Trump Reverses Biden's Healthcare Policies, Orders U.S. Withdrawal from WHO

In a series of executive actions following his inauguration, President Donald Trump has reversed several healthcare-related directives implemented by his predecessor, Joe Biden. These actions mark a significant shift in U.S. healthcare policy and global health engagement.

WHO Withdrawal and International Health Policy

President Trump signed an executive order to withdraw the United States from the World Health Organization (WHO), citing concerns over the organization's handling of the COVID-19 pandemic and alleged political influence from other member states. This decision rekindles Trump's previous attempt to leave the WHO in 2020, which was halted by Biden upon taking office in 2021.

The executive order claims that the WHO demands unfair financial contributions from the U.S. compared to other countries, particularly China. According to Trump, China contributes 90% less to the organization despite having a larger population. The U.S. has been the top donor to the WHO, contributing $1.28 billion in 2022 and 2023.

In response, the WHO has called on Trump to reconsider the withdrawal, emphasizing the U.S.'s role in major public health achievements such as the eradication of smallpox and near-elimination of polio.

Domestic Healthcare Policy Changes

Trump's actions have also targeted several domestic healthcare initiatives implemented by the Biden administration:

Affordable Care Act and Medicaid

The president terminated an executive order aimed at strengthening the Affordable Care Act (ACA) exchanges and Medicaid. This order had led some states to extend enrollment periods and increase funding to assist residents in obtaining coverage. Under Biden's presidency, ACA exchange enrollment had grown significantly, with over 24 million people signing up for health insurance coverage this year—more than double the number of enrollees from the 2021 open enrollment period.

Drug Pricing and Medicare Models

Trump rescinded an executive order that directed the Center for Medicare and Medicaid Innovation (CMMI) to develop new payment and healthcare models to limit drug spending. As a result, three experimental models developed by CMMI have been halted:

1. The Medicare High-Value Drug List Model, which would have allowed Medicare Part D drug plans to offer about 150 generic medications with a maximum $2 co-payment for a month's supply.
2. The Cell and Gene Therapy Access Model, designed to enable state Medicaid agencies to coordinate outcomes-based payment agreements with manufacturers.
3. The Accelerating Clinical Evidence Model, which aimed to adjust Medicare Part B payments for drugs in the Accelerated Approval Program to incentivize faster completion of clinical trials.

COVID-19 Response and Future Pandemic Preparedness

Several Biden-era executive orders related to the COVID-19 pandemic have been reversed, including directives that coordinated the federal government's response to the disease, prepared for future pandemics, and supported the public health workforce.

Artificial Intelligence in Healthcare

Trump also rescinded a comprehensive executive order that managed the federal government's approach to deploying artificial intelligence tools in healthcare safely. This order had established an AI task force within the Department of Health and Human Services (HHS) and directed the development of a strategic plan, which was released earlier this month.

The rescission of this order comes at a time of growing excitement and concern about AI's impact on the healthcare sector. The future of AI regulation in healthcare under the new administration remains uncertain, with experts noting potential challenges related to competition with China and the influence of regulations from other countries or states on U.S. developers and healthcare organizations.