Executive Orders Repeal Health Care Policies

Shortly after his inauguration on January 20, 2025, President Trump posted 46 Presidential Actions, including Executive Orders, Memoranda, and Proclamations on the White House website. One of the Executive Orders entitled “Initial Rescissions of Harmful Executive Orders and Action,” repeals prior Executive Orders regarding Medicare, the ACA, prescription drug price policies (linked here). A brief summary of the Executive Order’s repeal of Medicare, ACA, and prescription drug price polices is provided below. An additional update regarding the Executive Order’s repeal of COVID policies will follow.

Executive Order Authority

Executive Orders, though not explicitly defined in the Constitution, are considered inherent in the presidential powers. They gain the force of law when based on valid authority, but they are subject to judicial review and can be overturned if they lack Constitutional support. Executive Orders operate on a sliding scale of authority, with varying levels of power depending on the circumstances.

• Most authority: The President has the “express or implied” consent of Congress.
• Uncertain authority: Congress has not granted nor denied authority of the President and the Executive Order takes advantage of this “twilight zone.”
• Least authority: The Executive Order is “incompatible with the express or implied will of Congress.[1]

Implementation of the Executive Orders will depend on their interaction with current laws and regulations, possible court challenges, and further Trump Administration actions.

Executive Order “Initial Rescissions Of Harmful Executive Orders And Action”

Executive Order “Initial Rescissions Of Harmful Executive Orders And Action” repeals 67 prior Executive Orders and 11 Presidential Memoranda.[2] With regard to health care, it repeals:

• Executive Order 14009  (“Strengthening Medicaid and the Affordable Care Act”) & Executive Order 14070 (“Continuing To Strengthen Americans’ Access to Affordable, Quality Health Coverage”).

Executive Order 14009 set the policy objective to “protect and strengthen Medicaid and the ACA and to make high-quality healthcare accessible and affordable,” directing the agencies and departments with Medicaid and ACA authority to review policies or practices that would undermine this objective, such as work requirements and eligibility restrictions introduced by the first Trump Administration. Executive Order 14070 further expanded the policy, directing agencies to explore various avenues for expanding the accessibility of affordable health coverage, such as improving the comprehensiveness of coverage, and reducing medical debt. 

Executive Order 14009 also overturned two prior Trump Administration Executive Orders: (1) Executive Order 13765 (“Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal”) which weakened the enforcement of the ACA; and, (2) Executive Order 13813 (October 12, 2017) “Promoting Healthcare Choice and Competition Across the United States,” which promoted the sale of insurance across state lines through the expansion of association health plans, short-term limited duration insurance, and health reimbursement arrangements, which were not typically subject to all ACA coverage requirements and protections.

• Executive Order 14087  (“Lowering Prescription Drug Costs for Americans”).

Executive Order 14087, issued in October 2022, expanded the Biden Administration’s mandate to lower the prices of prescription drugs, as well as the price reduction mandates of the Inflation Reduction Act of 2022, directing HHS to develop policies to reduce drug costs and enhance access to drug therapies for Medicare and Medicaid beneficiaries. A report outlining three selected models was submitted and payment reform pilot testing has been in progress since 2023. The effect of the January 20^th Executive Order is unclear because it does not change any existing Medicare and Medicaid drug pricing laws or regulations, and doesn’t contain language that indicates whether the Trump Administration will terminate or continue the payment reform pilot programs.

• Executive Order 14110 (“Safe, Secure, and Trustworthy Development and Use of Artificial Intelligence”).

Executive Order 14110 established the White House Artificial Intelligence Council and directed over 50 federal entities to complete 100 specific deliverables to implement guidance and priorities for the development and use of AI across eight overarching policy areas, with the majority of due dates falling in 2024. HHS was tasked with a number of health care consumer protection requirements, such as development of AI standards for drug development, and safety measures to prevent AI-associated clinical errors.

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The rescinded Executive Orders of the Biden Administration can be found on the Federal Register website. 

[1] See “Executive Orders: An Introduction” issued by the Congressional Research Service https://crsreports.congress.gov/product/pdf/R/R46738. The CRS serves as nonpartisan shared staff to congressional committees and Members of Congress. It operates solely at the behest of and under the direction of Congress. 

[2] Presidential memoranda still have the force of law, but less authority than an Executive Order.