
Advocacy Alert - President Trump's Executive Orders
Our partners at the NAFC have provided this advocacy update on the beginning of the Trump administration.
President Trump’s Executive Orders
On January 20, 2025, Donald Trump was inaugurated as the 47th President of the United States, with JD Vance as Vice President. The NAFC is closely monitoring developments during the first 100 days of the new administration, including executive orders, Congressional actions, cabinet appointments, and other policy changes that may impact Free and Charitable Clinics, Pharmacies, State Associations, and the NAFC. Updates and resources will be shared with members through Advocacy Alerts and the Friday Five.
What is an Executive Order?
An executive order is a directive from the President that manages the operations of the federal government. These orders:
- Do not require Congressional approval
- Can only be overturned by a sitting U.S. President issuing a new executive order
- May face legal challenges, which can delay or halt implementation.
Executive orders are numbered and referenced by their assigned number or topic. While they are not legislation, Congress can pass laws or remove funding to make implementation more difficult.
Executive Orders That May Impact Organizations and Patients
The following executive orders have the most potential impact on NAFC member clinics, pharmacies, and state associations, as well as the NAFC itself. The NAFC will provide more information and action steps as additional details develop. Additionally, the NAFC will continue to update this list of orders through Advocacy Alerts and the Friday Five.
Ending Birthright Citizenship
- Policy Overview: Children born in the U.S. to undocumented immigrants or individuals on temporary visas will no longer automatically be granted citizenship.
- Key Details: This reinterpretation of the 14th Amendment focuses on the phrase “subject to the jurisdiction thereof,” which the order redefines to exclude children born to parents who are not U.S. citizens or permanent residents.
- Potential Impacts: Clinics serving immigrant populations may see increased fear and hesitation in accessing health care services due to concerns about citizenship status and deportation. Legal challenges are expected, which may delay or modify implementation.
Immigration and Border Security
- Policy Overview: A national emergency was declared at the U.S.-Mexico border, accompanied by a suite of immigration-related actions.
- Key Details: The administration halted refugee admissions for four months, reinstated the “Remain in Mexico” policy for asylum seekers, and directed military resources to strengthen border security. Migrants crossing the border illegally are no longer permitted to seek asylum in the U.S.
- Potential Impacts: These policies may limit access to care for vulnerable populations, increase demand for community health services in border regions, and redirect federal resources from other health-related priorities to border enforcement efforts.
Affordable Care Act
- Policy Overview: Trump rescinded Biden’s executive order that extended enrollment periods for ACA plans and increased funding for third parties assisting with enrollment.
- Key Details: The measures rescinded had led to increased ACA enrollment, nearly doubling it to 24 million people, largely due to government subsidies that lowered premiums.
- Potential Impacts: Clinics and organizations may see fewer individuals covered under ACA plans, potentially increasing the number of uninsured patients seeking care from NAFC member clinics/pharmacies.
Drug Pricing
- Policy Overview: Trump rescinded Biden’s executive order prompting CMMI to implement three drug pricing pilot programs.
- Key Details:
- The first program would have helped state Medicaid programs fund expensive cell and gene therapies through multi-state agreements, allowing non-payment for ineffective treatments.
- The second program proposed reduced Medicare payments for drugs approved through accelerated FDA approvals, incentivizing faster completion of confirmatory trials.
- The third initiative aimed to standardize $2 copays for generic drugs for common chronic conditions, encouraging adherence to prescribed medications. - Potential Impacts: Revoking these initiatives may delay cost-saving measures for patients and states, while also increasing out-of-pocket costs for those relying on innovative treatments or generics for chronic conditions.
COVID-19 Policies
- Policy Overview: Trump rescinded Biden’s COVID-19 policies aimed at pandemic preparedness and response.
- Key Details: These policies had focused on expanding testing, research, economic relief, and international cooperation for future outbreaks.
- Potential Impacts: The rollback may reduce the country’s ability to respond to future health crises, potentially impacting clinic readiness and access to emergency resources.
Gender and Sex Discrimination
- Policy Overview: Trump rescinded protections and programs supporting LGBTQ+ individuals and addressing gender discrimination.
- Key Details:
- Rescinded a 2022 policy prohibiting discrimination based on sexual or gender identity in schools and healthcare settings.
- Eliminated the Gender Policy Council established in 2021 to promote gender equity and protections against conversion therapy.
- Halted support for LGBTQ+ students and programs promoting gender identity protections. - Potential Impacts: Organizations may see increased barriers for LGBTQ+ patients seeking care, particularly in states without additional protections. Providers may face challenges in addressing patient needs under federal funding requirements.
Withdrawal from the World Health Organization (WHO)
- Policy Overview: The U.S. announced its withdrawal from the WHO, citing concerns over funding disparities and the organization’s handling of global health crises.
- Key Details: The administration claims the WHO failed to adopt necessary reforms and acted under inappropriate political influence during the COVID-19 pandemic.
- Potential Impacts: This withdrawal could reduce access to global health resources, disrupt international partnerships, and impact funding for critical health initiatives, including vaccinations, tuberculosis control, and HIV treatment.
Healthcare Areas to Watch
As President Trump moves through his first 100 days, more executive orders and regulatory actions are expected, specifically in the area of healthcare. Below are some of the actions we can anticipate in the coming weeks:
Reproductive Health
- Policy Overview: The administration is expected to reinstate the Mexico City policy, which could impact U.S. global health funding.
- Key Details: This policy prohibits NGOs from receiving federal funds if they provide or promote abortion services.
- Potential Impacts: These changes could disrupt international health initiatives related to maternal and child health, nutrition, and HIV/AIDS, limiting access to essential reproductive healthcare for vulnerable populations worldwide.
ACA Rollback Provisions
- Policy Overview: Potential rollbacks to Affordable Care Act (ACA) provisions related to nondiscrimination protections are expected.
- Key Details: These rollbacks could remove protections against discrimination based on gender identity and sexual orientation in healthcare settings.
- Potential Impacts: Patients may face increased barriers to accessing equitable care, and providers could see changes in federal requirements for compliance with anti-discrimination laws. This could disproportionately affect LGBTQ+ individuals and other marginalized groups.
Vaccine Mandates
- Policy Overview: Federal funds may be withheld from school districts with vaccine mandates, influencing public health practices nationwide
- Key Details: The administration may also limit CDC guidance on vaccines and masks, impacting state and local health policies
- Potential Impacts: These actions could lead to increased vaccine hesitancy and reduced vaccination rates, impacting herd immunity and public health.
Drug Pricing
- Policy Overview: The administration may revisit Medicare drug pricing models and address pricing concerns related to pharmacy benefit managers (PBMs).
- Key Details: Possible actions include tying Medicare drug prices to international benchmarks and revising Medicare drug price negotiation processes under the Inflation Reduction Act.
- Potential Impacts: Changes could impact the affordability and accessibility of prescription medications for patients, especially those served by free and charitable clinics.
Global Health
- Policy Overview: Funding for international health programs, including the WHO and U.N. Population Fund, may be reduced or eliminated.
- Key Details: These cuts could affect programs related to HIV treatment, tuberculosis, childhood vaccinations, and maternal health.
- Potential Impacts: Reduced funding could lead to significant gaps in global health initiatives, potentially increasing the burden on U.S.-based clinics to address these needs.
Immigration Policy
- Policy Overview: The administration has introduced stricter immigration policies that may impact healthcare access for migrant populations.
- Key Details: Policies include reinstating the “Remain in Mexico” policy, pausing refugee admissions for four months, and potentially reimplementing Title 42 for rapid migrant expulsions.
- Potential Impacts: These measures may increase barriers to care for migrant and undocumented populations, reduce access to critical health services, and heighten fears of deportation among vulnerable communities.
Stay Informed & Engaged
The NAFC is committed to supporting your work and the essential care you provide in your communities. As we navigate these policy changes, here’s how you can stay informed and engaged:
- Listserv Enrollment: Once data collection is complete, all members will be enrolled in the NAFC listserv to ensure timely communication. Members can opt out in the future if desired.
- Stay Subscribed to Communications: All updates will be shared electronically through the Friday Five and Advocacy Alerts. Please remain subscribed unless you no longer wish to receive notifications about programs, funding opportunities, or other critical updates.
- Congressional Contacts: Visit House.gov and Senate.gov to gather contact information for your members of Congress. This information will be essential for extending invitations to your organization and participating in outreach efforts. For broader outreach to Congress, the NAFC will utilize an automated system to streamline communications.
- Immigration Toolkit: Download the Immigration Toolkit for reference. This document, updated as of January 21, will be revised as additional information becomes available.
- NAFC Committees: Join NAFC committees to help shape policies and initiatives. Visit this link to sign up and get involved.
By staying connected through these resources, you can remain up to date on critical developments, access advocacy tools, and actively participate in shaping policies that impact your organization and the communities you serve.