Health Equity & Access Weekly Roundup: February 24, 2025

5 Key Health Care Moments During President Trump's First Month Back in Office

During his first month back in office, President Donald J. Trump has enacted significant health care changes, signaling a sharp policy shift. He issued executive orders reversing Biden-era policies, including scaling back Affordable Care Act provisions, rescinding drug pricing initiatives, and withdrawing from the World Health Organization. A federal grant freeze ordered on January 27 has raised concerns about Medicaid funding, leaving states uncertain about future federal support.

The FDA also quietly removed draft guidance on clinical trial diversity following Trump’s executive order cutting diversity, equity, and inclusion (DEI) programs, creating uncertainty for sponsors ahead of a statutory deadline. Meanwhile, the Senate confirmed Robert F. Kennedy Jr as HHS secretary in a near-party-line vote. Lastly, Trump signed an executive order on February 19 to expand in vitro fertilization (IVF) access by reducing costs, but its implementation remains unclear, particularly for LGBTQ+ individuals, following rollbacks of federal DEI protections.

Abortion in 2025: Access, Fertility, and Infant Mortality Updates

Abortion access and equity in US health care continue to face significant challenges, shaped by restrictive state policies following the Dobbs v Jackson ruling and Texas Senate Bill 8 (SB8), as highlighted in a series of studies published in JAMA. Research indicates that abortion bans have led to increased infant mortality and disproportionately affected marginalized communities, including Medicaid beneficiaries and racially diverse populations. Texas, a focal point in the abortion debate, has some of the most restrictive laws, resulting in a decline in abortion rates within the state while driving thousands of patients to seek care elsewhere. The state also faces a growing maternal health crisis due to provider shortages and a high uninsured rate among women of reproductive age.

Meanwhile, legislative efforts in Republican-led states seek to further restrict reproductive health care by reclassifying abortion medications as controlled substances despite scientific evidence refuting their addictive potential. Experts argue that ideological interference in medical decision-making threatens patient care, reinforcing the need for data-driven policy making to shape public discourse and health outcomes.

Trump Signs Executive Order Aimed at Expanding IVF

The president signed an executive order aimed at expanding access to IVF by lowering costs and removing barriers, acknowledging the financial and emotional burden infertility places on families. The order calls for policy recommendations within 90 days to reduce out-of-pocket expenses but does not establish new rights or guarantees, leaving implementation dependent on existing laws and funding. The move follows legal debates over embryo rights and Trump’s campaign promise of free IVF coverage, though critics, including Democratic lawmakers, argue the order lacks substantive action and fails to ensure affordability. Additionally, concerns remain over whether LGBTQ+ individuals will benefit, given existing barriers to fertility care and Trump’s rollbacks on protections for transgender individuals and diversity initiatives.

Geographic Barriers Impede Access to Novel Cancer Treatments

Bispecific and chimeric antigen receptor (CAR) T-cell therapies offer promising advancements in treating hematologic malignancies, but access remains a major barrier, particularly for patients living far from specialized centers. Sabarish Ayyappan, MD, of City of Hope Cancer Center, highlighted the challenges of integrating these therapies into both inpatient and outpatient settings, emphasizing that most CAR T-cell treatments are available only at academic centers. As these therapies expand into community settings and potentially solid tumors, access may improve, reducing the burden on patients who currently must travel long distances for care. These issues were discussed at a recent Institute for Value-Based Medicine^® event in Atlanta.

Adapting ACA Access Amid Medicaid Transition and Policy Reversals: Molly Dean

Following the end of the COVID-19 public health emergency in May 2023, states resumed Medicaid and Children’s Health Insurance Program eligibility reviews, leading to a decline of 14.7 million enrollees, including over 5.5 million pediatric patients. Some states provided financial assistance to help individuals transition to Affordable Care Act (ACA) marketplace plans, but access challenges persist. With Trump’s administration bringing potential changes to health policy, uncertainty looms over Medicaid funding and coverage stability. Policy experts, like Molly Dean, MSW, of Siftwell, stress the importance of supporting community health centers that serve underinsured populations, emphasizing the need for stable funding to maintain the health care safety net amid shifting Medicaid policies.