OPINION:
As the Trump administration takes over again after a four-year gap, America faces a number of challenges on the fiscal side — like an exploding deficit and debt — in addition to foreign policy issues. Regulatory reform will be a top priority, and I have three recommendations in particular.
The announcement of the Department of Government Efficiency (DOGE) is a promising new initiative.
But, for the initiative to work, Elon Musk should look to the playbook from the states as a guide. Virginia and Idaho stand out here.
Under Virginia Gov. Glenn Youngkin, the Office of Regulatory Management was established. The office is an independent entity that sets clear goals and guidance for regulatory reform. The office also seeks to engage state regulators in the process and has had tremendous success in reducing the footprint of regulation in the commonwealth. Estimates suggest that reducing regulatory accumulation has saved Virginia residents well over $1 billion each year.
Idaho is another shining star in this area and has already gained the attention of Elon Musk on social media. Idaho’s unique model of zero-based regulation would be an ideal starting point, allowing all federal regulations to sunset and changing the mindset from “what regulations should we cut” to “what regulations do we need in the first place.” This eliminates the inherent challenge of reducing regulation, as regulation scholars know it can be very difficult to eliminate existing regulations because of vested interests that profit from the status quo.
A second area where the Trump administration can enact important change is the regulation of health professionals’ practice authority. Most of the challenges in this area are state-by-state. For example, there are still important differences across states in the freedom of nurse practitioners to work to the full extent of their training. The same is true for other advanced practice registered nurses, physician associates, pharmacists and optometrists, to name a few.
The federal government is also hampering the potential of health professionals with archaic Medicare rules. As one striking example, advanced practice registered nurses are not permitted to make the determination that a patient needs diabetic shoes. Neither can podiatrists. Instead, both medical professionals must refer patients to a physician. This seems like an unnecessary and costly hurdle.
Federal legislation was introduced in the House and Senate two years ago, but each failed to advance to help remedy this issue. Eliminating some of this unnecessary red tape in the provision of health care should be a priority for the incoming administration.
A final suggestion would be to use the bully pulpit of the presidency to encourage states to reform outdated and costly regulations. In the previous Trump administration, an executive order laid out key principles for occupational licensing reform. This executive order was a key driver of several occupational licensing reforms, particularly with respect to states setting up a streamlined process for accepting licenses from other states. Today, the majority of states (26 in total) have enacted some form of universal recognition of occupational licenses.
Providing further guidance to states on this topic, as well as others that have had staying power and face resistance from powerful entrenched interests — like further full practice authority reforms and the removal of certificate-of-need laws — would be very helpful in encouraging further reforms.
The Trump administration took office with a laundry list of problems and challenges to address. Taking into consideration each of the recommendations offered here should help alleviate federal red tape while issuing proper guidance to the states. Streamlining regulation and making sure that unnecessary barriers are eliminated or reformed will help level the playing field and improve the well-being of all U.S. citizens.
• Edward Timmons is a service associate professor of economics and director of the Knee Regulatory Research Center. He is also a senior fellow with the Archbridge Institute.
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