U.S. President Donald Trump’s early actions on health care suggest he is likely to eliminate some Biden-era programs to reduce drug costs and expand coverage of public insurance programs. There is.
The orders he issued shortly after re-entering the White House have policymakers, medical professionals and patient advocates trying to read the tea leaves to determine what will happen next. Although the directive is not as sweeping as the one he issued at the beginning of his first term, he said it could increase the number of uninsured Americans and weaken safety net protections for low-income Americans. health researchers say, offering a possible roadmap.
But President Trump’s initial order will have little immediate impact. The Biden administration would need to take further regulatory action to completely reverse Biden’s policies, adding to the uncertainty about the direction the new president wants to take the U.S. health care system.
“Everyone is looking for signals about what President Trump will do on a number of health issues. Regarding early EOs (executive orders), Trump is showing no cards,” including KFF Health News said Larry Levitt, executive vice president of health policy at KFF, a health policy research, polling and news organization.
A flurry of executive orders and other actions that President Trump issued on his first day in office included reversing the directives of his predecessor, former President Joe Biden, to lower drug prices and expand coverage under the Affordable Care Act and Medicaid. was included.
Nicholas Bagley, a law professor at the University of Michigan, said the executive order “generally speaking is just a bombastic internal memo that says, ‘Government agency, can you please do something?'” “There may be reason to be concerned, but that’s in the future.”
That’s because changing established laws like the ACA or programs like Medicaid typically requires new rulemaking or Congressional action, both of which can take months. President Trump has confirmed several of his nominees to head federal health agencies, including anti-vaccination activist and former Democratic presidential candidate Robert F. Kennedy Jr., whom he nominated to head the Department of Health and Human Services (HHS). I haven’t gotten it yet. On January 20, he appointed Dorothy Fink, a physician who heads the HHS Office of Women’s Health, to serve as the agency’s acting secretary.
During the Biden administration, the Biden administration will extend the enrollment period for the ACA, increase funding to organizations that help people enroll, and support the Inflation Control Act, which increases subsidies to help people enroll, among other measures. Implemented reforms in line with health orders. Enrollment in ACA plans declined during the Trump administration, but skyrocketed under the Biden administration, hitting record highs each year. More than 24 million people are enrolled in Affordable Care Act plans for 2025.
The drug order that President Trump rescinded requires the Centers for Medicare and Medicaid Services to set co-pays for some generic drugs at $2 across the board in Medicare, the health care program for people 65 and older, and to encourage states to make efforts to He called for testing ways to lower drug costs, such as by using drugs to reduce drug costs. If we band together to buy certain expensive cell and gene therapies, we can get better prices.
This could indicate that President Trump expects to reduce drug pricing or roll back drug price negotiations in Medicare this term.
The White House did not respond to requests for comment.
Joseph Antos of the American Enterprise Institute, a right-wing research group, said Mr. Biden’s experiment in lowering drug prices never fully took off. Antos said he was a bit perplexed by the executive order ending the pilot program, given that President Trump supports the idea of tying U.S. drug costs to lower prices paid by other countries. .
“You know, Mr. Trump is a big fan of it,” Antos said. “Lowering drug prices is something people can relate to.”
In other moves, Mr. Trump also issued an order rescinding Mr. Biden’s orders on racial and gender equality and asserting that there are only two genders: male and female. HHS under the Biden administration supported gender-affirming health care for transgender people and provided guidance on civil rights protections for transgender youth. President Trump’s comments on gender have raised concerns within the LGBTQ+ community that he may seek to limit such considerations.
Omar González Pagán, senior advisor and health strategist at civil rights advocacy group Lambda Legal, said, “The administration fails to protect transgender people and those it deems ‘other’ and seeks to discriminate against them. I predict that.” . “As we have done with great success, we stand ready to fight the administration’s discriminatory actions and protect transgender people’s ability to access the care they need, including Medicaid and Medicare. .”
President Trump also halted new regulations in the works until they can be reviewed by the new administration. Vice chair Katie Keith, a professor at Georgetown University, said some proposals the Biden administration has yet to finalize include expanding coverage of anti-obesity drugs through Medicare and Medicaid and increasing coverage of nicotine in tobacco products. It includes rules to limit concentrations, and there is a possibility that these proposals could be abandoned. The director of the White House Gender Policy Council under the Biden administration wrote for Health Affairs Forefront.
“Interestingly, he did not block President Biden’s three executive orders and presidential memorandum on reproductive health care,” she wrote.
However, President Trump directed administration officials to seek additional orders or memorandums to rescind. (He rescinded President Biden’s order creating the Gender Policy Council.)
Democrats criticized President Trump’s health efforts. “Mr. Trump lies to the American people and proves once again that he doesn’t care about cutting costs. He and his ultra-wealthy friends,” Democratic National Committee spokesman Alex Floyd said in a statement. I’m only thinking about what’s best for them.”
Some policy experts say President Trump’s decision to repeal Biden-era executive orders aimed at improving the Affordable Care Act and Medicaid likely portends future cuts and changes to both systems. Point out that there is. The administration previously passed guidance that would open the door to work requirements in Medicaid, the federal-state program for low-income adults, children, and people with disabilities, and allow states to cap federal Medicaid funding. Published on. Medicaid and related children’s health insurance programs cover more than 79 million people.
“Medicaid is going to be a focus because it’s so widespread,” said Chris Pope, a senior fellow at the Manhattan Institute, a conservative policy group. “We’ve grown after the pandemic. We’ve expanded our provisions, including the use of social determinants of health.”
The administration may reevaluate a Biden administration move that allows Medicaid to pay for everyday living expenses such as air conditioning, food and housing that some states say impact recipients’ health.
One of President Trump’s directives directs government agencies to provide emergency price relief and “eliminate unnecessary administrative fees and rent collection practices that increase health care costs.” (Rent-seeking is an economic concept that describes efforts to exploit political systems for economic gain without producing other benefits to society.)
“It is unclear what this refers to, and it will be interesting to see how government agencies respond,” Keith wrote in the Health Affairs article.
Policy experts like Georgetown University’s Edwin Park also note that Republicans are working on a separate budget that could lead to significant cuts in Medicaid funding to pay for some of the tax cuts. Mentioned.
Sarah Lueck, vice president for health policy at the Center on Budget and Policy Priorities, a left-leaning research group, also told Congress: “On the one hand, what we get from President Trump’s executive order is important because This is because it shows.” The direction they are moving in with policy changes. But the other avenue is that there’s a lively conversation happening on the Hill about what’s going to be in the budget bill. They’re considering pretty significant cuts to Medicaid. ”