Trump made sweeping health care changes in first week

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President Donald Trump kicked off the first week of his second term with sweeping changes to U.S. health care and federal health agencies. 

Here are a few of the biggest changes we saw last week:

U.S. exit from the WHO

Trump signed an executive order to start to withdraw the U.S. from the World Health Organization, citing what he described as a “mishandling” of the Covid-19 pandemic and other international health crises. In 2021, the Biden administration halted Trump’s first formal attempt at a U.S. exit from the WHO. 

The implications for the U.S. could be significant: the WHO serves as a first alert system when a new disease outbreak occurs, which helps member countries quickly obtain the necessary information to help their citizens. The U.S. is also expected to lose access to the WHO’s global network that sets the flu vaccine’s composition each year. But the WHO will feel the effects of Trump’s decision even more, as the U.S. is its largest donor and offers extensive technical expertise to the agency. 

On Saturday, however, Trump said he may reconsider joining the WHO. 

“Maybe we would consider doing it again, I don’t know. Maybe we would. They would have to clean it up,” Trump said at a rally in Las Vegas, according to several outlets. 

Anti-abortion policies reinstated

Trump on Friday issued an executive order that reinstated a long-standing Republican anti-abortion proposal known as the “Mexico City Policy,” which bars federal fundi

ng from going to any overseas nongovernmental organization that performs or promotes abortions.

The rule was first put in place by President Ronald Reagan and has been rescinded by every Democratic president — and reimplemented by every Republican one — since then.

Also on Friday, Trump revoked two Biden administration executive orders that sought to expand access to abortions in the U.S.

HHS cease all communications 

The Trump administration told federal health agencies to pause external communications for now, several outlets reported last week. This includes the agencies that fall under the Department of Health and Human Services, such as the Centers for Disease Control and Prevention, the Food and Drug Administration and the National Institutes of Health.

A memo sent to leadership at federal health agencies noted the communication hiatus will extend through Feb. 1, ABC News reported, citing an internal CDC audio recording. 

Resources from the department, such as the CDC’s decades-old weekly public health publication, have been put on hold. 

Some staffers at health agencies are also temporarily banned from traveling and have been told to stop work with the WHO, ABC reported. 

Drug pricing models rescinded 

Trump rescinded an executive order from the Biden administration that created three drug pricing models aimed at lowering the cost of prescription drugs for people on Medicare and Medicaid. 

The Biden administration announced the proposals in February 2023, but they had not been implemented. They included a $2 monthly out-of-pocket cap on certain generic drugs and lower costs for cell and gene therapies. 

Biden’s major health-care initiatives under the Inflation Reduction Act, including the $2,000 annual out-of-pocket cap on prescription drugs and the Medicare drug price negotiation program, were not affected by Trump’s executive actions.

DEI, discrimination protections scrapped

Trump issued an executive order on his first day to end all federal government initiatives related to diversity, equity and inclusion. He also moved to end a range of policies that aimed to protect rights for LGBTQ+ people.

Trump specifically signed an executive order proclaiming that the U.S. government will recognize only two sexes, male and female. It essentially attempts to end legal recognition of transgender and nonbinary people under federal law.

It requires that the federal government use the term “sex” instead of “gender,” and directs the State Department and the Department of Homeland Security to “require that government-issued identification documents, including passports, visas, and Global Entry cards, accurately reflect the holder’s sex.”

In a statement, the American Civil Liberties Union said the gender order requires federal agencies to “discriminate against transgender people by denying who they are and threatening the freedom of self-determination and self-expression for all.” 

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UnitedHealth Group said the cyberattack on its subsidiary Change Healthcare affected around 190 million Americans, nearly double the previous estimate released by federal regulators in October. 

The figure cements the Change Healthcare leak as the largest reported health-care data breach in U.S. history, and there’s not a close second. The previous record was set by Anthem in 2015 when hackers compromised data from 78.8 million patients. 

UnitedHealth said the “vast majority” of affected individuals have been notified. An official final number will be submitted to the U.S. Department of Health and Human Services Office for Civil Rights “at a later date.”

“Change Healthcare is not aware of any misuse of individuals’ information as a result of this incident and has not seen electronic medical record databases appear in the data during the analysis,” the company said in a statement to CNBC.

In February, a ransomware group called Blackcat breached part of Change Healthcare’s information technology network. Change Healthcare offers revenue cycle management tools and other services for medical providers and payers, and it processes billions of transactions every year. 

UnitedHealth disconnected the compromised systems when it detected the cyberattack, and the disruption caused serious fallout across the U.S. health-care sector. Many doctors were temporarily left without a way to fill prescriptions or get paid for their services, and some providers took thousands of dollars out of savings to keep their doors open. 

In a congressional hearing about the breach in May, UnitedHealth CEO Andrew Witty estimated that around one-third of Americans could have been compromised– a guess that has now proved to be too low. Witty also confirmed that UnitedHealth paid a ransom of $22 million to the cybercriminals in the months following the attack.

The updated breach total likely won’t help UnitedHealth foster much goodwill with the American public, which unleashed a barrage of outrage toward the company following the fatal shooting of UnitedHealthcare CEO Brian Thompson in December. 

UnitedHealth announced last week that Tim Noel, a company veteran, will serve as the new head of the insurance arm.

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The health care sector saw big declines at the end of last year, led by health insurers and hospitals, amid concerns about Republicans cutting funding for Medicaid this year.  But analysts at Strategas said the budget cuts will not be an easy lift for this Congress, and health care will likely see a healthy bounce back this year. It’s already begun: the S&P health care sector is now the best performer in January.

While Robert F. Kennedy Jr.’s nomination to be secretary of Health and Human Services faces opposition over his stance on vaccines, his approach to food and nutrition is fueling cautious optimism among startups focused on nutrition counseling for patients in government plans. Nutrition counseling has begun to gain traction in Medicaid programs to help combat obesity and diabetes through diet rather than costly GLP-1 drugs. If he is confirmed, Kennedy could give the programs a boost. 

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