Since President Joe Biden took the reins of the federal executive branch, and with them the power to undo health policies of his predecessor, 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 ¹ú²ú¾«Æ·ÊÓƵ 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. For example, the Biden administration 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.
KFF ¹ú²ú¾«Æ·ÊÓƵ News 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: Affordable Care Act | HHS Operations | Immigration | Insurance | Medicaid | Prescription Drugs | Price Transparency | Public ¹ú²ú¾«Æ·ÊÓƵ | Women’s Reproductive ¹ú²ú¾«Æ·ÊÓƵ
—Latest Action
(updated May 6, 2024)
OVERTURNED Curtailed LGBTQ+ civil rights protections offered by the ACAWHEN: June 19, 2020
HOW:
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.
On May 6, 2024, the Biden administration reinstituting the protections.
Overturned Expanded the availability of short-term health plansWHEN: Aug. 3, 2018
HOW:
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.
A , would limit how long such plans can last (up to three months); would limit how many times they can be renewed (once, for only one month); and would require clearer notice to purchasers about what the plans do and do not cover.
The was issued April 3, 2024.
—Affordable Care Act
OVERTURNED Ordered federal officials to minimize “the economic burden” of the Affordable Care Act on states and individualsWHEN: Jan. 24, 2017
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: Revoked by Biden’s Jan. 28, 2021, .
overturned Cut funding for marketplace operations and urged states to drop out of healthcare.govWHEN: Jan. 19, 2021
HOW:
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.
OVERTURNED Cut funding for navigators and ACA marketplace enrollment outreach to consumersWHEN: Aug. 31, 2017
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: Biden indirectly ordered the Department of ¹ú²ú¾«Æ·ÊÓƵ and Human Services to restore funding as part of his Jan. 28, 2021, ACA and for outreach during a special 2021 open enrollment period.  on April 21, 2021, that it would provide $80 million for navigators for the 2022 plan year.
UNCHANGED Eliminated payments to insurers that helped cover the costs the ACA required them to pay for very low-income customersWHEN: Oct. 12, 2017
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: Policy remains unchanged.
IN Process Shortened marketplace open enrollment from three months to six weeksWHEN: April 18, 2017
HOW: Included in a larger HHS
STATUS/BIDEN ADMINISTRATION ACTION: Effectively overturned by Biden’s Jan. 28, 2021, .
IN PROCESS Allowed states to loosen requirements for the “essential health benefits” required by plans sold on the ACA marketplacesWHEN: April 17, 2018
HOW: Included in a larger Centers for Medicare & Medicaid
STATUS/BIDEN ADMINISTRATION ACTION: Regulation remains in effect, but Biden’s Jan. 28, 2021, mandated a review by HHS.Â
overturned Loosened 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, 2018
HOW: CMS
STATUS/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 PROCESS Changed the formula for indexing increases in ACA plan premiums — a move expected to lead to high consumer out-of-pocket costsWHEN: April 25, 2019
HOW:
STATUS/ BIDEN ADMINISTRATION ACTION: Regulation remains in effect. An HHS review was ordered as part of Biden’s Jan. 28, 2021, .
Overturned Allowed Georgia to pull out of healthcare.govWHEN: Nov. 1, 2020
HOW:
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 & Medicaid Services formally withdrew approval of the plan on April 29, 2022.
—HHS Operations
OVERTURNED Allowed health providers to refuse to offer any service that violates their consciencesWHEN: May 21, 2019
HOW:
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. The Biden administration on Jan. 5, 2023, to rescind parts of the Trump administration rule, narrowing the circumstances under which health providers can refuse to provide certain medical care. A was issued and took effect Jan. 9, 2024.Â
OVERTURNED Executive 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, 2019
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: Rescinded by Biden’s on Jan. 20, 2021.
IN PROCESS Regulation: Limited the government’s ability to use agency “guidance,” as opposed to formal regulation, to assess civil penalties against “regulated parties”WHEN: Jan. 14, 2021
HOW:
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 ¹ú²ú¾«Æ·ÊÓƵ and Human Services published to reinstate the pre-Trump era policy in the Federal Register on Oct. 20, 2021.
OVERTURNED Sunsetting 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.
—Immigration
overturned Expanded 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, 2019
HOW:
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 ¹ú²ú¾«Æ·ÊÓƵ 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.”
Overturned Blocked visas for immigrants who couldn’t show they could afford health insuranceWHEN: Oct. 4, 2019
HOW: announced Oct. 4, 2019, and published Oct. 9, 2019
STATUS/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.
—Insurance
IN PROCESS Allowed association health plansWHEN: June 21, 2018
HOW:
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.
UNCHANGED Expanded health reimbursement arrangements (HRAs) for employers to fund premiums for workers getting coverage on the individual marketWHEN: June 20, 2019
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: Regulation remains unchanged.
—Medicaid
IN PROCESS Allowed states to impose work requirements for some enrolleesWHEN: Jan. 11, 2018
HOW: Guidance
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.
UNCHANGED Weakened standards for Medicaid managed-care plansWHEN: Nov. 13, 2020
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: The regulation remains unchanged.
IN PROCESS Allows states to ask for a waiver to take their Medicaid federal contribution as a block grantWHEN: Jan. 30, 2020
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: HHS was ordered to “consider whether to suspend, revise, or rescind” the guidance in Biden’s Jan. 28, 2021, .
IN PROCESS Approved TennCare’s block grantWHEN: Jan. 8, 2021
HOW:
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, .
—Prescription Drugs
OVERTURNED Ordered HHS to establish “most favored nation” prices for Medicare drugs based on lowest price in other developed countriesWHEN: Nov. 27, 2020
HOW:
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 & Medicaid Services rescinding the policy, effective Feb. 28, 2022.
unchanged Required drug prices in TV adsWHEN: May 10, 2019
HOW:
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.
UNCHANGED Executive Order: Ordered discounts for consumers who get insulin and injectable epinephrine from community health centers that purchase through the 340B programWHEN: July 24, 2020
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: Order remains unchanged.
UNCHANGED Authorized prescription drug imports from CanadaWHEN: Oct. 1, 2020
HOW: and
STATUS/BIDEN ADMINISTRATION ACTION: A challenging the rule was filed by drugmakers on Nov. 23, 2020, and is pending.
IN PROCESS Altered drug rebate rules for Medicare prescription drugsWHEN: Nov. 30, 2020
HOW:
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.
overturned Regulation: Required discounts for consumers who get insulin and injectable epinephrine from community health centers that purchase through the 340B programWHEN: Dec. 23, 2020
HOW:
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.
—Price Transparency
IN PROCESS Required hospitals to publish “standard charges”WHEN: Nov. 27, 2019
HOW:
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.
UNCHANGED Called for hospital and insurer price transparency regulationsWHEN: June 24, 2019
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: Order remains unchanged.
UNCHANGED Required health insurers to provide estimated prices to patientsWHEN: Nov. 12, 2020
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: ¹ú²ú¾«Æ·ÊÓƵ 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.
—Public ¹ú²ú¾«Æ·ÊÓƵ
OVERTURNED Disbanded the Directorate on Global ¹ú²ú¾«Æ·ÊÓƵ Security and Biodefense, part of the National Security CouncilWHEN: May 2018
HOW: 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, .
OVERTURNED Withdrew the U.S. from the World ¹ú²ú¾«Æ·ÊÓƵ OrganizationWHEN: July 6, 2020
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: Biden announced the U.S. would rejoin WHO via a on Jan. 21, 2021
IN PROCESS Changed the rules for distributing organs for transplantWHEN: Dec. 2, 2020
HOW:
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.
OVerturned Added new restrictions on funding for National Institutes of ¹ú²ú¾«Æ·ÊÓƵ research using fetal tissue from elective abortionsWHEN: July 26, 2019
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: ´¡²ÔÌýÂ 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.
—Women’s Reproductive ¹ú²ú¾«Æ·ÊÓƵ
Overturned Barred abortion providers from Title X family planning programWHEN: March 4, 2019
HOW:
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.
OVERTURNED Reinstated 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, 2017
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: Jan. 28, 2021.
OVERTURNED Withdrew U.S. funding from the U.N. family planning agencyWHEN: April 3, 2017
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: Funding was by Secretary of State Antony Blinken on Jan. 28, 2021, following Biden’s that day.
UNCHANGED Ordered the HHS secretary to “consider changing” the ACA’s contraceptive mandate regulationsWHEN: May 9, 2017
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: Written into multiple regulations Oct. 13, 2017, and Nov. 15, 2018. Remains unchanged.
UNCHANGED Interim final regulation: Allowed employers with moral objections to opt out of offering contraceptive coverage under the ACAWHEN: Oct. 13, 2017
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: Litigated alongside final regulation (below). on July 8, 2020.
UNCHANGED Interim final regulation: Allowed employers with religious objections to opt out of offering contraceptive coverage under the ACAWHEN: Oct. 13, 2017
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: Litigated alongside final regulation (below). on July 8, 2020.
UNCHANGED Reinterpreted “free choice of provider” guidance for Medicaid recipients, which allows people to receive services from any qualified providerWHEN: Jan. 19, 2018
HOW: CMS
STATUS/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.
IN PROCESS Final regulation: Allowed employers with moral objections to opt out of offering contraceptive coverage under the ACA.WHEN: Nov. 15, 2018
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: Upheld by the on July 8, 2020. would eliminate the ability of employers to exercise “moral” (as opposed to religious) objections to offer contraceptive coverage.
UNCHANGED Final regulation: Allowed employers with religious objections to opt out of offering contraceptive coverage under the ACAWHEN: Nov 15, 2018
HOW:
STATUS/BIDEN ADMINISTRATION ACTION: Upheld by the on July 8, 2020.
overturned Required separate ACA premiums for abortion coverageWHEN: Dec. 27, 2019
HOW:
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.
KFF ¹ú²ú¾«Æ·ÊÓƵ News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .Some elements may be removed from this article due to republishing restrictions. If you have questions about available photos or other content, please contact khnweb@kff.org.
