This week, our In Focus section highlights how the new Administration and Congress are poised to significantly change healthcare policies, ranging from health equity and Affordable Care Act (ACA) Marketplace subsidies to Medicaid services and prescription drug costs. Stakeholders seeking to influence these potential changes should plan to engage quickly. Today鈥檚 section covers important developments that occurred through 2 pm January 29, and healthcare stakeholders will need to remain attune to future developments impacting federal healthcare programs.
Executive Action
Over the first week of his second term, President Donald J. Trump has issued several executive orders (EOs) and presidential directives affecting healthcare stakeholders. Presidents have increasingly used EOs at the beginning of their administration to rescind policies of their predecessors and direct the federal departments and agencies to exercise their authorities in line with the president鈥檚 directives.
Though some EOs require no further action, many are just the beginning of the policymaking process, with agencies tasked with implementing the directives. This timeline can provide stakeholders with opportunities to work with to policymakers to inform how they shape the rules for compliance with these directives.
Initial EOs issued so far by President Trump include policies that:
- , including:
- Executive Order 13985 of January 20, 2021, Advancing Racial Equity and Support for Underserved Communities Through the Federal Government聽
- Executive Order 13988 of January 20, 2021, Preventing and Combating Discrimination on the Basis of Gender Identity or Sexual Orientation聽
- Executive Order 13990 of January 20, 2021, Protecting Public Health and the Environment and Restoring Science to Tackle the Climate Crisis聽
- Executive Order 14009 of January 28, 2021, Strengthening Medicaid and the Affordable Care Act聽
- Executive Order 14070 of April 5, 2022, Continuing to Strengthen Americans鈥� Access to Affordable, Quality Health Coverage聽
- Executive Order 14075 of June 15, 2022, Advancing Equality for Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Individuals聽
- Executive Order 14087, of October 19, 2022, Lowering Prescription Drug Costs for Americans聽
- 聽the Office of Management and Budget (OMB), the Attorney General, and Office of Personnel Management (OPM) to 鈥渃oordinate the termination of all discriminatory programs,鈥� including diversity, equity, and inclusion (DEI) programs, policies, and activities in the federal government.聽
- 聽鈥渋llegal private-sector diversity, equity, and inclusion (DEI) preferences, mandates, policies, programs, and activities.鈥澛�
- 聽federal rulemaking until department heads appointed or designated by the president can review and approve the rules and withdraw rules that have been sent to but not yet published in the聽Federal Register聽so they can be reviewed.聽
- 聽and implement the Department of Government Efficiency (DOGE) as a temporary organization within the Executive Office of the President that reports to the White House Chief of Staff. Executive agencies are directed to establish DOGE teams of at least four employees. DOGE is intended to modernize Federal technology and software to maximize governmental efficiency and productivity.聽
- 聽OMB, OPM, and DOGE to submit a plan within 90 days to reduce the size of the federal government鈥檚 workforce through efficiency improvements and attrition.聽
Developments on the Federal Funding Pause
Notably, the White House OMB issued a memo () on January 27, 2025, to all agencies with instructions to temporarily pause and provide a comprehensive analysis of all activities related to obligation or disbursement of federal financial assistance programs that EOs may affect. On January 29, 2025, the administration retracted the directive for a temporary pause on federal payments, though reiterated it will continue to review federal funding.
Though it is customary for a new administration to pause communications, regulatory activity, and new funding opportunities as incoming political appointees are confirmed and policy agendas are solidified, the breadth of the federal funding pause exceeds prior orders. The first lawsuit was on January 28, and a federal judge for the US District Court for the District of Columbia quickly issued a temporary stay on the federal funding pause until at least February 3, 2025, while she considers arguments in the case.
The now-rescinded January 27 memo was scheduled to take effect at 5:00 pm ET on January 28, 2025, to give the Trump Administration 鈥渢ime to review agency programs and determine the best uses of the funding for those programs consistent with the law and the President鈥檚 priorities.鈥� According to the memo, the pause did not apply to Medicare or Social Security payments. In a subsequent , OMB further clarified that 鈥渕andatory programs like Medicaid and SNAP [the Supplemental Nutrition Assistance Program] will continue without pause.鈥�
What to Watch: Executive Actions and Budget Reconciliation
The Trump Administration has indicated that federal programs and funding should be aligned with his administration鈥檚 priorities. Healthcare stakeholders should be prepared for additional scrutiny of future funding awards.
Meanwhile, congressional Republicans are preparing to quickly leverage the budget reconciliation process to pass legislation related to several priority areas, including taxes, immigration, and domestic energy production (see Spotlight on Congress: Budget Reconciliation Update). Budget reconciliation provides a rare opportunity to pass significant healthcare legislative changes on a party-line basis. House Republicans have begun to develop their menu of healthcare options, which range from changes to the ACA premium tax credit structure, expanding Health Savings Accounts, and changes in Medicaid financing and eligibility.
In a January 2025 ,鈥痚xperts from Leavitt Partners, an 黑料不打烊 company, , ,&苍产蝉辫;补苍诲鈥�痙iscussed the potential health policy priorities of the Trump Administration, the implications of reconciliation for healthcare stakeholders, and the challenges and opportunities presented while navigating this expedited process.
Navigating Change
黑料不打烊 experts are working with federally funded entities to quickly analyze their federal awards and plan for the next phase of federal agency actions and oversight. 黑料不打烊 companies also help healthcare stakeholders seeking to inform, shape, prepare for, and implement federal policy changes. Organizations seeking to influence the outcome of these policy debates and to thrive in a dynamic legislative and regulatory environment must have the most up-to-date information, informed by partners that understand the processes and the underlying policies under consideration.
黑料不打烊 experts provide additional complementary services, including analyses to predict how the Congressional Budget Office will score the costs or savings of specific policies. Especially in the reconciliation environment, the budgetary impact of particular policies can significantly influence their likelihood of passage.
Connect with Us
To learn more about the these policy changes and the impact on your organization,聽聽our January 2025 policy webinar and contact one of our featured experts below.
