The First 100 Days: Healthcare Under Trump

Param Malik
6 days ago
10 min read

The 47th President's first few months in office have radically reshaped American science and medicine. In an exclusive inside look, Healthcare Insights analyzes the most transformative actions taken by the Trump Administration and the implications on health, innovation, and the competitiveness of the United States going forward.

Healthcare Insights | Exclusive

April 30, 2025

WASHINGTON, D.C. - A shaft of sunlight, unusually sharp for a Washington spring, slices across the Oval Office as the 47th President restlessly paces across the room. A nervous energy, masked by the West Wing's calm facade, crackles within its walls, a faint echo of the apprehensive unease that permeated a nation beyond its wrought-iron gates.

The weight of those four years away pressed down on him. The legacy he was shaping, the narrative he was writing, extended far beyond the walls of the White House.

But the Oval Office felt familiar now, the weight of history a comfortable pressure.

He was rebuilding America, making it stronger than ever. And the world had to know.

His thoughts jumped, as they often did. The news outlets spoke of a nation in flux, of lines redrawn and old alliances tested. 100 days. It was just the beginning. There was so much more to do. So much more to fix. So much more to win.

And Trump was just getting started.

The second term, he’d always known, would be the real show.

While the first 100 days of any administration provide a crucial glimpse into future policy, for the nearly $4 trillion United States healthcare ecosystem, Donald J. Trump's second term carried an amplified, almost seismic weight. The initial phase of a presidency often sets the tone for the years to come, and in Trump's case, that tone was one of radical transformation.

Leveraging executive authority with unprecedented speed, the administration has initiated a series of orders and policy directives that are rapidly reshaping the operational landscape of key agencies, including those impacting healthcare.

American Science Stands at a Precipice

Within the span of a hundred days, Trump formally withdrew the United States from the World Health Organization (WHO), destabilized eight decades of government support for science, slashed billions of dollars in federal funding from research universities and laboratories across the nation, and has terminated more than 1,000 grants in areas such as climate change, cancer and Alzheimer’s disease.

And while the administration touts its plan to cut NASA’s science budget by nearly 50% in the next year and continues infiltrating federal agencies like the DHHS, over 75% of scientists in the United States are considering leaving to Europe or Canada in search of a more encouraging research ecosystem, as reported by Nature.

The administration's rhetoric champions a focus on transparency and efficiency, framing these as responsible stewardship of taxpayer dollars.

However, this narrative clashes starkly with the essential nature of R&D, basic science, and the pursuit of scientific rigor. True progress often emerges from seemingly tangential or exploratory research, the kind that doesn't always fit neatly into pre-defined "nationally significant" boxes. A laser focus on immediate returns and narrowly defined goals risks stifling the very innovation that drives long-term healthcare advancements.

Federal funding for medical research faced an abrupt recalibration in 2025. And constrictive actions from federal agencies like the DHHS and DOGE have fundamentally altered the nation's capacity to respond to public health crises, compromised the rigor of drug and device approvals, and dismantled the infrastructure that sustains evidence-based medical practice, a concern echoed by scientists across the nation. Efficiency gains achieved through cuts to research budgets or staffing at agencies like the NIH and FDA may yield immediate savings, but they threaten to undermine the rigorous scientific processes that ensure the safety and efficacy of new treatments and therapies.

And on April 1, nearly 2,000 scientists signed a joint letter warning the White House of a newfound "climate of fear" among research institutions and an urgent call to halt policies that are negatively impacting the nation's research capacity.

For an industry already grappling with seismic shifts – from technological disruption to ever-present pressures of access and affordability – Trump’s second term has already significantly dismantled the nation’s research infrastructure.

Trump holds an executive order signed at the Oval Office in Washington, D.C. - Anna Moneymaker/Getty Images

A record 139 executive orders, signed in the first 100 days, have redefined the scope of presidential power. The unprecedented surge circumvents traditional legislative channels, signaling a dramatic shift in governance. Critics allege an overreach, while proponents cite necessary speed in implementing the administration's agenda. And sidestepping the traditional legislative process has potentially undermined the checks and balances designed to prevent executive overreach.

Select List of Executive Orders Impacting Healthcare Signed by President Trump in 2025:

Executive Order	Date Signed
EO 14273: Lowering Drug Prices by Once Again Putting Americans First	April 15, 2025
EO 14221: Making America Healthy Again by Empowering Patients With Clear, Accurate, and Actionable Healthcare Pricing Information	February 28, 2025
EO 14282: Transparency Regarding Foreign Influence at American Universities	April 23, 2025
EO 14267: Reducing Anti-Competitive Regulatory Barriers	April 9, 2025
EO 14255: Establishing the United States Investment Accelerator	March 31, 2025
EO 14257: Regulating Imports with a Reciprocal Tariff to Rectify Trade Practices that Contribute to Large and Persistent Annual United States Goods Trade Deficits	April 2, 2025
EO 14212: Establishing the President's Make America Healthy Again Commission	February 13, 2025
EO 14155: Withdrawing the United States From the World Health Organization	January 20, 2025

Just as the future of discovery and innovation feels the pull of new priorities, American healthcare now teeters on a fulcrum.

A sweeping reorganization within the Department of Health and Human Services (DHHS) has placed loyalists in key leadership positions, leaving the future of federal healthcare policy and regulation at the hands of controversial figures like Robert F. Kennedy Jr.

Following the stepping down of FDA's Peter Marks, and a wave of uncertainty regarding federal staffing and research budgets throughout DHSS agencies, including the Food & Drug Administration and the National Institutes of Health, a widespread call for change has surfaced from the voices of countless American researchers and scientific leaders.

Many such leaders have publicly decried the proliferation of misinformation and the erosion of public trust, citing political opportunism within the DHHS's new leadership.

Robert F. Kennedy Jr. as Secretary of the Department of Health & Human Services (DHHS) - Allison Bailey/NurPhoto via AP Images

In fact, 15 of the 24 directors across the FDA, including the agency’s Commissioner, Robert Califf, have stepped down in the last six months, with leaders like Marks, who led the Center for Biologics Evaluation & Research, describing an "unprecedented assault on scientific truth".

“It has become clear that truth and transparency are not desired by the secretary [RFK Jr.], but rather he wishes subservient confirmation of his misinformation and lies,” Marks wrote in a letter to acting FDA Commissioner Sara Brenner, a copy of which was obtained by Healthcare Insights.

This growing chorus of dissent from within the scientific community underscores the profound anxieties surrounding the administration's reshaping of the nation's regulatory infrastructure. As these concerns ripple outward, the tangible effects of the second term's policies are beginning to manifest across the healthcare sector, revealing a series of key shifts with potentially far-reaching consequences.

Key Shifts Impacting Healthcare

ACA changes: Expect higher premiums, less coverage.
Medicaid cuts: States face budget strain, less patient access.
Drug prices: Potential for lower costs, market disruption.
Hospital funding: Reimbursements down, services at risk.
FDA speed-up: Faster approvals, safety concerns rise.
Research funds: Focus shifts, basic science impact unclear.
Private sector R&D: More industry influence on medical research.
Telehealth growth: Regulations loosen, access expands.
Workforce shortages: Immigration changes impact healthcare staffing.
Public health cuts: Pandemic response capacity reduced.
Price transparency: Patients see costs, market competition increases.
AI in healthcare: Regulation uncertainty, adoption speeds up.
Insurance plans: More choice, potential coverage gaps.
Value-based care: Increased pressure on patient outcomes.
Medical supply chain: "America First" affects foreign dependencies.

The administration's healthcare policies, now in effect, have triggered a cascade of tangible shifts across the sector. ACA premiums are projected to rise, alongside a contraction of Medicaid coverage, raising concerns over access for vulnerable populations.

Drug price reductions, while anticipated, have introduced market volatility and potential long-term impacts on pharmaceutical innovation. Hospital reimbursements have been cut, jeopardizing service stability amid workforce shortages exacerbated by immigration policy changes. And the FDA's accelerated approval process has expedited therapy access, but heightened safety concerns necessitate increased post-market surveillance.

Amidst these sweeping changes, Trump has appointed prominent cardiothoracic surgeon Dr. Mehmet Oz as the 17th Administrator of the Centers for Medicare & Medicaid Services (CMS). Proponents of the appointment cite Dr. Oz's extensive medical background and public health advocacy, expressing optimism that his expertise will bring valuable insights to CMS policy and potentially recalibrate the agency's direction.

The move is viewed by some as a strategic attempt to leverage Dr. Oz's public profile to re-establish trust in the agency and communicate effectively to the American public.

Dr. Mehmet Oz, confirmed April 3, 2025, as 17th Administrator for the Centers for Medicare & Medicaid Services (CMS.)

Following the administration's broader restructuring of healthcare agencies, the economic implications of these policy shifts have become a focal point of intense scrutiny. The series of executive orders, as documented by sources including Maynard Nexsen and the American Journal of Managed Care, have initiated changes with potentially far-reaching financial consequences.

The administration's emphasis on deregulation and market-driven solutions, while intended to spur economic growth, has introduced significant volatility into the healthcare sector. Reductions in hospital reimbursements, coupled with fluctuating drug prices, have placed financial strain on healthcare providers, potentially jeopardizing service availability and quality. The push for price transparency, while aiming to empower consumers, has created uncertainty regarding market dynamics and potential cost shifts.

Furthermore, the redirection of federal research funding has raised concerns about the long-term economic impact on medical innovation. The slashing of budgets for basic science research, as well as the termination of numerous grants, could stifle the development of new treatments and therapies, ultimately impacting the nation's economic competitiveness. The increased influence of private sector R&D, while potentially accelerating the pace of innovation, also raises questions about the accessibility and affordability of future medical advancements.

The economic implications extend beyond the healthcare industry itself. The potential for increased insurance premiums and reduced Medicaid coverage could place a financial burden on individuals and families, affecting their ability to access essential healthcare services. Additionally, the administration's immigration policies, which have exacerbated workforce shortages in the healthcare sector, could lead to increased labor costs and further strain on the system.

The administration's claims of "efficiency" and "responsible stewardship of taxpayer dollars" are being challenged by economists and healthcare experts, who point to the potential for increased long-term costs and economic instability. The coming months will be crucial in determining the true economic impact of these policies and whether the administration's vision of a market-driven healthcare system can deliver on its promises.

The Next 100 Days and Beyond

The first 100 days of this administration have laid a clear foundation, one that will undoubtedly shape the trajectory of American healthcare, science, research, and innovation for years to come. While the immediate impacts are now becoming discernible, the long-term consequences of these initial policy shifts remain a crucial area of analysis for industry leaders and policymakers alike.

One key area to watch will be the nuanced evolution of regulatory changes. While the initial push for deregulation might have been broad, the coming months will likely see a more granular approach, with agencies like the FDA and NIH grappling with the specifics of implementation. The balance between accelerating innovation and maintaining rigorous safety standards will be a continuous tightrope walk.

The next few months will reveal the true impact of the administration's policies. The implementation of price transparency measures will be closely watched for its effectiveness in driving down costs and its potential unintended consequences on market dynamics. The future of the Affordable Care Act, even without outright repeal, will continue to cast a shadow over coverage rates and market stability. And the interplay between federal policies and state-level responses, particularly regarding Medicaid and insurance regulations, will add further complexity to an already dynamic landscape.

Looking beyond the immediate horizon, the long-term vision for American healthcare under this administration will begin to solidify. And the resilience and adaptability of the US healthcare ecosystem, its capacity to absorb these changes while continuing to advance patient care and scientific discovery, will be the ultimate measure of this transformative period.

Healthcare Insights will continue to provide in-depth coverage and expert insights as this new era unfolds, ensuring our readers remain at the forefront of understanding the evolving landscape.