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In collaboration with:
January 22, 2025
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In an effort to help our Funding Partners better understand the changing health policy landscape in the new administration and Congress, Grantmakers In Health (GIH) is expanding the GIH Health Policy Update newsletter to three issues per month. Working in collaboration with Leavitt Partners, a leading health care policy consultancy, we are adding new installments of the newsletter on the first and third Wednesdays of the month, while we will continue to partner with Trust for America’s Health on the installment released on the second Wednesday of the month. The Health Policy Update is published with support from Robert Wood Johnson Foundation and Missouri Foundation for Health. Please email us at info@gih.org if you have any questions or comments about the newsletter.
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Spotlight
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As we enter the new year, we are pleased to offer Funding Partners a timeline previewing expected and potential regulatory and legislative health policy events. Click here to view the federal timeline (Funding Partner login required) along with access to NCSL’s 2025 State Legislative Session Calendar.
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The 119th Congress officially began on January 3 with the swearing in of new members of Congress and the election of the Speaker of the House. Mike Johnson (R-LA) was re-elected as Speaker, leading a very small majority. The tight margin will impact the ability of House Republicans to legislate, with individual members having the ability to hold up votes.
In the first few months of the year, Congress is expected to focus on a bill including priorities of the Trump administration, such as tax cuts and border security provisions. President Trump recently stated his preference that these be included in a single piece of legislation. Congress is likely to use a special procedure called “budget reconciliation” which allows for the passage of legislation with only a simple majority (51 votes) in the Senate and House (218 votes) but can only address provisions that are primarily budgetary in nature. Health-related policies are not expected to be the focus of this first bill; however, policies that generate budgetary savings, such as some Medicaid changes, may be part of the legislation.
In the first weeks of the new Congress, the Senate will also be busy with confirmation hearings and votes on President Trump’s nominees. The Senate Finance and Health, Education, Labor and Pensions (HELP) Committees will hold confirmation hearings for Department of Health and Human Services (HHS) nominees, including the confirmation of the Secretary of Health and Human Services, Food and Drug Administration (FDA) Commissioner, Administrator of the Center for Medicare and Medicaid Services (CMS), and the Directors of the Center for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), but these hearings have not yet been scheduled.
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President Trump Inaugurated
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On January 20, 2025, Donald J. Trump was inaugurated as the 47th President of the United States. Following the Inauguration, President Trump began signing executive actions directing federal agencies to implement his agenda, including executive actions to:
- Freeze rulemaking until rules can be reviewed by department heads appointed or designated by the President. Those appointed and designated by the President can review and approve the rule and withdraw rules that have been sent but not yet published by the Federal Register so they can be reviewed.
- Establish and implement the Department of Government Efficiency (DOGE) as a temporary organization within the Executive Office of the President and reporting to the White House Chief of Staff. The Executive Order renamed the United States Digital Service as the United States DOGE Service (USDS) and executive agencies are directed to establish DOGE teams of at least four employees in consultation with USDS. DOGE is intended to modernize federal technology and software to maximize governmental efficiency and productivity.
- Freeze the hiring of federal civilian employees.
- Require the Office of Management and Budget (OMB), the Office of Personnel Management (OPM), and DOGE to submit a plan within 90 days to reduce the size of the federal government’s workforce through efficiency improvements and attrition.
- Direct OMB, the Attorney General, and OPM to coordinate the termination of diversity, equity, and inclusion (DEI) programs, policies, and activities in the federal government and place staff responsible for DEI programs on administrative leave.
- Direct the withdrawal of the U.S. from the World Health Organization (WHO) and directing the director of the White House Office of Pandemic Preparedness and Response Policy to review, rescind, and replace the 2024 U.S. Global Health Security Strategy as soon as practicable.
- Reinstate Executive Order 13957 of October 21, 2020, Creating Schedule F in the Excepted Service.
- Ensure agency officials have the authority to reassign and remove career Senior Executive Service (SES) individuals, who are generally senior-level federal government employees.
- Withdraw the United States from international environmental agreements, including the Paris climate agreement.
- Eliminate birthright citizenship for children born in the United States to parents who are unauthorized immigrants or temporary visa holders.
- Recognize only two sexes, male and female, and direct agencies to “ensure grant funds do not promote gender ideology.”
- Pause external communications from all HHS agencies, including CDC, FDA, and NIH.
The executive actions generally followed up on campaign promises to address border security, immigration, and the federal workforce. While not directly focused on health care, these executive actions could have a significant impact on health policy, particularly impacting the federal employees at HHS and its agencies.
In addition to these executive actions, President Trump also rescinded multiple Executive Orders (EOs) issued by President Biden, including:
- Executive Order 13996, which directed Federal departments to address the cost of COVID-19 testing and support the training of public health workers.
- Executive Order 13997, which directed federal departments and agencies to accelerate the development of novel therapies to treat COVID-19 and improving the capacity of the nation's health care systems to address COVID-19.
- Executive Order 14009, which directed HHS to consider establishing a new special enrollment period for ACA enrollment and examine policies that “undermine Medicaid or the ACA.”
- Executive Order 14087, which directed the Centers for Medicare and Medicaid Innovation to consider testing new health care payment and delivery models that would lower drug costs and promote access to innovative drug therapies for beneficiaries enrolled in the Medicare and Medicaid programs. This action does not end any specific CMMI models.
These EO recissions, which largely mirror the actions that President Trump said he would take upon returning to the White House, will require federal departments and agencies to consider and take action to change relevant policies within federal programs, which will be further detailed by the departments and agencies in coming weeks and months.
Additional EOs and executive actions are expected in the coming weeks. It is expected that several of these EOs will be subject to legal challenges.
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Health Care in the Administration
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Upon taking office, President Trump announced the individuals who will serve in “acting” roles for Cabinet-level positions until his nominees are confirmed. Dorothy Fink was named Acting Secretary of Health and Human Services. Dr. Fink, who is board certified in endocrinology, internal medicine, and pediatrics, started at HHS during the first Trump Administration and was the Deputy Assistant Secretary for Women's Health and Director of the Office on Women's Health prior to being named Acting Secretary. As Acting Secretary, Dr. Fink will be responsible for carrying out directives from President Trump until a Secretary of Health and Human Services is confirmed by the Senate. The Senate Finance Committee and Senate HELP Committee, which will conduct hearings on President Trump’s health care nominees, have yet to schedule hearings so it could still be several weeks before President Trump’s health nominees can be confirmed.
On January 17, CMS released the list of 15 drugs that will be included in the second round of price negotiations under the Medicare Drug Price Negotiation Program, which will take place this year. The first round of drug price negotiations took place in 2024 and included 10 drugs for which negotiated prices will be effective January 1, 2026. The negotiated prices from this first round are discounted by a range of 38 to 79 percent from their list prices. Negotiated prices for this second round of drugs will become effective January 1, 2027.
On January 16, CDC issued a Health Advisory stressing heightened vigilance for Avian Influenza A(H5N1) infections amid high seasonal flu activity. The Health Advisory urges clinicians and laboratories to expedite subtyping of all influenza A specimens from hospitalized patients, particularly those in intensive care units (ICUs), to help identify potential human infections with avian influenza A(H5N1) viruses. This recommendation follows an ongoing avian influenza A(H5N1) outbreak among wild birds and animals in the U.S., with 67 confirmed human cases since 2022, including one fatality. The CDC emphasizes testing hospitalized patients for both seasonal and non-seasonal influenza, especially those with relevant exposure to infected animals, and to implement appropriate infection control measures if avian influenza is suspected.
On January 16, FDA approved a petition requesting the revocation of the authorization for color additive Red No.3 for use in food and ingested drugs. The Federal Food, Drug, and Cosmetic Act (FD&C Act) allows FDA to regulate “color additives,” while the Delaney Clause of the Color Additives Amendment to the FD&C Act prohibits FDA authorization of a color additive if it is known to cause cancer in humans or animals. The petition, originally submitted in 2022 by Center for Science in the Public Interest, a GIH Funding Partner, states that FD&C Red No. 3 has been shown to cause cancer in male laboratory rats, specifically thyroid tumors. Manufacturers who use FD&C Red No. 3 in food and ingested drugs must reformulate their products before January 15, 2027 for foods or January 18, 2028 for ingested drugs.
On January 14, FDA proposed a requirement to provide front-of-package (FOP) nutrition labeling for most packaged food. The proposed rule, if finalized, would require a FOP nutrition label that offers clear information on saturated fat, sodium, and added sugars, and categorizes the percentage of the daily value for each of these nutrients as “high,” “medium,” or “low.” According to FDA estimates, the annualized costs for relabeling products over ten years will range between $66 million and $154 million. FDA also estimates that for food manufacturers who choose to reformulate products, the cost of the proposed requirements will be between $125 million to $377 million. The proposed rule is open for public comment until May 16, 2025.
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If your organization submits comments, please share a copy with GIH (info@gih.org) so we can track and compile input from health funders.
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On January 22, the Senate Budget Committee will hold a hearing on the nomination of Russell Vought to be the Director of the OMB. OMB plays a significant role in setting policy and conducting oversight of government spending and federal personnel. OMB is also expected to work closely with DOGE. The Budget Committee hearing follows a recent hearing in the Senate Homeland Security and Governmental Affairs Committee (HSGAC) on Vought’s nomination. During these hearings, members on both sides of the aisle are able to ask questions of and receive commitments from nominees. During the HSGAC hearing, Majority members emphasized the role of the Director of OMB in reining in government spending and increasing accountability in the federal government and expressed confidence in Mr. Vought’s ability to be successful in the role. Additionally, Minority members expressed concern that, as Director of OMB, Mr. Vought would work to usurp Congressional authority in the appropriation of government funds. Since nominees for the position of Director of OMB are jointly referred to HSGAC and the Budget Committee, both committees must vote to report the nomination out of committee prior to the nomination being considered by the full Senate.
On January 16, Senators Mark Kelly (D-AZ) and Marsha Blackburn (R-TN) reintroduced legislation intended to address nursing shortages in designated Health Professional Shortage Areas (HPSAs). The PRECEPT Nurses Act creates a seven-year pilot program in which experienced nurses who serve as clinical preceptors can receive a $2,000 tax credit for nursing students, advanced practice nurse candidates, or new nurses. The legislation would also direct the IRS in conjunction with HRSA to report to Congress annually on the program’s impact.
On January 15, CBO released a spreadsheet of programs with expired authorizations and authorizations of appropriations that will expire in FY 2025. Stakeholders seeking to continue funding or make changes to the following programs and policies will want to engage with the relevant Congressional committees early this year. Authorizations of appropriations expiring in FY 2025 include programs to support older Americans, telehealth, rural health, public awareness on vaccines, public health data modernization, and health care workforce programs. Agencies and programs with already expired authorizations include Ryan White HIV/AIDS programs, the Agency for Healthcare Research and Quality, Title X family planning programs, and the NIH. Numerous programs and agencies with expired authorizations often continue to receive annual appropriations from Congress to operate. However, in this Congress, programs with expired authorizations could receive additional scrutiny following comments by Elon Musk and Vivek Ramaswamy, who wrote in an op-ed in November 2024 that DOGE “will help end federal overspending by taking aim at the $500 billion plus in annual federal expenditures that are unauthorized by Congress or being used in ways that Congress never intended.”
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2025 Health Policy Timeline
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View Now
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(Funding Partner login required)
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