President Trump’s Latest Executive Orders Impacting Health Care

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In the first few days of his second presidential term, newly inaugurated President Trump signed a number of executive orders that will have an impact on the health care industry, some issuing new policies and some rescinding policies set forth by prior administrations. Like the executive orders issued by any president, these proclamations will generally begin the process of rulemaking and drafting regulations at the federal agency level. Here is a summary of the changes thus far.

1. Affordable Care Act.

President Trump rescinded former President Joe Biden’s order that extended the enrollment periods for Affordable Care Act (ACA) plans in most states, and granted additional funding for third parties aiding enrollment in ACA insurance. While ACA enrollment nearly doubled under the Biden administration to about 24 million people, those gains are attributed primarily to government subsidies that lowered the cost of ACA premiums. The effect this rescission will have on enrollment trends is one thing to watch in the coming years.

2. Drug Pricing.

President Trump issued an order rolling back policies to limit drug spending by Medicaid and Medicare. In particular, he rescinded an executive order that asked the Center for Medicare and Medicaid Innovation (CMMI) to consider new payment and healthcare models to limit drug spending. The former Biden-era order had prompted CMMI to announce in 2023 its intention to test three models aimed at lowering drug costs, none of which have fully gotten off the ground yet. The purpose of President Trump’s rescission is reportedly to facilitate better price negotiations with drug companies, as the second round of Medicare drug price negotiations are slated for 2025. Thus far, 15 drugs have been added to the negotiation list, indicating the administration’s intention to lower prices for those drugs, including Ozempic and Wegovy.

3. Artificial Intelligence.

President Trump has rescinded President Biden’s “Executive Order on Safe, Secure, and Trustworthy Development and Use of Artificial Intelligence,” which described the federal government’s stance on “responsible” deployment of Artificial Intelligence (AI), including in the health care space. Pursuant to that order, the United States Department of Health and Human Services (HHS) was tasked with establishing an AI task force and developing a strategic plan, which they released at the beginning of January. President Biden’s order, according to the Trump administration, “established unnecessarily burdensome requirements for companies developing and deploying AI that would stifle private sector innovation and threaten American technological leadership.”

President Trump has named a new Special Advisor for AI and Crypto, and has called for the development of an AI action plan within 180 days. President Trump signed a new order titled “Removing Barriers to American AI Innovation,” which claims the Biden-era order hindered innovation and placed “unnecessary government control over the development of AI.” It also states that “American development of AI systems must be free from ideological bias or engineered social agendas.

President Trump has publicly announced support for the $500B “Stargate Initiative,” which is meant to fuel AI adoption in healthcare, manufacturing, and defense through private funding. The leaders of the AI companies funding this initiative have highlighted AI’s ability to transform health care, including using AI to rapidly develop new vaccines. While the new administration’s support for innovation in AI is apparent, the direction for the regulation and oversight of AI in health care is murkier than ever before.

4. World Health Organization.

President Trump issued an Order requiring the United States to leave the World Health Organization (WHO), which is consistent with his 2020 push for the United States’ exit that former President Biden blocked shortly after he was inaugurated in 2021. President Trump cites in the Order the “mishandling of the COVID-19 pandemic” and the WHO’s “inability to demonstrate independence from the inappropriate political influence” of other member states. He also stated that the WHO demands unfair payments from the U.S., the top donor to the WHO, when compared to the other member countries. For example, China contributes 90% less to the WHO than the U.S. despite having a larger population.

5. Gender Affirming Care.

The Trump administration has issued an order titled “Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” which essentially removes the concept of gender identity from federal government policies and procedures, including removing health care afforded to people on that basis. President Trump also rescinded a number of orders from the Biden-era that promoted protections on the basis of sex and gender identity in schools, and did away with the Gender Policy Council. These new orders are consistent with the President’s promises on the campaign trail and in his inauguration speech, but legal challenges are likely.

6. Immigration.

Another Biden-era policy rescinded by President Trump includes a policy not to arrest people without legal residency at or near “sensitive locations,” which includes hospitals, which Congress had attempted to formalize in 2023. The purpose of the rescission is to boost the ability of the U.S. Immigration and Customs Enforcement (ICE) to enforce immigration laws. The effect on health care is that immigrants could potentially be arrested in hospitals and while receiving medical care. Health care providers and facilities should pay close attention to immigration policy updates under the Trump administration.

7. Covid-19.

President Trump acted to revoke several policies implemented by former President Biden, the purpose of which were aimed at responding to the Covid-19 pandemic and future infectious disease outbreaks by bolstering testing, research into treatments, providing economic relief, and enhancing cooperation with other countries in the event of another pandemic. For the most part, these rescissions remove lingering policies that have run their course after the Covid-19 pandemic.

8. Abortion Spending.

President Trump has signed an Executive Order to end the use of Federal taxpayer dollars to fund or promote “elective abortion” by reinstating the Hyde Amendment, which was passed in 1976 and attached Medicaid appropriations to the restriction of federal funding from supporting abortions. On the same day, President Trump also signed an Order reinstating the Mexico City Policy, which had been rescinded by former President Biden. The Mexico City Policy requires foreign nongovernmental agencies to certify that they don’t provide or promote abortion if they receive U.S. federal funds for family planning assistance. Also on Friday, President Trump’s administration directed federal prosecutors to scale back enforcement of the Freedom of Access to Clinical Entrances (FACE) Act. The FACE Act is a 1994 law that makes it illegal to harm, threaten, or interfere with a person obtaining or providing abortion and reproductive health services or to damage a facility where those services are provided.

9. Regulatory Freeze.

President Trump, through the Office of Management and Budget (OMB), ordered a government-wide freeze stopping the rulemaking process for 60 days in an effort to review rules posted in the Federal Register. This freeze includes and implicates HHS’s ability to issue healthcare regulations. During the regulatory freeze, HHS will assess the regulatory landscape and decide which regulations it wants to keep or toss from the former administration. It will also assess regulations proposed but not finalized under the former administration, including the proposed updates to the Health Insurance Portability and Accountability Act (HIPAA) Security Rule and the proposed rule for the prescribing of controlled substances via telehealth. We’ll be watching for how the Trump administration will deal with the proposed updates to Medicare Advantage and Medicare Part D prescription drug programs. The freeze ends on February 1^st.

10. Freeze on Federal Grants and Loans.

In conjunction with the directive to freeze the regulatory process, the Trump administration issued OMB Memorandum M-25-13, which sought to place a temporary pause on trillions of dollars of federal grants and loans. However, the OMB quickly rescinded its memorandum after a federal judge blocked the order for constitutionality concerns after legal challenges from nonprofit organizations and concerns from state and local governments over the freeze’s impact on health care and crucial infrastructure spending. The White House clarified that this was not a rescission of their intent to implement a funding freeze, but rather an attempt to alleviate confusion around the application of the directive and doubled down on their commitment to review federal spending. For many hospitals and healthcare providers, a pause on the receipt of federal grants and other financial assistance could have a substantial impact on their ability to provide care to their patients. As a result, hospitals and healthcare provides should closely track this initiative from the Trump administration and the legal challenges as it makes its way through the courts.

Follow along with Maynard Nexsen’s health care team as we continue to closely monitor how President Trump’s administration will impact health care.