Executive Orders: Health Care
Last updated February 12, 2025
Below are executive orders related to health care that are most likely to impact the professions and those you serve. Some executive orders rescind executive orders from previous Administrations. ASHA will update this information periodically.
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ASHA is providing this information to its members and others for educational purposes only. The information provided on this webpage should not be construed or relied on as legal advice or opinion. Readers should consult with their own legal counsel before making any decisions regarding this information.
Summary: Executive Order 14155 outlines the U.S.’ intent to withdraw from the World Health Organization (WHO), including pausing all future transfers of government funding, support, or other resources to WHO; recalling or reassigning U.S. government personnel or contractors working with WHO; and ceasing negotiations related to the WHO Pandemic Agreement.
Impact: U.S. withdrawal from WHO could impact international cooperation, global health security, and public health programs and initiatives that rely on WHO guidelines and support, including those within the U.S. Health disparities could be exacerbated if programs serving people with disabilities and other underserved communities lose funding and support. In addition, WHO owns the International Classification of Diseases (ICD) and the International Classification of Functioning, Disability and Health (ICF), which could impact use of ICF and ICD to support service delivery and health care billing. The U.S. could also potentially lose its access to disease-based data sets owned by WHO.
ASHA currently engages with WHO through its collaboration with the Pan-American Health Organization (PAHO), as well as through involvement with the World Rehabilitation Alliance, and World Hearing Day, among other initiatives.
Status: On January 29, 2025, this executive order was published in the Federal Register [PDF] and is in effect.
Summary: Executive Order 14009 [PDF], issued February 2021 by a previous Administration, was intended to protect and strengthen both Medicaid and the Affordable Care Act (ACA) to encourage health care accessibility and affordability.
Impact: This executive order has been rescinded. As a result, we could see elimination of special enrollment periods, reduced ACA subsidies, and increased barriers to coverage through Medicaid and ACA Health Insurance Marketplace plans, which would result in fewer Americans enrolling in these programs. There is also the potential for changes in policies or practices that may undermine protections for people with pre-existing conditions, coverage of habilitative and rehabilitative services as essential health benefits, and the return of policies or practices that may undermine the Health Insurance Marketplace or the individual, small group, or large group markets for health insurance (e.g. lifetime caps on services, per-capita caps/block grants).
Any changes to the Medicaid program at the federal level could result in a lower federal government contribution to state Medicaid programs (known as the Federal Matching Assistance Percentage, or FMAP).
If the FMAP is lowered, there are serious implications for many populations, especially optional populations (e.g., families with income above federally established minimums) and services (e.g., Home and Community Based Services [HCBS)]), including those who live in states that have expanded Medicaid to adult populations. Currently, the federal government covers at least 90% of the total costs for the adult Medicaid expansion population and states pay 10%. "Trigger laws" in some states will automatically cut all benefits to the expansion population if the FMAP dips below a certain threshold.
If Medicaid is limited financially at the federal level, states will face tough choices when budgeting for coverage of mandatory populations. For example, cutting provider reimbursement rates could be one way states meet their federal legal obligations of coverage, but Medicaid providers, and those they serve, would suffer.
Resources: ASHA provides resources related to Medicaid and essential health benefits under the ACA. ASHA members can also write their members of Congress to urge them to protect access to care for Medicaid beneficiaries.
Status: On January 28, 2025, the new Administration issued Executive Order 14148, which was published in the Federal Register [PDF]; thereby rescinding all provisions previously established in Executive Order 14009.
Summary: Executive Order 14070 [PDF], issued April 2022 by a previous Administration, directed federal agencies to identify strategies for expanding health coverage, enhancing quality, strengthening benefits, and increasing enrollment.
Impact: With the rescission of this executive order, changes in enrollment deadlines, eligibility criteria and federal subsidies for ACA plans will likely reduce the number of enrollees in both Medicaid and ACA plans. This could result in potentially reducing the number of people who are able to seek audiology and/or speech-language pathology services.
Resources: ASHA provides resources related to Medicaid and essential health benefits under the ACA. ASHA members can also write their members of Congress to urge them to protect access to care for Medicaid beneficiaries.
Status: On January 28, 2025, the new Administration issued Executive Order 14148, which was published in the Federal Register [PDF]; thereby rescinding all provisions previously established in Executive Order 14070.
Summary: Executive Order 14187 seeks to end surgical and chemical transgender medical interventions for individuals under the age of 19. It requires agencies to rescind guidance from the World Professional Association for Transgender Health (WPATH) and “HHS (Health and Human Services) Notice and Guidance on Gender Affirming Care, Civil Rights and Patient Privacy.” HHS is tasked with completing a literature review and providing recommendations for "children who assert gender dysphoria, rapid-onset gender dysphoria, or other identity-based confusion." The order also asks Congress to develop legislation to further the reach of this executive order and asks the Judiciary to prioritize related cases.
Impact: While the order is specific to pharmacological and surgical interventions, the implications are much broader. For example, this could amend current policies outlined in Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination in health care and applies to providers who receive federal funds (e.g., practices that receive Medicare or Medicaid payments). It could also impact coverage of essential health benefits under ACA marketplace plans, which include habilitative and rehabilitative services. In addition, the WPATH guidance that agencies must rescind includes a full chapter on voice and communication. Along with several other executive actions, this could eliminate coverage of gender-affirming voice and communication services through federal payers. Noncompliant facilities could lose research funding and the ability to bill federal payers for any and all services. At this time, it is unclear whether facilities will be required to stop all nonsurgical or chemical gender-affirming care even if patients have private insurance or pay cash, but many may choose to do so as a precaution.
Resources: ASHA provides resources related to gender-affirming voice therapy advocacy and essential health benefits under the ACA.
Status: On February 3, 2025, this executive order was published in the Federal Register [PDF] and is in effect.
