Nothing is New, Yet Everything Has Changed: Executive Orders on Healthcare, Employers, and Employees

The shifting tides of executive power in Washington have once again brought sweeping changes to America’s healthcare system. Recent executive orders are not introducing entirely new debates but are fundamentally reshaping long-standing policies—bringing uncertainty for healthcare providers, insurers, employers, and employees alike.

From regulatory freezes and data security concerns to Medicaid cuts and drug pricing rollbacks, these shifts will have a profound impact on the state of healthcare in America. While businesses strive to maintain stability, they must now navigate a regulatory landscape that looks the same on the surface but operates in dramatically different ways.

A New Era of Cost-Cutting – But at What Price?

Elon Musk has confirmed that his focus has shifted to the Centers for Medicare & Medicaid Services (CMS) in an effort to eliminate wasteful government spending. His involvement, enabled through President Trump’s Department of Government Efficiency (DOGE), has raised significant concerns, including lawsuits from government employee unions. The fear? That personal and financial data could be compromised under the guise of cost reduction.

While waste reduction in healthcare spending is a priority for many, the potential consequences of these measures remain uncertain. If cuts go too deep, patients, providers, and insurers alike may face disruptions in coverage, payment processes, and administrative oversight.

Regulatory Freeze and the Uncertain Future of Healthcare Rules

One of the most immediate changes is the Trump administration's government wide regulatory freeze, halting all new healthcare-related rulemaking for 60 days. This means:

• Delays in HIPAA Security Rule updates, which could have strengthened data privacy protections.

• Stalled telehealth prescribing rules, which would have impacted how controlled substances are prescribed remotely.

• A broader uncertainty surrounding any healthcare regulation changes initiated under the Biden administration.

For employers, this regulatory limbo creates challenges in compliance planning, especially in areas related to benefits administration and data security.

AI Guardrails Removed: A New Era of Risk

Artificial Intelligence (AI) in healthcare was on track to be governed by safety standards ensuring transparency, fairness, and privacy protections. However, those guardrails have now been removed, meaning:

• Less oversight on algorithmic bias in AI-powered healthcare solutions.

• Fewer safeguards in place for large-scale patient data usage.

• Greater risks for employers relying on AI-driven health and benefits platforms.

Without these protections, businesses using AI-powered HR tools must be especially vigilant in ensuring that automated systems do not unintentionally introduce discriminatory practices in hiring, benefits, or healthcare access.

Employer Health Plans and the ACA: What’s Next?

Two key executive orders supporting the Affordable Care Act (ACA) and Medicaid expansion have been revoked, affecting both employers and employees:

• ACA enrollment protections and coverage expansion efforts are now at risk.

• Protections against low-quality coverage plans have been rescinded.

• Employer health plans may see higher costs and fewer safeguards for employees, as Medicaid reductions could lead to an influx of uninsured workers seeking employer-sponsored coverage.

Employers should prepare for potential increases in healthcare costs, as more employees may rely on employer-sponsored plans due to restricted ACA access.

Rescinding DEI and Discrimination Protections: A "Canary in a Coal Mine"

The rollback of DEI policies in federal healthcare agencies, coupled with abortion restrictions, serves as a warning sign of a broader shift that could disrupt the entire healthcare system. These changes could set a legal precedent allowing healthcare providers to determine who receives what type of care based on institutional discretion rather than a mandate for equal treatment. This shift could impact a wide range of services, from reproductive care and end-of-life decisions to prescription coverage and emergency interventions.

As healthcare decisions become increasingly subjective rather than standardized, the risk grows that access to essential care could become inconsistent and unpredictable for all patients—not just specific groups.

For employers, these changes introduce significant uncertainty in health benefits administration and compliance.

• Healthcare providers and insurers potentially limiting access to certain services - companies may face difficult decisions about their employee benefits offerings, particularly if coverage varies by location, provider, or insurer policy.

• Employers caught between competing legal and ethical obligations - especially if employees demand coverage for services that insurers or providers restrict.

Additionally, as healthcare access becomes less predictable, businesses may see increased absenteeism, reduced workforce productivity, and higher overall healthcare costs, all of which could have long-term financial and operational consequences. In an already complex regulatory environment, these shifts could make it even harder for employers to ensure consistent, comprehensive healthcare benefits for their workforce.

Drug Pricing: Will Costs Rise Again?

One of the most consequential rollbacks is the rescission of Biden’s three drug pricing models, which aimed to:

1. Lower the cost of cell and gene therapies.

2. Cap certain generic drugs at $2/month.

3. Accelerate FDA approval for drugs treating unmet medical needs.

While CMS has confirmed that ongoing negotiations with drug manufacturers may continue, the rollback means uncertainty in drug cost relief for employers and employees alike. Higher drug prices could result in increased premiums and out-of-pocket costs, putting additional strain on employer-sponsored health plans.

Immigration Policy Changes: Patient Privacy at Risk?

The rollback of sensitive location protections in immigration enforcement raises serious concerns about patient privacy and data security, extending beyond immigration status to affect all patients and employers offering healthcare benefits. Without clear restrictions, healthcare facilities may face increasing pressure to share patient information with law enforcement or other entities, creating uncertainty about what data is collected, who can access it, and how it’s used.

For employers, this shift introduces new risks in workforce healthcare management:

• Erosion of healthcare privacy – Employees may hesitate to seek care if they fear their data could be accessed by third parties.

• Increased compliance challenges – Businesses could face new legal risks if patient data security policies change.

• Trust in employer-sponsored health plans – Concerns about data security may impact enrollment and engagement in workplace health benefits.

The Bottom Line: Uncertainty Ahead

For employers, employees, and the healthcare industry as a whole, these executive orders create turbulence in an already complex landscape. While no entirely new policies have been introduced, the removal of existing protections and safeguards has fundamentally altered how healthcare, benefits, and regulatory compliance will operate moving forward.

Businesses and HR professionals must remain vigilant, flexible, and proactive in their approach to healthcare benefits, compliance, and cost management. As the saying goes, “Nothing is new, but nothing is the same”—and in today’s evolving healthcare environment, adaptation is key.