A new health policy research brief from the Baker Institute for Public Policy at Rice University is drawing attention to the sweeping pace of health care policy changes implemented during the first year of President Donald Trump’s second administration.
The brief examines how executive actions, federal spending priorities and legislative reforms are reshaping health care access, insurance coverage and public health programming across the United States.
The administration moved with “considerable speed and volume” following Trump’s inauguration Jan. 20, 2025, introducing major policy shifts within days and continuing to expand reforms throughout the year, according to the report.
Researchers from the Baker Institute’s Center for Health Policy compiled “Health Policy in the First Year of Trump’s Second Administration” to assess the broader implications of these changes on health care access, affordability and federal oversight. Rather than offering a comprehensive review of every reform, the report focuses on the policies most likely to have significant downstream effects on health care systems and patients.
One of the report’s central findings is that the administration has centered heavily on reducing federal spending, a strategy they say could affect insurance access, state-level health care resources and public health programming.
The researchers also highlight the administration’s reliance on executive authority to accelerate policy implementation. While some reforms were enacted through congressional legislation, many changes occurred through executive orders, agency appointments and regulatory modifications within federal departments.
Health care policy appears to be one of the administration’s major strategic priorities, according to the report, pointing specifically to the use of executive action to redirect federal health care priorities and restructure oversight responsibilities.
The One Big Beautiful Bill Act, a major legislative vehicle for shifting programmatic funding responsibilities from the federal government to the states, will cut approximately $900 billion in funding over the next decade, resulting in 7.5 million more uninsured Americans.
“These policy changes could have long-term implications for health care delivery, insurance markets and public health infrastructure, particularly in states that rely heavily on federal health care funding,” said Heidi Russell, director of the institute’s Center for Health Policy.
The health care policy landscape remains highly dynamic, she said.
“Additional reforms and administrative actions are expected throughout the remainder of the administration’s term,” Russell said. “The cumulative impact of this health care agenda may significantly alter how Americans access care, how providers operate and how states manage public health programs in the years ahead.”
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