclusion
Obviously, Trump has a constituency for these issues. Otherwise, he would not have been re-elected. In the years ahead, EMS will realize positives and negatives if Trump鈥檚 actions in office live up to his campaign trail promises.
Admittedly, I think the current state of EMS, especially its funding, is pretty bleak. I am especially interested in hearing your thoughts on what actions stemming from Trump鈥檚 campaign promises will solidify EMS funding and service quality. What do you think a Trump presidency means for EMS? Message us at editor@ems1.com.
Author鈥檚 note: You are welcome to judge how well my 2016 predictions for a Trump presidency held up and to question why in the fog of the COVID pandemic and post-election chaos I didn鈥檛 write a similar article about President Biden in 2020.
