Trump’s executive orders that impact healthcare

President Trump’s flurry of executive orders on January 20, 2025 marks a sharp turn in U.S. healthcare policy, with ripple effects that will touch everything from vaccine guidelines to hospital hiring practices. A close examination of these orders reveals fundamental changes to how Americans receive and access healthcare information and services.

Trump’s executive orders that impact healthcare

Defending Women From Gender Ideology Extremism and Restoring Biological Truth

The order defines sex as “binary” and “grounded in fundamental and incontrovertible reality,” requiring all federal agencies to recognize only “biological sex.” It mandates that “female” means “a person belonging, at conception, to the sex that produces the large reproductive cell.”

Healthcare Impact: The Centers for Disease Control and Prevention (CDC) faces perhaps the most immediate impact. Within hours of the orders taking effect, over 1,000 CDC, NIH, and HHS websites went dark – including crucial resources for healthcare providers like vaccine schedules and contraception guidelines. The administration framed this as part of its push against “gender ideology,” objecting to terms like “pregnant people” rather than “pregnant women.” But the scope extends far beyond terminology – entire epidemiological databases and public health tracking systems are now offline.

Healthcare facilities receiving federal funds must revise their policies on room assignments, medical records, and treatment protocols regarding nonbinary and trans individuals. The order could limit access to certain health services and reshape how medical research categorizes study participants.

Withdrawing the United States From the World Health Organization

The order immediately halts U.S. funding to WHO, recalls all U.S. personnel working with the organization, and terminates participation in WHO’s pandemic treaty negotiations.

Healthcare Impact: This withdrawal disrupts international disease surveillance networks and pandemic response capabilities. American doctors may lose access to global health data and early warning systems for emerging diseases. U.S. influence in global health policy will likely diminish.

Removing Barriers to American Leadership in Artificial Intelligence

The order revokes Biden’s Executive Order on AI which provided ethical guidelines and oversight mechanisms.  It eliminates requirements for testing AI systems for bias or safety before deployment. The order directs development of AI systems “free from ideological bias or engineered social agendas.”

Healthcare Impact: Medical AI development faces fewer restrictions but also fewer safeguards. Hospitals and healthcare providers can implement AI systems without previous requirements for bias testing or safety validation. While this might accelerate innovation in areas like diagnostic AI and automated treatment recommendations, patient advocacy groups warn about potential risks to patient safety and fair treatment. The removal of bias testing requirements particularly concerns specialists in healthcare equity.

Restoring Accountability to Policy-Influencing Positions

The order borrows from and expands upon Trump’s previous “Schedule F” executive order from 2020, that created a new employment category called “Policy/Career” positions. Federal employees in these roles lose standard civil service protections, making them easier to remove without typical procedural safeguards. The order specifically states that while employees aren’t required to “personally or politically support the current President,” they must “faithfully implement administration policies to the best of their ability.”

Healthcare Impact: This order could trigger unprecedented turnover at federal health agencies – like as seen with a key cyber defense group investigating Chinese-backed cyberattacks. Career scientists and public health experts at the CDC, FDA, and NIH who express views contrary to administration policies could face swift removal.

For example, researchers studying climate change health impacts or publishing findings about gender-affirming care might be vulnerable. The order may particularly affect departments overseeing controversial health policies like vaccine recommendations or reproductive health guidelines.

Reforming the Federal Hiring Process and Restoring Merit to Government Service

The order directs the creation of a new Federal Hiring Plan that explicitly prohibits consideration of race, sex, or religion in hiring decisions. It mandates prioritizing candidates “passionate about the ideals of our American republic” and requires implementing “technical and alternative assessments” for hiring. The order specifically calls out and rejects what it terms “commitment to illegal racial discrimination under the guise of ‘equity'” in hiring practices.

Healthcare Impact: Federal healthcare institutions, including VA hospitals and Indian Health Service facilities, must overhaul their hiring practices. The order could reverse decades of efforts to build a healthcare workforce that reflects America’s diverse patient population. 

Enforcing the Hyde Amendment

The order revokes Biden-era executive orders that expanded abortion access through federal programs. It specifically targets Executive Orders 14076 and 14079, which had allowed federal funds to support abortion services in certain circumstances. The order frames this as returning to “longstanding consensus that American taxpayers should not be forced to pay for that practice.”

Healthcare Impact: This order will significantly affect healthcare access and delivery across multiple federal programs. Healthcare facilities receiving federal funding must review and potentially revise their reproductive health services.

 Programs particularly affected include:

• Medicaid coverage for abortion services in cases beyond the Hyde Amendment exceptions (rape, incest, life of mother)
• Federal employee health benefits
•  Military healthcare services
• Indian Health Service programs
• Federal prison health services

Healthcare providers must now navigate stricter limitations on when federal funds can support abortion services. State Medicaid programs face particular challenges, as they must now review all reproductive health services to ensure compliance. Healthcare administrators expect increased administrative costs and potential legal challenges as they work to interpret and implement the new restrictions while maintaining other essential reproductive health services.

Ending Radical and Wasteful Government DEI Programs

The order requires federal agencies to “terminate all DEI, DEIA, and ‘environmental justice’ offices and positions” within 60 days. It mandates ending all “equity action plans,” initiatives, and programs, including equity-related grants or contracts. Agencies must provide detailed lists of any DEI positions or programs that existed before November 2024 and identify attempts to preserve these functions under different labels.

Healthcare Impact: This sweeping elimination of DEI programs could fundamentally alter healthcare delivery and research. The NIH must halt numerous health disparity research initiatives. Programs designed to increase minority representation in medical professions face defunding. The CDC’s Office of Minority Health and Health Equity, which tracks and addresses health disparities, could be dismantled. Healthcare experts warn this could worsen existing health inequities, particularly in communities with historically limited access to medical care.

Restoring Freedom of Speech and Ending Federal Censorship

The order prohibits federal employees from engaging in or facilitating “any conduct that would unconstitutionally abridge the free speech of any American citizen.” It directs the Attorney General to investigate federal activities over the past four years that may have suppressed protected speech. The order specifically targets what it calls “censorship of Americans’ speech on online platforms” through “coercive pressure on third parties.”

Healthcare Impact: Public health agencies face new constraints in addressing health misinformation. The CDC and FDA may need to scale back their social media monitoring and response programs. Healthcare professionals worry this could hamper efforts to counter dangerous medical myths, particularly during health emergencies. The order’s broad language could affect how federal health agencies communicate about controversial topics like vaccine safety or reproductive health.

Immigration and security orders

These paired orders – Protecting the Meaning and Value of American Citizenship and Protecting the U.S. from Foreign Terrorists – establish new restrictions on immigration and citizenship. They end birthright citizenship for children of non-citizens and mandate enhanced vetting of foreign nationals. The security order specifically requires investigation of “hostile attitudes toward its citizens, culture, government, institutions, or founding principles.”

Healthcare Impact: These orders create complex challenges for healthcare delivery. Hospitals must potentially verify immigration status before providing non-emergency care. Medical facilities may need new systems to determine citizenship status of newborns. The orders could significantly affect healthcare access for immigrant communities, both documented and undocumented. International medical professionals, who fill crucial roles in underserved areas, face additional scrutiny and barriers. Public health experts predict reduced preventive care and delayed treatment seeking among immigrant populations, potentially increasing overall healthcare costs and public health risks.

Sweeping changes to American healthcare: What comes next

These ten executive orders represent an unprecedented restructuring of America’s healthcare system, touching everything from data access to reproductive rights. The immediate effects are already visible: thousands of CDC webpages offline, WHO collaboration suspended, and federal health agencies preparing for potential staff changes. Healthcare providers must now navigate complex new requirements while trying to maintain quality care.

The long-term implications could be far-reaching. Research institutions must recalibrate their studies under new AI and DEI guidelines. Public health agencies face restrictions on how they communicate health information. Immigration-related changes could affect both healthcare access and staffing. Reproductive healthcare providers must revise their services under stricter funding rules.

Legal challenges are expected for several orders, particularly those affecting civil service protections and healthcare access. The success or failure of these orders will likely shape public health policy for years to come, affecting everything from how we track diseases to who provides our medical care. Healthcare providers, administrators, and patients must now adapt to this radically altered landscape while maintaining the fundamental mission of protecting public health.