As of yesterday, President Donald J. Trump is 1 month into his second term. During this short time, much has already changed within the health care landscape, including the reversal of several Biden administration policies and the confirmation of Robert F. Kennedy Jr as HHS secretary.
President Donald J. Trump has pushed for significant health care changes during his first month back in office, including executive orders affecting managed care, drug pricing, and clinical trial diversity guidance. | Image Credit: Vacclav – stock.adobe.com
Here is a recap of 5 major moments in the health care realm since Trump returned to office on January 20, 2025:
1. Executive Orders Suggest Swift Pivot in Managed Care and Health Policy
Within his first hours as our 47th president, Trump took steps to reverse Biden administration policies, including scaling back Affordable Care Act provisions, rescinding drug pricing initiatives, and withdrawing from the World Health Organization.1 These executive orders mark a sharp shift in federal health policy, raising concerns among public health experts and advocates about the future of health care equity, cost-saving reforms, and pandemic preparedness. However, key initiatives, such as the insulin cap and Medicare drug price negotiations, remain in place, though future support is uncertain.
Learn more here.
2. Trump’s Federal Grant Freeze Threatens Medicaid Funding
A memo from the Office of Management and Budget issued on January 27 ordered all federal agencies to suspend grant payments pending review, potentially disrupting billions of dollars in health care funding.2 During a White House press conference on January 28, White House Press Secretary Karoline Leavitt said that the freeze would not affect individual assistance programs, such as Medicare, food stamps, welfare benefits, and Social Security.
However, these protections do not include Medicaid, leaving states uncertain whether they will continue receiving federal Medicaid matching funds. It is also unclear how long this “temporary pause” will last. Although the memo indicated it would go into effect on January 28 at 5 pm EST, neither the memo nor the press conference provided a timeline for when it would be lifted.
Learn more here.
3. FDA Quietly Removes Draft Guidance on Diversity in Clinical Trials Following Executive Order on DEI
The FDA quietly removed previously issued draft guidance on clinical trial diversity from its website following Trump’s January 21 executive order, which cut diversity, equity, and inclusion (DEI) programs and prohibited federal recognition of gender identity beyond biological sex.3 The removal, first noticed by the public on January 23, has raised concerns about the FDA’s stance on clinical trial diversity requirements and the statutory obligations of sponsors. Without the draft guidance, and the statutory deadline for final guidance approaching on June 26, 2025, sponsors face uncertainty about how the agency will evaluate the Diversity Action Plans required under the Food and Drug Omnibus Reform Act.
Learn more here.
4. Robert F. Kennedy Jr Confirmed as HHS Secretary, Nearly Along Party Lines
Despite rocky confirmation hearings, the US Senate confirmed Robert F. Kennedy Jr, a longtime vaccine skeptic, critic of processed foods, and initiator of the Make America Healthy Again agenda, as HHS secretary on February 13 in a 52-48 vote.4 The vote was nearly along party lines, with the lone Republican holdout being Sen Mitch McConnell (R, Kentucky), a polio survivor who opposed Kennedy’s history of vaccine skepticism.
As HHS secretary, Kennedy inherits major health policy challenges, including implementing clinical trial diversity guidance and overseeing the Trump administration’s policies on drug pricing, pharmacy benefit manager regulations, and more. He has also pledged to promote healthier foods, address the root causes of chronic disease, tackle pollution, and ban prescription drug ads.
Learn more here.
5. Trump Signs Executive Order Aimed at Expanding IVF
Trump signed an executive order on February 19 to expand access to in vitro fertilization (IVF) by lowering costs and removing barriers to care.5 The order acknowledges that 1 in 7 couples struggles with infertility and highlights the high costs of IVF; it calls for policy recommendations within 90 days to lower out-of-pocket expenses and improve access.
However, the order does not establish new rights or guarantees, leaving implementation subject to available funding and existing laws. It is also unclear who will benefit from the expansion, particularly among lesbian, gay, bisexual, transgender, queer, plus individuals after the administration rolled back protections for transgender people and terminated DEI programs within the federal government.
Learn more here.
References
1. Grossi G. Executive orders suggest swift pivot in managed care and health policy. AJMC®. January 22, 2025. Accessed February 20, 2025. https://www.ajmc.com/view/executive-orders-suggest-swift-pivot-in-managed-care-and-health-policy
2. Klein H. Trump’s federal grant freeze threatens Medicaid funding. AJMC®. January 28, 2025. Accessed February 20, 2025. https://www.ajmc.com/view/trump-s-federal-grant-freeze-threatens-medicaid-funding
3. Grossi G. FDA quietly removes draft guidance on diversity in clinical trials following executive order on DEI. AJMC®. January 31, 2025. Accessed February 20, 2025. https://www.ajmc.com/view/fda-quietly-removes-draft-guidance-on-diversity-in-clinical-trials-following-executive-order-on-dei
4. Mattina C. Robert F. Kennedy Jr confirmed as HHS secretary, nearly along party lines. AJMC®. February 13, 2025. Accessed February 20, 2025. https://www.ajmc.com/view/robert-f-kennedy-jr-confirmed-as-hhs-secretary-nearly-along-party-lines
5. Steinzor P. Trump signs executive order aimed at expanding IVF. AJMC®. February 19, 2025. Accessed February 20, 2025. https://www.ajmc.com/view/trumps-signs-executive-order-aimed-at-expanding-ivf
