In a series of executive actions taken shortly after returning to the White House, President Donald Trump has begun to dismantle some of the health care policies established during Joe Biden's presidency. These moves have raised concerns among policymakers, healthcare executives, and patient advocates about the future direction of U.S. health care. While the immediate impact of these orders is limited, they suggest that Trump may seek to reduce public insurance coverage and weaken protections for low-income individuals. The administration will need to take further regulatory steps to fully reverse Biden’s policies, which could take months or even longer.
Trump's early actions in the health sector highlight his intention to reverse several initiatives introduced by the previous administration. Shortly after taking office, he rescinded directives aimed at lowering drug costs and expanding coverage under the Affordable Care Act (ACA) and Medicaid. This move has left many wondering about the administration's long-term strategy for the U.S. healthcare system. Analysts note that while executive orders can signal intent, they often require additional legislative or regulatory measures to implement significant changes.
The new president has already made it clear that he intends to undo what he views as "unpopular" and "illegal" practices embedded by the Biden administration. One of the first orders signed by Trump involved rescinding over 70 directives from the previous term, including those related to health policy. For instance, an order that encouraged the Centers for Medicare & Medicaid Services to explore ways to lower drug costs was revoked. This action may indicate a shift away from efforts to negotiate drug prices in Medicare or limit future initiatives in this area.
During Biden's tenure, the administration had implemented various measures to enhance ACA enrollment and support the Inflation Reduction Act, which provided subsidies to help people afford health insurance. As a result, enrollment in ACA plans reached record highs, with more than 24 million people currently enrolled. Trump's decision to rescind these policies could potentially lead to fewer people having access to affordable health coverage. Additionally, his administration has signaled a possible rollback of other progressive health reforms, such as expanded anti-obesity medication coverage and tobacco regulation.
Beyond health care, Trump also issued orders addressing racial and gender equity. His directive asserting only two sexes has sparked concern within the LGBTQ+ community, particularly regarding access to gender-affirming care. Advocacy groups have vowed to challenge any discriminatory policies that may emerge from the new administration. Meanwhile, Trump halted new regulations pending review, which could result in abandoning proposals that were not finalized under Biden, such as limits on nicotine levels in tobacco products.
The administration's focus on reducing administrative expenses and eliminating rent-seeking practices in healthcare remains unclear, leaving experts to speculate on how agencies will respond. Concurrently, Republicans in Congress are considering budget proposals that could lead to substantial cuts in Medicaid funding. This dual approach—through both executive orders and potential legislative action—suggests a broader effort to reshape the U.S. healthcare landscape. Despite the uncertainty surrounding these early moves, one thing is clear: the coming months will be crucial in determining the future of health care in America.