Name: One Year In, How Much of Trump’s Health Agenda Has Biden Undone?
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One Year In, How Much of Trump’s Health Agenda Has Biden Undone?

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Originally Published March 25, 2021It’s been a year since President Joe Biden took the reins of the federal executive branch, and with them the power to undo health policies of his predecessor. So how much has this administration accomplished?It depends on how — and what — you count. Biden or his health officials were quick to reverse many of the policies President Donald Trump implemented that did not require formal regulations. Those include having the U.S. rejoin the World Health Organization, rolling back the “Mexico City” policy that banned aid or international organizations that support abortion rights, and canceling a ban on the use of federal funds to study fetal tissue from elective abortions.The administration also managed more complex unwindings. Final to restore the ability of Planned Parenthood and other abortion providers to participate in the federal family planning program. Also was the Trump administration’s effort to link prescription drug prices to their lowest available costs, equivalent to those of other industrialized countries.But other high-profile Trump policies remain in place, at least for now. The Biden administration has yet to take action to rein in so-called short-term insurance policies that skirt coverage requirements of the Affordable Care Act. It also has not yet attempted to amend Trump policies allowing prescription drug imports from Canada, although Biden officials have yet to approve any of the state plans submitted under that policy.KHN will continue to follow the Biden administration’s actions on Trump executive branch policies and update this interactive tool, which covers executive orders, agency guidance, formal regulations, and court matters.Topics: | | | | | | | |(updated Dec. 29)OVERTURNEDOrdered HHS to establish “most favored nation” prices for Medicare drugs based on lowest price in other developed countriesWHEN: Nov. 27, 2020HOW:STATUS/BIDEN ADMINISTRATION ACTION: Lawsuits were filed and several U.S. district courts — including those for the and the — blocked the rule. Following the courts’ actions, on Dec. 28, 2020, that the rule would not be implemented without further rule-making. The Biden administration on Aug. 10, 2021, published that would formally rescind the policy. On Dec. 29, 2021, the Centers for Medicare &amp; Medicaid Services rescinding the policy, effective Feb. 28, 2022.OVERTURNEDOrdered federal officials to minimize “the economic burden” of the Affordable Care Act on states and individualsWHEN: Jan. 24, 2017HOW:STATUS/BIDEN ADMINISTRATION ACTION: Revoked by Biden’s Jan. 28, 2021, .overturnedCut funding for marketplace operations and urged states to drop out of healthcare.govWHEN: Jan. 19, 2021HOW:STATUS/BIDEN ADMINISTRATION ACTION: Regulation remains in effect. An HHS review was ordered as part of Biden’s Jan. 28, 2021, . The policy was reversed as part of the final 2022 , which took effect on Nov. 26, 2021.OVERTURNEDCut funding for navigators and ACA marketplace enrollment outreach to consumersWHEN: Aug. 31, 2017HOW:STATUS/BIDEN ADMINISTRATION ACTION: Biden indirectly ordered the Department of Health and Human Services to restore funding as part of his Jan. 28, 2021, ACA and for outreach during a special 2021 open enrollment period. &nbsp;on April 21, 2021, that it would provide $80 million for navigators for the 2022 plan year.UNCHANGEDEliminated payments to insurers that helped cover the costs the ACA required them to pay for very low-income customersWHEN: Oct. 12, 2017HOW:STATUS/BIDEN ADMINISTRATION ACTION: Policy remains unchanged.IN ProcessShortened marketplace open enrollment from three months to six weeksWHEN: April 18, 2017HOW: Included in a larger HHSSTATUS/BIDEN ADMINISTRATION ACTION: Effectively overturned by Biden’s Jan. 28, 2021, .IN PROCESSAllowed states to loosen requirements for the “essential health benefits” required by plans sold on the ACA marketplacesWHEN: April 17, 2018HOW: Included in a larger Centers for Medicare &amp; MedicaidSTATUS/BIDEN ADMINISTRATION ACTION: Regulation remains in effect, but Biden’s Jan. 28, 2021, mandated a review by HHS.&nbsp;overturnedLoosened rules for Section 1332 waivers under the ACA, which allow states to experiment with different coverage options. This was a change to the “guardrails” that sought to ensure that all ACA plans offered the same comprehensive coverage and that state experiments not cause a reduction in enrollment.WHEN: Oct. 24, 2018HOW: CMSSTATUS/BIDEN ADMINISTRATION ACTION: The guidance was written into the day before Trump’s term ended, Jan. 19, 2021. A in U.S. District Court in Washington in January challenging both the guidance and the regulation. A review by HHS was ordered as part of Biden’s Jan. 28, 2021, . The policy was reversed as part of the final 2022 , which took effect on Nov. 26, 2021.IN PROCESSChanged the formula for indexing increases in ACA plan premiums — a move expected to lead to high consumer out-of-pocket costsWHEN: April 25, 2019HOW:STATUS/ BIDEN ADMINISTRATION ACTION: Regulation remains in effect. An HHS review was ordered as part of Biden’s Jan. 28, 2021, .OverturnedAllowed Georgia to pull out of healthcare.govWHEN: Nov. 1, 2020HOW:STATUS/BIDEN ADMINISTRATION ACTION: Remains in effect. Georgia’s plan is to move out of healthcare.gov for insurance policies purchased for 2023. A in U.S. District Court in Washington on Jan. 14, 2021. An HHS review was ordered as part of Biden’s Jan. 28, 2021, . The Centers for Medicare &amp; Medicaid Services formally withdrew approval of the plan on April 29, 2022.OVERTURNEDCurtailed LGBTQ civil rights protections offered by the ACAWHEN: June 19, 2020HOW:STATUS/BIDEN ADMINISTRATION ACTION: by the U.S. District Court for the Eastern District of New York on Oct. 29, 2020. Biden’s Jan. 20, 2021, mandates that agencies “consider whether to revise, suspend, or rescind” actions that do not fully implement statutes barring discrimination. On May 10, 2021, it would resume enforcement of discrimination prohibitions based on sexual orientation or gender identity, citing court decisions that the department said supported the change.OVERTURNEDExecutive Order: Limited the government’s ability to use agency “guidance,” as opposed to formal regulation, to assess civil penalties against “regulated parties”WHEN: Oct. 9, 2019HOW:STATUS/BIDEN ADMINISTRATION ACTION: Rescinded by Biden’s on Jan. 20, 2021.IN PROCESSRegulation: Limited the government’s ability to use agency “guidance,” as opposed to formal regulation, to assess civil penalties against “regulated parties”WHEN: Jan. 14, 2021HOW:STATUS/BIDEN ADMINISTRATION ACTION: Biden ordered the Office of Management and Budget to “promptly take steps to rescind” the regulation in his Jan. 20, 2021, . The Department of Health and Human Services published to reinstate the pre-Trump era policy in the Federal Register on Oct. 20, 2021.OVERTURNEDSunsetting all regulations unless they are reviewed within five years, and then reviewed again at least once every 10 years after thatWHEN: Jan. 19, 2021HOW: RegulationSTATUS/BIDEN ADMINISTRATION ACTION: Several health groups filed suit in U.S. District Court for the Northern District of California on March 9, 2021, asking that the regulation be overturned. On March 23, 2021, the Biden administration postponed, pending judicial review, the effective date of the regulation to March 22, 2022. After delaying the implementation several times, the Biden administration on May 26, 2022.overturnedExpanded the list of federal assistance programs that if used by immigrants could make them potentially “public charges,” a designation that would hamper their ability to become lawful, permanent residents. The expansion included Medicaid.WHEN: Aug. 14, 2019HOW:STATUS/BIDEN ADMINISTRATION ACTION: The regulation has been blocked by several federal district courts and upheld by circuit courts. The Supreme Court dismissed pending appeals on March 9, 2021, after the Biden administration the provision. Biden ordered a review of the regulation in an on Feb. 2, 2021. The Department of Health and Human Services advised states in an “” on July 22, 2021, that receipt of Medicaid, other than for long-term care, would not be considered in determining whether an immigrant is a “public charge.”OverturnedBlocked visas for immigrants who couldn’t show they could afford health insuranceWHEN: Oct. 4, 2019HOW: announced Oct. 4, 2019, and published Oct. 9, 2019STATUS/BIDEN ADMINISTRATION ACTION: The policy was challenged in court but by a panel of judges from the 9th Circuit Court of Appeals on Dec. 21, 2020. The plaintiffs have requested a review by the full court. Biden ordered a review of the policy in an on Feb. 2, 2021. On May 13, 2021, Biden formally the proclamation.UNCHANGEDExpanded the availability of short-term health plansWHEN: Aug. 3, 2018HOW:STATUS/BIDEN ADMINISTRATION ACTION: The regulation was challenged in court but by the U.S. Court of Appeals for the District of Columbia on July 17, 2020.IN PROCESSAllowed association health plansWHEN: June 21, 2018HOW:STATUS/BIDEN ADMINISTRATION ACTION: A judge in U.S. District Court in Washington parts of the regulation on March 28, 2019. The case was appealed to the Court of Appeals for the D.C. Circuit, which on Nov. 14, 2019, but has not yet issued an opinion. On Jan. 28, 2021, the Biden administration to delay its decision by at least 60 days.UNCHANGEDExpanded health reimbursement arrangements (HRAs) for employers to fund premiums for workers getting coverage on the individual marketWHEN: June 20, 2019HOW:STATUS/BIDEN ADMINISTRATION ACTION: Regulation remains unchanged.IN PROCESSAllowed states to impose work requirements for some enrolleesWHEN: Jan. 11, 2018HOW:STATUS/BIDEN ADMINISTRATION ACTION: The waivers granted to states were challenged, and a federal district judge vacated several approvals. That was appealed and the case made its way to the Supreme Court, which set a hearing date of March 29, 2021. The court from its calendar on March 11, 2021, but the case could still be heard later. In his Jan. 28, 2021, , Biden mandated that HHS “consider whether to suspend, revise, or rescind” the guidance, which has since been removed from the CMS website. As of June 29, 2021, HHS had notified , , and that it is withdrawing their work requirement waivers.UNCHANGEDWeakened standards for Medicaid managed-care plansWHEN: Nov. 13, 2020HOW:STATUS/BIDEN ADMINISTRATION ACTION: The regulation remains unchanged.IN PROCESSAllows states to ask for a waiver to take their Medicaid federal contribution as a block grantWHEN: Jan. 30, 2020HOW:STATUS/BIDEN ADMINISTRATION ACTION: HHS was ordered to “consider whether to suspend, revise, or rescind” the guidance in Biden’s Jan. 28, 2021, .IN PROCESSApproved TennCare’s block grantWHEN: Jan. 8, 2021HOW:STATUS/BIDEN ADMINISTRATION ACTION: HHS was ordered to “consider whether to suspend, revise, or rescind” the waiver for Tennessee’s Medicaid program in Biden’s Jan. 28, 2021, .unchangedRequired drug prices in TV adsWHEN: May 10, 2019HOW:STATUS/BIDEN ADMINISTRATION ACTION: Drugmakers filed a lawsuit seeking to overturn the rule. The rule was by the U.S. Court of Appeals for the District of Columbia on June 16, 2020.UNCHANGEDExecutive Order: Ordered discounts for consumers who get insulin and injectable epinephrine from community health centers that purchase through the 340B programWHEN: July 24, 2020HOW:STATUS/BIDEN ADMINISTRATION ACTION: Order remains unchanged.UNCHANGEDAuthorized prescription drug imports from CanadaWHEN: Oct. 1, 2020HOW: andSTATUS/BIDEN ADMINISTRATION ACTION: A challenging the rule was filed by drugmakers on Nov. 23, 2020, and is pending.IN PROCESSAltered drug rebate rules for Medicare prescription drugsWHEN: Nov. 30, 2020HOW:STATUS/BIDEN ADMINISTRATION ACTION: The U.S. District Court in Washington most of the provisions a year, so they won’t take effect until Jan. 1, 2023. HHS, under the Biden administration, issued a on Feb. 2, 2021, delaying the effective date of the parts of the rule that had not been stayed by the judge until March 22, 2021. The administration has until April 1 to decide whether to proceed to defend the remainder of the lawsuit.overturnedRegulation: Required discounts for consumers who get insulin and injectable epinephrine from community health centers that purchase through the 340B programWHEN: Dec. 23, 2020HOW:STATUS/BIDEN ADMINISTRATION ACTION: The Biden administration implementation of the regulation until at least March 22, 2021. On March 23, the Biden administration the effective date to July 20, 2021. On June 16, 2021, HHS published a proposed rule in the that would rescind the Trump rule. The final version of the was published on Oct. 1, 2021.IN PROCESSRequired hospitals to publish “standard charges”WHEN: Nov. 27, 2019HOW:STATUS/BIDEN ADMINISTRATION ACTION: The American Hospital Association sued to overturn the regulation, but a judge in U.S. District Court in Washington on June 23, 2020. The regulation took effect Jan. 1, 2021. On July 19, 2021, the Biden administration that would substantially raise penalties for hospitals that fail to comply with the rules.UNCHANGEDCalled for hospital and insurer price transparency regulationsWHEN: June 24, 2019HOW:STATUS/BIDEN ADMINISTRATION ACTION: Order remains unchanged.UNCHANGEDRequired health insurers to provide estimated prices to patientsWHEN: Nov. 12, 2020HOW:STATUS/BIDEN ADMINISTRATION ACTION: Health plans and insurers must for policies that take effect starting Jan. 1, 2022, and they must provide cost-sharing information on 500 specified services the following year. Information on all items and services is required for policies that take effect starting Jan. 1, 2024.OVERTURNEDDisbanded the Directorate on Global Health Security and Biodefense, part of the National Security CouncilWHEN: May 2018HOW: A reorganization ordered by then-national security adviser John Bolton, the details of which were .STATUS/BIDEN ADMINISTRATION ACTION: The office was reconstituted under Biden’s Jan. 20, 2021, .OVERTURNEDWithdrew the U.S. from the World Health OrganizationWHEN: July 6, 2020HOW:STATUS/BIDEN ADMINISTRATION ACTION: Biden announced the U.S. would rejoin WHO via a on Jan. 21, 2021IN PROCESSChanged the rules for distributing organs for transplantWHEN: Dec. 2, 2020HOW:STATUS/BIDEN ADMINISTRATON ACTION: A challenge by major organ transplant centers in federal district court was on Jan. 16, 2020. The regulation was on Feb. 2, 2021, as part of a 60-day review of Trump administration regulations.OVerturnedAdded new restrictions on funding for National Institutes of Health research using fetal tissue from elective abortionsWHEN: July 26, 2019HOW:STATUS/BIDEN ADMINISTRATION ACTION: An&nbsp;&nbsp;from the director of the NIH informed outside researchers that the new restrictions would be lifted and that NIH would not convene an ethics advisory board to review new research using human fetal tissue from elective abortions.OverturnedBarred abortion providers from Title X family planning programWHEN: March 4, 2019HOW:STATUS/BIDEN ADMINISTRATION ACTION: Multiple lawsuits were filed, but the full upheld the regulation on Feb. 24, 2020. Biden’s Jan. 28, 2021, instructed HHS to act to “suspend, revise, or rescind” the regulation.On April 14, HHS proposed that would return the program to the policies in effect pre-Trump. The were published in the Federal Register on April 15. Biden ordered a review of the policy in an on Feb. 2, 2021. On May 17, the Supreme Court , after the Biden administration said it would continue to enforce the Trump rules (except in Maryland, where they were blocked by a separate court order) until its new rules are finalized. The regulations were on October 7, 2021.OVERTURNEDReinstated and expanded the so-called Mexico City policy, or “global gag rule,” which limits funding to organizations that perform or support abortion outside the United StatesWHEN: Jan. 23, 2017HOW:STATUS/BIDEN ADMINISTRATION ACTION: Jan. 28, 2021.OVERTURNEDWithdrew U.S. funding from the U.N. family planning agencyWHEN: April 3, 2017HOW:STATUS/BIDEN ADMINISTRATION ACTION: Funding was by Secretary of State Antony Blinken on Jan. 28, 2021, following Biden’s that day.UNCHANGEDOrdered the HHS secretary to “consider changing” the ACA’s contraceptive mandate regulationsWHEN: May 9, 2017HOW:STATUS/BIDEN ADMINISTRATION ACTION: Written into multiple regulations Oct. 13, 2017, and Nov. 15, 2018. Remains unchanged.UNCHANGEDInterim final regulation: Allowed employers with moral objections to opt out of offering contraceptive coverage under the ACAWHEN: Oct. 13, 2017HOW:STATUS/BIDEN ADMINISTRATION ACTION: Litigated alongside final regulation (below). on July 8, 2020.UNCHANGEDInterim final regulation: Allowed employers with religious objections to opt out of offering contraceptive coverage under the ACAWHEN: Oct. 13, 2017HOW:STATUS/BIDEN ADMINISTRATION ACTION: Litigated alongside final regulation (below). on July 8, 2020.UNCHANGEDReinterpreted “free choice of provider” guidance for Medicaid recipients, which allows people to receive services from any qualified providerWHEN: Jan. 19, 2018HOW: CMSSTATUS/BIDEN ADMINISTRATION ACTION: Guidance remains in effect. Lawsuits challenging individual states’ efforts to exclude Planned Parenthood from Medicaid are at various stages of litigation, but no suits have been filed challenging the federal guidance.UNCHANGEDFinal regulation: Allowed employers with moral objections to opt out of offering contraceptive coverage under the ACAWHEN: Nov. 15, 2018HOW:STATUS/BIDEN ADMINISTRATION ACTION: Upheld by the on July 8, 2020.UNCHANGEDFinal regulation: Allowed employers with religious objections to opt out of offering contraceptive coverage under the ACAWHEN: Nov 15, 2018HOW:STATUS/BIDEN ADMINISTRATION ACTION: Upheld by the on July 8, 2020.in processAllowed health providers to refuse to offer any service that violates their consciencesWHEN: May 21, 2019HOW:STATUS/BIDEN ADMINISTRATION ACTION: The regulation was blocked by several federal district courts. A hearing on the rule before the 9th Circuit Court of Appeals scheduled for March 17, 2021, at the request of the Biden administration.overturnedRequired separate ACA premiums for abortion coverageWHEN: Dec. 27, 2019HOW:STATUS/BIDEN ADMINISTRATION ACTION: A federal district judge in Maryland on July 10, 2020. The decision has been appealed. The policy was reversed as part of the final 2022 , which took effect on Nov. 26, 2021.KHN reporter Victoria Knight contributed to this report.Copy HTMLWe encourage organizations to republish our content, free of charge. Here’s what we ask:You must credit us as the original publisher, with a hyperlink to our khn.org site. If possible, please include the original author(s) and “Kaiser Health News” in the byline. Please preserve the hyperlinks in the story.It’s important to note, not everything on khn.org is available for republishing. If a story is labeled “All Rights Reserved,” we cannot grant permission to republish that item.Have questions? 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Originally Published March 25, 2021It’s been a year since President Joe Biden took the reins of the federal executive branch, and with them the power to undo health policies of his predecessor. So how much has this administration accomplished?It depends on how — and what — you count. Biden or his health officials were quick to reverse many of the policies President Donald Trump implemented that did not require formal regulations. Those include having the U.S. rejoin the World Health Organization, rolling back the “Mexico City” policy that banned aid or international organizations that...

One Year In, How Much of Trump’s Health Agenda Has Biden Undone?

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