Here’s a summary of key healthcare-related executive orders and actions affecting hospitals and the broader U.S. healthcare system. A handful, described below, stand to affect hospitals most directly.
Recent EOs affecting hospitals
1. Drug pricing. A Jan. 20 executive order rescinded former President Joe Biden’s previous order to lower prescription drug costs for Medicare and Medicaid patients. The original order had instructed the Center for Medicare and Medicaid Innovation to develop and test three experimental drug pricing models, including a proposal to cap Medicare patients’ monthly out-of-pocket costs for certain generic drugs at $2.
Not all of President Biden’s drug pricing moves were reversed, such as the $35 monthly cap on insulin, the $2,000 annual out-of-pocket cap on prescription drugs, and Medicare’s authority to negotiate drug prices under the Inflation Reduction Act.
2. Gender-affirming care. President Trump signed an executive order Jan. 28 to restrict federal funding and support for gender-affirming care for minors. The order directs federal agencies to reassess policies and to keep institutions that provide gender-related care from receiving federal research or education grants. Some hospitals in the U.S. have paused gender-affirming care for minors after the executive order was signed.
3. The ACA. On January 20, President Trump rescinded President Biden’s 2021 executive order that established a special enrollment period for ACA plans in most states, as well as a 2022 executive order that directed federal agencies to develop new ways to lower costs, simplify Medicaid and ACA enrollment, and increase coverage access for Americans.
4. Tariffs on imports from China. President Trump issued three executive orders Feb. 1, directing the nation to impose tariffs on certain goods from Canada, Mexico and China. Initially, President Trump ordered a 25% levy on goods from Mexico and Canada, and a 10% tariff on imports from China. On Feb. 3, the White House said the tariff orders involving Canada and Mexico had been suspended. Tariffs on all imports from China remain and are expected to begin on March 12.
Health experts and medical associations have warned that the tariffs could spur shortages or raise the price of crucial medical devices and prescription drugs. The American Hospital Association has urged the White House to exempt medications and medical device supplies from the tariffs.
5. Make America Healthy Again Commission. After Robert F. Kennedy Jr. was confirmed as HHS Secretary on Feb. 13, President Trump issued an executive order creating the Make America Healthy Again Commission. Chaired by Mr. Kennedy, the commission is tasked with investigating the root causes of the nation’s chronic disease crisis. It will begin by assessing childhood chronic diseases and developing a national action plan to improve children’s health.
6. In vitro fertilization. On Feb. 18, President Trumped signed an executive order to expand access to in vitro fertilization. The federal order directs agencies to develop policy recommendations to protect IVF access and “aggressively reduce” costs for patients and health plans. During his campaign, President Trump vowed to require that public and private payers cover all costs associated with IVF treatments. The executive order did not share how the treatments would be made more affordable.
Recent actions affecting healthcare at large
Here are five additional executive orders, policy changes or actions made recently that could impact healthcare nationally and globally.
1. U.S. exit from the World Health Organization. President Trump signed an executive order Jan. 20 removing the U.S. from the World Health Organization due to “the organization’s mishandling of the COVID-19 pandemic that arose out of Wuhan, China, and other global health crises, its failure to adopt urgently needed reforms and its inability to demonstrate independence from the inappropriate political influence of WHO member state,” according to the order. Various physician and medical groups have warned that withdrawing from the WHO will hinder the nation’s ability to identify and respond to global public health emergencies.
2. Pandemic preparedness efforts. President Trump reversed a number of Biden-era executive orders related to the COVID-19 pandemic, calling them destructive and radical. The Biden orders included directives that coordinated response to COVID-19, prepared for future pandemics and supported the public health workforce. Most of President Biden’s COVID-19 executive orders aimed at strengthening COVID-19 research, testing, global cooperation and economic relief. Public health experts have expressed concern that the move will hinder the nation’s pandemic preparedness, especially in light of bird flu.
3. NIH funding. Though not an executive order, President Trump’s administration announced Feb. 7 it was immediately reducing by half indirect cost payments the National Institutes of Health makes to universities, hospitals and research institutes to help cover facilities and administrative costs. The move was met by much opposition from researchers, and 22 states filed a lawsuit Feb. 10 to fight the research cuts. A federal judge blocked NIH from making changes until a Feb. 21 hearing can be held.
4. Regulatory freeze. On Jan. 20, President Trump issued a presidential memorandum, “Regulatory Freeze Pending Review,” directing “all executive departments and agencies” to refrain from proposing or issuing “any rule in any manner” until a department or agency head appointed or designated by the president reviews and approves the rule. If the policy goes forward, healthcare may be affected because it impacts OSHA activity and freezes regulations to allow time for the Trump administration to delete or modify Biden-era rules. This includes proposed updates to HIPAA and telehealth prescribing standards, the final rule on nurse staffing mandates and updates to the Medicare Advantage and Medicare Part D drug programs.
5. DOGE. President Donald Trump issued an executive order Jan. 20 to create the Department of Government Efficiency, a panel led by Elon Musk focused on restructuring federal agencies and cutting federal spending by $1 trillion. In early February, DOGE gained access to payment and contracting systems at CMS, examining the spending data for potential fraud or waste. In response, 19 states sued the federal government over DOGE’s access to this data. A federal judge has temporarily blocked DOGE’s access to sensitive Treasury records and ordered those who are now prohibited from accessing these systems to destroy any information downloaded since Jan. 20. On Feb. 11, a federal judge left the ban intact until the next hearing on Feb. 14.