Health IT Implications for H.R. 1 and the "Make Our Children Healthy Again Assessment"

MAHA Commission

First I will start with the recent release of the "Make Our Children Healthy Again Assessment" report, produced by The President's MAHA Commission. This report has sounded a clarion call for urgent action. American children are facing an unprecedented health crisis, with over 40% of those aged 0-17 suffering from at least one chronic condition, such as obesity, diabetes, or behavioral disorders. Despite the United States outspending peer nations on healthcare, it ranks last in life expectancy among high-income countries and suffers higher rates of chronic diseases. The report points to poor diet, environmental chemicals, lack of physical activity and chronic stress, and overmedicalization as the key culprits behind this troubling trend. It also emphasizes the need for "radical transparency" and "gold-standard science" to turn the tide.

Health information technology, or HIT, emerges as a powerful ally in this fight, offering innovative ways to address these challenges head-on. Picture a world where technology doesn't just support healthcare but transforms it, weaving data, transparency, and prevention into the fabric of children's lives. This narrative explores how HIT can rise to the occasion, drawing inspiration from the report's findings to craft a healthier future.

Transparency lies at the core of the report's vision, and HIT can make it a reality. Imagine a national database, accessible to everyone, tracking everything from childhood obesity rates to the quality of school lunches. Parents could log in to see how their community stacks up, while policymakers use the same data to shape smarter interventions. To ensure this information is trustworthy, blockchain technology could step in, locking health records into a tamper-proof system. This would tackle the report's concerns about "corporate capture," where industry interests skew data, by making every entry secure and verifiable.

Research, too, stands to gain from HIT’s touch. The report highlights a "replication crisis," where studies can’t be reproduced, eroding confidence in science. What if researchers had a shared platform, powered by HIT, where they could post datasets and findings for all to test? A system using federated learning could let scientists collaborate across borders without risking privacy, analyzing patterns in childhood health without ever moving sensitive data. This would break down the walls around "industry firewalled data," as the report calls it, and rebuild science on a foundation of openness.

When it comes to diet, the stakes couldn’t be higher. The report reveals that nearly 70% of children’s calories come from ultra-processed foods, packed with additives and stripped of nutrients. HIT can fight back with tools like mobile apps that scan food labels and offer instant feedback, guiding families toward whole foods. Picture a game-like app that turns healthy eating into an adventure for kids, rewarding them with virtual badges for choosing carrots over cookies. Schools could tap into similar systems, using HIT to overhaul lunch programs and steer kids away from the processed traps the report warns about.

Environmental threats, another focus of the report, often fly under the radar, but HIT can bring them into sharp focus. By linking electronic health records with real-time environmental data—like air pollution levels or water quality—researchers could uncover hidden risks to kids’ health. A nationwide dashboard might take this further, alerting families to local hazards with a few clicks. Machine learning could sift through this data, spotting trends like a rise in allergies tied to a nearby chemical spike, giving parents and schools a heads-up to act.

Physical inactivity and stress, fueled by screen time and modern pressures, weigh heavily on kids today. HIT offers a lifeline here, too. Wearable devices could nudge children to move more, turning steps into a game where they "level up" with every goal met. For mental health, telemedicine already connects kids to therapists remotely, but virtual reality could push this further. Imagine a child stepping into a VR world to unwind or rebuild strength after an injury, blending therapy with play in a way that feels natural and fun.

Overmedicalization, driven by profit motives and skewed guidelines, is another dragon the report seeks to slay. HIT can arm doctors with AI-powered tools that sift through patient data and suggest alternatives to pills—maybe a diet tweak or a walk instead of a prescription. These systems could flag overprescription risks, cutting through the noise of industry influence and putting kids’ well-being first.

The report also calls out corporate sway over science and medicine, and HIT can expose it. Databases tracking financial ties between researchers and companies, paired with natural language processing, could scan studies for bias and flag red flags—like a drug trial bankrolled by its maker. A public portal could put this power in everyone’s hands, letting parents and doctors judge research for themselves.

At its boldest, the report dreams of "AI-Powered Surveillance" and real-world data platforms to spot health threats early. HIT makes this possible, knitting together data from clinics, schools, and sensors into a living map of childhood health. A federated learning network could refine this further, letting experts share insights without compromising privacy. If an AI spots a link between a food additive and a rash outbreak, it could spark action before more kids suffer.

In the end, the "Make Our Children Healthy Again Assessment" isn’t just a warning—it’s a chance to rethink how we protect our kids. Health information technology weaves these threads together, from transparent data to smarter prevention, into a tapestry of change. With tools like blockchain, AI, and virtual reality, we’re not just patching up problems—we’re building a world where America’s children can thrive once more.

The report is officially due to be released tomorrow, but is available online here: https://static01.nyt.com/newsgraphics/documenttools/fd441e56ad4bcf36/2f18e38b-full.pdf

H.R.1 - One Big Beautiful Bill Act (OBBA)

The “One Big Beautiful Bill Act” (H.R. 1), recently passed by the House of Representatives and poised for consideration in the Senate, has sparked national attention for its sweeping scope. While headlines have focused on its tax cuts, immigration policy, and reforms to social safety net programs like Medicaid, embedded within the bill are provisions with profound implications for the future of health information technology (HIT). These changes reveal a strategic alignment between fiscal reform and digital modernization, pointing toward a new era in the management and exchange of health data in America.

Central to the bill is a massive infusion of funding to update outdated federal IT infrastructure. The Department of Commerce is slated to receive $500 million for the purpose of replacing legacy systems, improving cybersecurity, and deploying commercial artificial intelligence (AI) technologies. This commitment to modernization signals a federal endorsement of AI as a tool to drive efficiency, particularly in domains where public health intersects with large-scale data operations.

Within healthcare, the bill explicitly instructs the Secretary of Health and Human Services to deploy AI tools to identify and recover improper payments under Medicare Parts A and B. This is not merely a budgetary maneuver but a signal that future healthcare finance systems will increasingly rely on intelligent automation. It opens the door to broader public-private partnerships in which vendors of AI-enabled fraud detection and claims analytics will play an expanded role. It also provides a template that Medicaid, the VA, and even commercial payers may choose to emulate.

Another pivotal area addressed in the bill concerns the accuracy and integrity of beneficiary data. Under the legislation, states must regularly verify Medicaid and CHIP enrollee information using authoritative sources such as the National Change of Address Database and managed care records. These new verification mandates are not simply bureaucratic hurdles; they point to a coming surge in the demand for real-time data exchange capabilities and secure interoperability between government databases and health systems. Technology vendors will need to develop or enhance platforms that can handle this increased load while meeting strict privacy and audit requirements. Moreover, innovation in identity verification—such as biometric tools and advanced authentication frameworks—will be critical to managing this complexity while maintaining compliance with federal privacy standards.

Closely related to these developments is the Act’s emphasis on standardizing data exchange. The legislation promotes improved interoperability between states and federal agencies while reinforcing commitments to privacy. Though it stops short of mandating specific technical frameworks, the policy environment it cultivates is clearly favorable to standards like HL7 FHIR and efforts like the Trusted Exchange Framework and Common Agreement (TEFCA). These initiatives seek to make health data more accessible, portable, and usable across care settings. As systems strive for compatibility, HIT vendors will increasingly be required to align their products with these evolving national standards. The outcome could be a significant reduction in data silos, enabling patient records to follow individuals more seamlessly across providers and jurisdictions.

The bill also places a clear spotlight on fraud prevention. With heightened requirements for risk assessment, eligibility audits, and financial oversight, health IT systems will become the central nervous system for fraud detection efforts. Predictive analytics platforms that surface anomalous claims or suspicious patterns will be essential tools for program integrity. Secure logging and audit trail capabilities—once optional features—will become foundational for compliance, particularly as government agencies tighten oversight and transparency expectations.

As more sensitive data is exchanged between agencies and providers, cybersecurity becomes paramount. The bill’s broader IT modernization provisions, though not healthcare-specific, may indirectly benefit HIT security by funding shared infrastructure improvements and reinforcing the need for zero-trust security models, continuous monitoring, and advanced encryption protocols across the board.

In the end, while the One Big Beautiful Bill Act may be remembered for its political drama and fiscal realignment, its implications for health information technology are no less significant. It presents a rare convergence of federal investment, regulatory mandate, and digital opportunity. By linking financial stewardship with digital transformation, the Act sets the foundation for a health system that is not only more efficient but also more intelligent, secure, and responsive to the needs of patients and providers alike.

The bill is available online here https://www.congress.gov/bill/119th-congress/house-bill/1/text