President of the United States of America Donald Trump Early action on health care An indication of his possible intention to cancel some Biden-era programs to reduce drug costs and expand coverage under public insurance programs.

The orders he issued shortly after returning to the White House had policymakers, health care executives and patient advocates trying to read the tea leaves to determine what was coming. The guidance, though less broad than the orders he issued at the start of his first term, provides a potential roadmap that health researchers say could increase the number of uninsured Americans and weaken safety net protections for low-income people.

However, Trump’s initial orders will have little immediate impact. His administration will have to take further regulatory steps to fully reverse Biden’s policies, and the actions have left unclear the direction in which the new president aims to steer the US health care system.

“Everyone is looking for signs about what Trump might do on a range of health issues. In the early EOs [executive orders]Trump is not showing his cards, said Larry Levitt, executive vice president for health policy at KFF, the health policy research, polling and news organization that includes KFF Health News.

wave of Executive orders Other actions Trump issued in his first days back in office included rescinding guidance issued by his predecessor, former President Joe Biden, that encouraged lower drug costs and expanded coverage under the law. Affordable Care Act And Medicaid.

Nicholas Bagley, a law professor at the University of Michigan, said executive orders “generally are nothing more than internal memos saying, ‘Hey agency, can you do something?’” “There may be cause for concern, but that’s what’s going to happen.”

This is because Make changes to applicable law Such programs as the Affordable Care Act (ACA) or programs like Medicaid generally require new rules or action by Congress, either of which can take months. Trump hasn’t won yet Senate confirmation For any of his picks to lead federal health agencies, incl Robert F. Kennedy Jrthe anti-vaccine activist and former Democratic presidential candidate who nominated him to lead the Department of Health and Human Services (HHS). On January 20, he appointed Dorothy Fink, the physician who runs the Department of Health and Human Services’ Office of Women’s Health, as acting secretary of the department.

During Biden’s term, his administration has implemented changes consistent with his health orders, including lengthening the ACA enrollment period and increasing funding for groups that help and support people to enroll. Inflation reduction lawwhich boosted subsidies to help people buy coverage. After declining under the Trump administration, enrollment in ACA plans has soared under Biden, reaching record levels each year. More than 24 million people are enrolled in Affordable Care Act of 2025 plans.

The drug order that Trump rescinded called the centers to Medical care and medical aid services To test ways to lower drug costs, such as setting a flat $2 copayment for some generic drugs in Medicare, the health program for people 65 and older, and having states try to get better prices by banding together to buy some expensive cell and gene therapies .

This may indicate that Trump expects to do less on drug pricing this term or even step back from negotiating drug prices in Medicare.

The White House did not respond to a request for comment.

Joseph Antos of the American Enterprise Institute, a right-wing research group, said Biden’s experiments in lowering drug prices have not been entirely successful. Antos said he was a bit puzzled by Trump’s executive order ending the pilot programs, given that he had supported the idea of ​​tying drug costs in the United States to lower prices paid by other countries.

“You know, Trump is a big fan of that,” Antos said. “Reducing drug prices is something people can easily recognize.”

In other moves, Trump also made He canceled Biden’s orders Regarding racial and gender equality, he issued an order confirming that there are only two sexes, male and female. The Department of Health and Human Services under the Biden administration has supported gender-affirming health care for transgender people and provided guidance on civil rights protections for transgender youth. Trump’s message on gender has intensified concerns within the LGBTQ+ community that he will seek to restrict such care.

“The administration expected that it would fail to provide protections and would seek to discriminate against transgender people and anyone else it deemed ‘other,’” said Omar Gonzalez Pagan, senior counsel and health care strategist at Lambda Legal, a civil rights advocacy group. . “We stand ready to respond to the Administration’s discriminatory actions, as we have done previously with great success, and to defend the ability of transgender people to access the care they need, including through Medicaid and Medicare.”

Trump also halted new regulations that were in development so the new administration could review them. He could drop some proposals that the Biden administration has not yet finalized, including expanded coverage of anti-obesity drugs through Medicare and Medicaid and a rule that would limit nicotine levels in tobacco products, said Katie Keith, a Georgetown University professor who was Vice President. The director of the White House Gender Policy Council under Biden wrote in an article for Health Affairs Forefront.

Interestingly, he did not bother with President Biden’s three executive orders and the presidential memorandum on them Reproductive health care“, she wrote.

However, Trump has instructed senior officials in his administration to look for additional orders or memos to rescind them. (So ​​he canceled Biden ordered Who established the Gender Policy Council.)

Democrats criticized Trump’s health actions. “Trump proves once again that he has lied to the American people and does not care about cutting costs — only what is best for himself and his super-rich friends,” Democratic National Committee spokesman Alex Floyd said in a statement.

Some policy experts say Trump’s decision to end a Biden-era executive order aimed at improving the Affordable Care Act and Medicaid may foreshadow coming cuts and changes to both programs. Previously, his administration opened the door to work requirements in Medicaid — the federal-state program for low-income adults, children, and people with disabilities — and previously issued guidance enabling states to cap federal Medicaid funding. Medicaid and the associated Children’s Health Insurance Program cover more than 79 million people.

“Medicaid will be a focus because it has become so sprawling,” said Chris Pope, a senior fellow at the Manhattan Institute, a conservative policy group. “It has grown after the pandemic. Provisions, such as the use of social determinants of health, have expanded.

The administration may reevaluate steps taken by the Biden administration to allow Medicaid to pay for everyday expenses that some states have said affect recipients’ health, including air conditioning, meals and housing.

One of Trump’s directives orders agencies to provide emergency rate relief and “eliminate unnecessary administrative expenses and rent-seeking practices that increase health care costs.” (Rent seeking is an economic concept that describes efforts to exploit the political system for financial gain without creating other benefits for society.)

“It’s not clear what this indicates, and it will be interesting to see how agencies respond,” Keith wrote in her Health Affairs article.

Policy experts like Edwin Park at Georgetown University have also noted that Republicans, separately, are working on budget proposals that could lead to significant cuts in Medicaid funding, in part to pay for tax cuts.

Sarah Locke, vice president for health policy at the Center on Budget and Policy Priorities, a left-leaning research group, also pointed to Congress: “On the one hand, what we see coming from Executive orders from Trump It is important because it shows us the direction they are headed in with policy changes. But the other path is that there are active conversations in Congress about what goes into budget legislation. They’re considering some huge cuts to Medicaid.