The State of the Nation’s Health Under Trump
- Society of Bioethics and Medicine
- Apr 1, 2025
- 3 min read
Updated: May 2, 2025
Writer: Shane McGlone
Editor: Rayyan Bhuiyan
On January 20, 2025, convicted former president now back in office, Donald Trump, took back the oval office. In his inauguration speech at the US Capitol Rotunda, Trump addressed the nation and beckoned for the “golden age” of America, instilling the promise of a swift rightward shift of the federal government to reinstate “common sense” and “prosperity”. In this, President Trump spoke about a myriad of issues that currently press the country, mainly the economy, foreign relations, civil rights, and healthcare. On the latter issue, Trump proclaimed that “we [America] have a public health system that does not deliver in times of disaster” and that “together, we will end the chronic disease epidemic and keep our children safe, healthy and disease free”[1]. Following his swearing in, Trump took to immediate action, rescinding 78 Biden-Era executive orders and signing over 20 orders of his own on his first day in office- the most of any president. While there is no question as to the quantity of his actions so far, this article will focus on the quality of his plans, proposals, and promised pragmatism as they relate to his public health initiatives.
Executive Order
So what exactly is an executive order? The American Bar Association describes an executive order as an official document that enforces the initiative of a sitting president over executive agencies and “[has] the force of law”. Secondly, “they require no approval from Congress, and Congress cannot simply overturn them”. In the scope of American checks-and-balances, this might raise some eyebrows. To “undo” an executive order, congress can vote to void and nullify the order (usually under the pretense of unconstitutionality) or to cease the allocation of funds to the initiative. Until congress intervenes, however, executive orders are effective immediately and indefinitely[2].
Of the 78 Biden orders rescinded by Trump, the following directly pertain to public health. I have chosen to omit those that refer to COVID-era mandates as they are less pertinent.
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 14087 (Lowering Prescription Drug Costs for Americans)[3]
Executive Order 14009
Under this executive order, 15 million more Americans received Medicaid coverage due to an increase in federal funds[4]. Also, the Affordable Care Act allowed for an increase in the premium coverage it allowed low-income Americans. It is estimated that this initiative cost the government tens of billions of dollars. When Trump took office on a promise to give Americans tax cuts, he evidently chose to make changes in this department. While removing this order does not take away coverage from those who benefited from its expansion, it certainly makes it harder for low-income Americans to receive medical-based welfare who did not previously receive it.
Executive Order 14070
Executive order 14070 was essentially an extension of executive order 14009. Under this, 5 million more Americans were granted access to Medicare and also received similar increased premium coverage[4].
Executive Order 14087
Under this order, Medicare would have the ability to negotiate the price of certain drugs in hopes to reduce national inflation brought upon by the pharmaceutical industry. Secondly, insulin cost was capped off at 35 dollars per month and drug costs for seniors was capped off at 2,000 dollars a year[4]. This is an especially controversial overturn, especially as many fear that those who previously could not afford insulin would be affected. Trump, however, has plans to target the private distributors of medications who work as “middlemen” between the pharmaceutical companies and consumers rather than the companies themselves1. In the meantime, however, it is understandable why Americans are scared. Without a directly stated or performed initiative to follow through with this promise, there is much left unanswered.
In Void
With these executive orders undone, and without replacements, Trump’s effect on healthcare is not immediately foreseeable. His approach to lowering healthcare costs by allowing tax cuts within welfare programs and supporting pharmaceutical companies in a more “free-market” manner seems unorthodox and, arguably, unproductive. The truth is, however, that Americans are suffering and Biden-Era orders did much to offer a short term solution, but did little to offer long term relief. Trump has made significant promises for the country and, in his typical style, is bold that he will follow through. Following his first day in office, in which he undid a lot and did very little, Americans face nervousness as their healthcare access remains in the void: a strange limbo of uncertainty.
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