President Donald Trump reversed several of his predecessor’s healthcare-related executive orders on Monday, including some aimed at managing the COVID-19 pandemic, overseeing artificial intelligence and boosting support for the Affordable Care Act exchanges.
Trump called the rescinded orders — all inked by President Joe Biden — “destructive” and “radical” after his inauguration yesterday.
Trump also signed an executive order to withdraw the U.S. from the World Health Organization, an United Nations agency focused on global public health.
Leaving the WHO
Trump’s order to leave the more than 70-year-old public health agency — of which the U.S. is a founding member — isn’t entirely unexpected. The newly inaugurated president moved to remove the nation from the WHO in 2020, but Biden signed an executive order preventing the U.S. exit shortly after he was inaugurated.
In his executive order, Trump said the U.S. is leaving due to the WHO’s “mishandling of the COVID-19 pandemic” and its “inability to demonstrate independence from the inappropriate political influence” of other member states.
Trump also said the organization demands unfair payments from the U.S. compared with other countries. In the order, Trump claims that China contributes 90% less to the organization, despite having a larger population. The U.S. is the top donor to the WHO, contributing $1.28 billion in 2022 and 2023, according to the organization.
In a statement, WHO called on Trump to reconsider, noting the U.S.’ work with the organization has contributed to major public health successes like ending smallpox and nearly eradicating polio.
CMMI models on drug costs
Trump cut an executive order asking the Center for Medicare and Medicaid Innovation to consider new payment and healthcare models to limit drug spending.
The CMMI developed three experiments, called the Medicare High-Value Drug List Model, the Cell and Gene Therapy Access Model and the Accelerating Clinical Evidence Model, as a result of Biden’s original order.
The first would allow Medicare Part D drug plans to offer a defined set of about 150 generic medications with a maximum co-payment of $2 for a month’s supply. The cell and gene therapy experiment — which was accepting state applications through the end of next month — would have let state Medicaid agencies allow the CMS to coordinate outcomes-based payment agreements with manufacturers.
The third model would have adjusted Medicare Part B payments for drugs in the Accelerated Approval Program to incentivize manufacturers to speed and finish clinical trials.
Artificial intelligence
Trump also rescinded a sweeping executive order that managed the federal government’s approach to safely deploying artificial intelligence tools in healthcare.
Among other policies, the directive asked the HHS to establish an AI task force and develop a strategic plan, which was just released earlier this month.
The end of the executive order comes as excitement — and worry — about the technology’s impact on the healthcare sector grows. The outlook for AI regulation in healthcare is unclear under the new administration, which will have to grapple with competition from China as well as regulations from other countries or states that could affect U.S. developers and healthcare organizations, experts say.
Coordinating COVID-19 response
Trump reversed a number of Biden-era executive orders related to the COVID-19 pandemic, including directives that coordinated the federal government’s response to the disease, prepared for future pandemics and supported the public health workforce.
Affordable Care Act coverage
The president also ended an executive order that aimed to strengthen the ACA exchanges and Medicaid, which led some states to lengthen enrollment periods and provide more funding to help residents sign up for coverage.
The ACA exchanges grew significantly under President Biden. More than 24 million people signed up for health insurance coverage on the marketplaces for this year, more than double the number of enrollees from the open enrollment period for 2021, according to the CMS.