Trump Administration Rescinds Biden-era Orders, Implements Regulatory Freeze

In a move that has garnered significant attention, last week President Trump issued an executive order that rescinded a series of previously issued executive orders by the Biden Administration.

These rescinded orders, which focused on various healthcare reforms, have had a substantial impact on healthcare providers across the U.S., and their repeal marks a dramatic policy shift that could change the operational landscape for healthcare professionals, insurers, and patients. 

The Trump Administration also issued a freeze on all non-final federal regulations/rules, with instructions not to unfreeze them until they can be “reviewed and approved by a department or agency head.”

Let’s first go back to the executive orders.

Several of the orders that President Trump rescinded had distinct goals, mostly aimed at expanding access to care, reducing healthcare costs, and improving patient outcomes. Here’s a brief rundown of their major provisions:

Two of the rescinded orders sought to strengthen Medicaid and the Patient Protection and Affordable Care Act (PPACA) by bolstering the PPACA, enhancing Medicaid enrollment, and improving affordability and accessibility of health insurance, while also expanding the PPACA’s protections, particularly for those with pre-existing conditions.

Other rescinded orders addressed efforts to strengthen the U.S. healthcare system more generally by facilitating access to affordable insurance and increasing healthcare choices for low-income families, as well as strengthening efforts to combat the COVID-19 pandemic, including supporting the healthcare workforce and enhancing public health infrastructure.

The withdraw of these orders carries significant implications for healthcare providers, as many of their initiatives directly affect the day-to-day operations of healthcare organizations. Consider some of the following key impacts:

The orders aimed at strengthening the PPACA and Medicaid sought to simplify the insurance landscape and make reimbursements more predictable for providers. The rescindment of these orders could lead to greater uncertainty in insurance markets, potentially increasing the administrative burden on providers.

This uncertainty may require healthcare organizations and providers to adapt quickly to shifting policies on insurance enrollment, premium structures, and eligibility requirements.

Meanwhile, rescinding the executive orders that dealt with supporting the COVID-19 response and public health workforce are likely to reduce funding and support for related public health initiatives, which could lead to staffing shortages, increased burnout, and delays in critical healthcare services.

Providers, in particular, still somewhat strained by the continuing demands from the pandemic, may now face additional challenges in maintaining a strong and well-supported workforce.

Now, let’s not forget about that regulatory freeze, which is also currently in place. The freeze spans all federal agencies and is intended to allow new agency leaders to review Biden-era rules/regulations and decide whether to keep, change, or discard them.

As I mentioned previously, the freeze applies to all non-final regulations and finalized rules that have not yet taken effect, including noteworthy regulations such as:

1. A proposed Health Insurance Portability and Accountability Act (HIPAA) security regulation that focuses on cybersecurity, requiring plans and providers to implement a range of administrative, physical, and technical safeguards;
2. A Consumer Financial Protection Bureau final rule that prohibits credit agencies from including medical bills on credit reports sent to lenders, who are banned from considering the medical debt; and
3. A Drug Enforcement Administration (DEA) proposed rule addressing prescription of controlled substances via telehealth.

In sum, President Trump’s rescindment of the Biden-era executive orders has the potential to create new challenges for the healthcare industry, especially as all other expected rules and regulations sit in limbo.

From insurance uncertainties to barriers in expanding care, the implications of this decision are far-reaching, and the healthcare industry should remain vigilant while it navigates these changes, as the future of healthcare policy remains in flux. As usual, the role of healthcare providers in adapting to this uncertainty will be more important than ever.

Reference Material

1. Biden Executive Orders:EO 14009, EO 14070, EO 14110, 13987, 13996, 13997.
2. Initial tranche of executive orders signed by President Trump.
3. Biden-era executive orders rescinded by President Trump.
4. Trump Admin. Regulatory Freeze Pending Review.
5. Proposed HIPAA security regulation
6. CFPB final rule
7. DEA proposed rule