In a series of executive actions on Monday, President Donald Trump reversed several key healthcare policies established under the Biden administration, targeting areas like prescription drug pricing and the Affordable Care Act (ACA). While these moves are expected to have little immediate impact on out-of-pocket healthcare costs for many Americans, they signal a shift in priorities as Trump positions his second-term health agenda.
The executive order, referred to by the White House as the “initial rescissions order,” targets what the administration describes as “deeply unpopular” and “radical” policies pushed by Biden. Among the changes, Trump rescinded Biden’s efforts to reduce prescription drug prices for those enrolled in Medicare and Medicaid and rolled back measures designed to strengthen the ACA and expand Medicaid protections.
One of the key initiatives overturned by Trump aimed to reduce prescription drug costs for Medicare beneficiaries, including a proposed $2 monthly cap on certain generic drugs. However, experts note that this measure was still in the early stages of development and was unlikely to be implemented anytime soon. “It was unclear whether it would have been put into effect at all,” said Stacie Dusetzina, a health policy professor at Vanderbilt University.
Trump’s action did not disrupt some of Biden’s more significant healthcare reforms, including a $35 cap on insulin prices, a $2,000 annual cap on out-of-pocket prescription drug costs, and provisions allowing Medicare to negotiate drug prices. These provisions, which are central to Biden’s Inflation Reduction Act, remain in place for now.
Experts suggest that Trump’s decision to undo Biden’s policies may be largely symbolic, part of a broader strategy to distinguish his administration from Biden’s. “When administrations change, there’s often a desire to undo actions from the previous one, even when those actions are more symbolic than practical,” said Dusetzina. However, she cautioned that the move might also signal a reluctance by Trump to continue the work initiated by his predecessor, especially in terms of healthcare reform.
A Change in Priorities?
Some of Trump’s actions on Monday, including those aimed at dismantling the ACA, were widely expected. During his first term, Trump repeatedly sought to weaken the ACA, also known as Obamacare. This time, Trump rolled back a policy that had extended the ACA’s open enrollment period by an additional 12 weeks in 36 states, offering more time for uninsured Americans to sign up.
He also rescinded a measure that had been intended to bolster Medicaid, including provisions to increase funding for outreach efforts in states. Interestingly, some of the policies Trump eliminated had previously aligned with his administration’s priorities, potentially signaling a shift in his approach to healthcare. Larry Levitt, executive vice president of health policy at KFF, a nonprofit research organization, noted that Trump’s decision to cancel Biden’s order on lowering out-of-pocket prescription costs could suggest a reduced emphasis on addressing high healthcare costs in the U.S.
“Trump seems to be wiping the slate clean,” Levitt said. “It’s a different approach to healthcare than we saw during his first term.”
Levitt also raised questions about Trump’s stance on Medicare’s authority to negotiate drug prices, a central provision of Biden’s Inflation Reduction Act. Last week, Medicare announced its next round of drugs up for negotiation, including popular medications like Ozempic and Wegovy. It remains unclear whether the Trump administration will support this negotiation process or attempt to repeal it.
Caution Ahead
While the Trump administration’s actions so far have largely focused on reversing Biden-era policies, experts caution that it’s too early to determine the long-term impact on U.S. healthcare. Arthur Caplan, head of medical ethics at NYU Grossman School of Medicine, suggested that Trump’s approach to healthcare costs thus far has been cautious, avoiding major disruptions to Biden’s more significant reforms. Caplan noted that Trump is aware of the high cost of healthcare in the U.S. compared to other countries and might ultimately recognize the need for government intervention.
“I hope he leaves the Medicare negotiation provision in place,” Caplan said. “Right now, he seems to be nibbling on the edges, but I hope he doesn’t go further.”
As the Trump administration continues to shape its health policy agenda, the coming months will likely reveal whether the president’s cautious approach evolves into a more aggressive stance on healthcare reform.
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