5 Major Changes the Trump Administration Has Made in Health Care

The first 6 months of the second Trump administration have been accompanied by several notable changes to health care in the US, including rescinding vaccine recommendations, budget cuts, and pulling out of global health initiatives. With so many changes coming in this short time, it is imperative to be aware of the change that could affect Americans the most, for both good and ill.

1. Trump Administration Suspends Funding of PEPFAR

The President’s Emergency Plan for AIDS Relief (PEPFAR) was established in 2003 by the Bush administration to help in the fight against the HIV/AIDS global epidemic. The fund aimed to achieve control of the epidemic through providing services related to prevention, care, and treatment of HIV and AIDS in areas with higher risk of HIV transmission.

On January 21, 2025, President Donald Trump signed an executive order that would suspend all foreign aid to other countries for 90 days, pending a review,¹ stating that the foreign aid industry was not aligned with American interests. Although some funding was reinstated, the Joint United Nations Programme on HIV and AIDS stated that these funding cuts have caused multiple disruptions in care, which has led to prevention programs for HIV suspending their operations.² The attack on PEPFAR could have ripple effects in health outcomes across the globe.

2. Cancellation of Federal Grants From the NIH

The National Institutes of Health (NIH) made news in February when cuts were made to hundreds of research grants, specifically targeting any grant that the institution stated was not aligned with agency priorities. These included grants for the study of sexual and gender minorities, racial and ethnic groups, vaccines, pandemic threats, and diversity initiatives. Not only were grants cancelled, but more than 1100 grants are currently experiencing delays in funding, totaling $740 million as of last month. These delayed grants include for research on tuberculosis, malaria, blood cancer, dementia, and vision loss, among others.³ These cancellations and delays put a pause on research that could potentially save lives and improve current medical treatments. The cancellations are currently being battled in court.

3. Budget Bill Slashes Funding for Medicaid

Medicaid came under fire by the Trump administration almost immediately, with President Trump endorsing budget bills that would slash funding for Medicaid over the course of 10 years. This budget became a reality on July 3, when the House passed the One Big Beautiful Bill Act that would later be signed into law by Trump. Amid its many funding decisions were cuts to Planned Parenthood; the most notable was cutting the budget of Medicaid, which could leave 11.8 million people uninsured by 2034.⁴ The cuts to the Supplemental Nutrition Assistance Program could also have downstream health consequences, as 3 million people will lose their benefits also by 2034.

4. Trump Signs Executive Order to Introduce Most Favored Nation Pricing

In April, the president signed an executive order that aimed to target the high prices of drugs in the country, indicating that he sought “most favored nation” pricing.⁵ The executive order also aimed to introduce more transparency around pharmacy benefit managers’ fees. The executive order specifically requested that the Department of Commerce, the Department of Justice, HHS, and the Federal Trade Commission meet to identify practices that keep drug prices high and limit competition within 180 days of the signing of the order. The executive order was not expected to curb the prices of drugs in the US immediately and would need Congressional collaboration to achieve much of its agenda.

5. RFK Jr Assumes HHS Secretary Position, Makes Sweeping Decisions

After his confirmation in February, Robert F. Kennedy Jr has made several decisions that could affect preventive care, specifically targeting vaccines. In June, he removed all members of the CDC Advisory Committee on Immunization Practices in favor of 8 members who have previously expressed vaccine skepticism and skepticism around the severity of COVID-19.⁶ This decision has already yielded new recommendations surrounding the flu vaccine, with the advisory committee rescinding federal recommendations for flu vaccines containing thimerosal, which has been incorrectly linked to autism.⁷

References

1. Imray G, Magome M, Mutsaka F, Banchereau M. Africa knew Trump’s ‘America first’ pledge meant it might be last. Then came the freeze on aid. AP News. Updated February 3, 2025. Accessed July 24, 2025. https://apnews.com/article/trump-africa-aid-freeze-pepfar-usaid-hiv-d1c34ac35af30e8f680f580f7d1b3029
2. AIDS, crisis and the power to transform: UNAIDS global AIDS update 2025. UNAIDS. 2025. Accessed July 24, 2025. https://www.unaids.org/sites/default/files/2025-07/2025-global-aids-update-JC3153_en.pdf
3. Hwang I, Huang J, Anthes E, Migliozzi B, Mueller B. The disappearing funds for vaccine research, chronic diseases, global health. The New York Times. June 4, 2025. Accessed July 24, 2025. https://www.nytimes.com/interactive/2025/06/04/health/trump-cuts-nih-grants-research.html
4. Shaw M. Proposed GOP Medicaid cuts threaten loss of coverage for millions. AJMC^®. May 12, 2025. Accessed July 24, 2025. https://www.ajmc.com/view/proposed-gop-medicaid-cuts-threaten-loss-of-coverage-for-millions
5. Steinzor P. Trump signs executive order to lower drug prices. AJMC. April 16, 2025. Accessed July 24, 2025. https://www.ajmc.com/view/trump-signs-executive-order-to-lower-drug-prices
6. Bonavitacola J. Vaccine skeptics among CDC vaccine panel replacements named by RFK Jr. AJMC. June 12, 2025. Accessed July 24, 2025. https://www.ajmc.com/view/vaccine-skeptics-among-cdc-vaccine-panel-replacements-named-by-rfk-jr
7. Bonavitacola J. Federal recommendations for vaccines containing thimerosal rescinded. AJMC. July 24, 2025. Accessed July 24, 2025. https://www.ajmc.com/view/federal-recommendations-for-vaccines-containing-thimerosal-rescinded