Early updates from the new administration on healthcare policy

As the new administration begins its term, it's already taken significant action through executive orders (EOs), some of which could affect healthcare policies and agencies like HHS and CMS.

As such, we'd like to highlight three key activities:

1. A regulatory freeze
2. The rescission of several Biden-era EOs
3. The issuance of new orders that signal a shift in federal priorities

1. Regulatory freeze

One of the early actions was a regulatory freeze EO -a common practice when a new administration takes office. A regulatory freeze gives the incoming leadership time to review, modify, or delay pending or recently finalized regulations to better align them with their priorities.

This freeze directs federal agencies to:

• Refrain from issuing new rules until reviewed and approved by a department head
• Withdraw rules sent to the Office of the Federal Register (OFR) but not yet published
• Postpone the effective dates of published rules that haven't taken effect, with the possibility of reopening comment periods

The freeze likely affects several healthcare-related rules finalized or issued late in the previous administration, including proposed 2026 Medicare Advantage and Part D policies as well as the rate notice and final 2026 Notice of Benefit and Payment Parameters (for public insurance Marketplace coverage).

While expected, this freeze could create uncertainty for stakeholders-including states, insurers, and providers-as they plan for 2026 programs.

2. Rescission of Biden administration executive orders

The president rescinded more than 50 Biden-era EOs, including several with implications for HHS and CMS. Below are summaries of the most relevant EOs.

Advancing racial equity (EOs 13985 and 14091)

EO impact on HHS/CMS: These EOs prompted creation of the HHS Equity Action Plan and CMS Framework for Health Equity, which influenced program design and quality measures aimed at addressing health disparities.

Rescission implications: Equity initiatives may be halted or deprioritized, including potential changes to health equity-related quality measures or social determinants of health (SDOH) initiatives.

Preventing discrimination based on gender identity (EO 13988)

EO impact on HHS/CMS: With EOs 13985 and 14091, this EO set CMS's vision as "attaining the highest level of health for all people and eliminating health disparities." It also prompted creation of Sexual Orientation and Gender Identity (SOGI) questions in some CMS tools (example).

Rescission implications: Demographics terminology and related data collection and analysis may change. Nondiscrimination prohibitions and related protections outlined by regulations (e.g., implementing Section 1557 of the ACA) may be reconsidered.

Protecting public health and the environment, tackling the climate crisis (EOs 13990 and 14008)

EO impact on HHS/CMS: These EOs supported the creation of the HHS Office of Climate Change and Health Equity and inspired decarbonization initiatives in Models (example).

Rescission implications: Federal environmental health initiatives within HHS/CMS may lose funding or operational support.

Strengthening Medicaid and the ACA (EOs 14009 and 14070)

EO impact on HHS/CMS: These EOs encouraged Medicaid/ACA enhancements and influenced Medicaid HCBS and Access rules.

Rescission implications: This shift likely signals less federal emphasis and promotion of Medicaid and ACA programs (e.g., less navigator or outreach support). States may also gain increased flexibility to shape Medicaid programs.

Lowering prescription drug costs (EO 14087)

EO impact on HHS/CMS: This EO led CMMI to design models such as the Medicare High-Value Drug List Model, the Cell and Gene Therapy Access Model, and the Accelerating Clinical Evidence Model.

Rescission implications: Unclear; these models may be modified or discontinued.

Safe and trustworthy AI (EO 14110)

EO impact on HHS/CMS: This EO directed HHS/CMS to appoint an AI lead and develop a strategic plan for ethical AI use in healthcare, emphasizing equity, privacy, and security.

Rescission implications: AI oversight and strategic planning may diminish but could be replaced with new policies emphasizing different priorities.

3. New executive orders on diversity, equity, and inclusion (DEI) and SOGI

In addition to rescinding Biden-era EOs, the administration issued new orders reflecting its priorities including.

Eliminates federal DEI-related positions (e.g., Chief Diversity Officer), programs, grants, and contracts as well as equity action plans. Relatedly, employees in federal DEI offices have been put on paid leave.

Establishes policies based solely on biological sex, rejecting gender identity as a basis for agency legal definitions.

Requires HHS to provide other agencies and the public clear guidance expanding on the sex-based definitions set forth in the order (i.e., "sex" as biologically male or female).

Context and next steps

These early actions by the administration signal a significant shift in federal priorities, particularly in the areas of equity, public health, healthcare affordability programs, and AI innovation. While some initiatives may be phased out, others could continue in modified forms, reflecting the administration's strategic focus.

Rescinding EOs or issuing new ones does not immediately terminate all associated programs-particularly those codified in federal regulations. Programs tied to regulations may require formal rulemaking or new regulatory guidance, which could take time.

These actions are occurring against the backdrop of congressional deliberations on healthcare policies, including potential cuts. Stakeholders should closely monitor developments from HHS, CMS, and Congress as these changes take shape.

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