President Donald Trump wasted no time reshaping U.S. health care policy during his first day back in office. On Monday, Trump signed a sweeping executive order aimed at dismantling several Biden-era health care initiatives, signaling a shift in priorities for his second term.
The order targeted a range of policies implemented by President Joe Biden, including efforts to reduce prescription drug costs for Medicare and Medicaid recipients, enhance the Affordable Care Act (ACA), and increase Medicaid protections. According to a White House statement, the moves are part of Trump’s broader strategy to undo what it describes as “radical” and “unpopular” policies.
“This administration is committed to reversing the damage done by the previous administration’s overreach,” said Trump during a press briefing.
Prescription Drug Costs
One Biden initiative scrapped by Trump had directed Medicare to explore capping out-of-pocket costs for certain generic drugs at $2 per month. However, health policy experts say this was still in the developmental stages and unlikely to impact Americans immediately.
“Many of these actions are more symbolic than substantive at this stage,” said Stacie Dusetzina, a health policy professor at Vanderbilt University. “But they signal the Trump administration’s unwillingness to build on Biden’s health care efforts.”
Notably, Trump’s actions left untouched some of Biden’s marquee health care reforms, including a $35 monthly insulin cap, a $2,000 annual out-of-pocket drug cap, and Medicare’s authority to negotiate drug prices under the Inflation Reduction Act.
“Trump is kind of wiping the slate clean,” said Larry Levitt, executive vice president of health policy at KFF. “It’s a stark contrast from his first term, where health care was a higher priority.”
Changes to the ACA and Medicaid
Trump also took aim at the Affordable Care Act, reversing a Biden-era policy that extended the ACA’s open enrollment period by 12 weeks in 36 states. Additionally, he rescinded an order bolstering Medicaid outreach funding, a move critics argue could weaken access to health care for low-income Americans.
“These actions reflect a clear pivot in priorities,” Levitt said. “Some of the policies Trump is overturning had previously aligned with his own goals, which suggests a shift in focus.”
A Cautious Approach to Drug Pricing
Trump’s decision to leave Biden’s Medicare drug price negotiations intact has drawn attention. Experts suggest this reflects a cautious approach to health care costs, a sensitive issue given the United States’ high drug prices.
Arthur Caplan, head of the medical ethics division at NYU Grossman School of Medicine, said Trump’s restraint might signal his awareness of the public’s dissatisfaction with skyrocketing health care costs.
“Right now, he seems to be nibbling on the edges,” Caplan said. “I hope he doesn’t go further and undo the progress made on Medicare drug price negotiations.”
Trump’s first-day health care moves underscore a broader shift in priorities for his administration, as it focuses on dismantling Biden’s policies while cautiously approaching contentious areas like drug pricing. Whether this approach will satisfy Americans’ health care needs remains to be seen.