2025 healthcare policies timeline

The Trump administration and the Republican-led Congress have launched a flurry of healthcare initiatives and proposals since their first days.

To help readers keep track of the wave of initiatives, below is a timeline of federal actions and our related coverage.

Executive Actions

Aug. 25: Healthcare fraud enforcement ramps up in the Trump administration, with implications for all stakeholders. Healthcare fraud enforcement ramps up in the Trump administration

June 23: After meeting with the Trump administration, the health insurance industry has volunteered to scale back the process and introduce new accommodations. Insurers promise to make prior authorization processes easier

June 2: An updated version of President Donald Trump’s FY26 budget request to Congress includes new information on how proposed spending cuts would affect HHS and its subsidiary agencies. More details on HHS budget proposals for FY26

May 14: In congressional testimony, HHS Secretary Robert F. Kennedy Jr. endorsed proposed Medicaid cuts as affecting fraud, waste and abuse rather than beneficiaries who most need the program. RFK Jr. defends HHS budget to Congress

May 2: President Donald Trump’s FY26 budget proposal released. Trump proposes big spending cuts to healthcare programs | HFMA 

April 24: Congress and the White House are proposing 340B Drug Pricing Program changes that could add administrative burdens and ultimately limit the available savings for hospitals. 340B changes loom as the program attracts scrutiny

April 2: A wide range of tariffs go into effect. Tariff impact on hospitals may be relatively restrained

March 27: HHS restructuring announced. HHS restructures for the DOGE era

March 12:  Trump administration starts to streamline the portfolio of alternative payment models sponsored by the Center for Medicare & Medicaid Innovation (CMMI). Trump administration charts a new course at CMMI

Feb. 25: President Donald Trump signs executive order on price transparency. Trump signs executive order on price transparency

Mid-February: DOGE employees begin to analyze CMS payment systems. Elon Musk-led department of government efficiency targets federal healthcare spending | HFMA

Feb. 13: Robert F. Kennedy Jr. is sworn in as the secretary of HHS. RFK Jr. becomes HHS secretary as policy questions mount.

Feb. 10: White House statement on the Consumer Financial Protection Bureau raises questions on a new rule preventing medical debt from appearing on consumer credit reports. New medical debt rule already is just about null and void

Early February: Kennedy provides post-confirmation hearing responses to senators’ questions on surprise-billing payer requirements, rural healthcare support and Medicaid changes. Robert F. Kennedy Jr. supports surprise billing reforms, Medicaid flexibility | HFMA

Feb. 1: Trump signs tariffs of 25% on goods from Canada and Mexico and 10% for China, with possible impacts on healthcare supply chain. New tariffs are expected to strain the healthcare supply chain

Regulatory Actions

Sept. 30: CMS proposal for 340B repayment sparks concerns over hospital funding cuts. Medicare 340B clawback rule faces hospital backlash | HFMA

Sept. 22: CMS warns it may reject state-directed payments. CMS to reject incomplete SDP submissions immediately | HFMA

Sept. 19: Proposed 340B rebate model generates an array of concerns among providers. Proposed 340B rebate model generates an array of concerns

Sept. 15: CMS describes how $50 billion will be distributed for rural healthcare. CMS describes how $50 billion will be distributed to rural hospitals

Sept. 15: CMS describes how $50 billion will be distributed for rural healthcare. CMS describes how $50 billion will be distributed to rural hospitals

Sept. 9: CMS gives updates on upcoming Medicaid state-directed payment limits. CMS gives update on limits to Medicaid state-directed payments

Sept. 9: CMS broadens access to catastrophic plans. Affordable catastrophic health plans now for all ages | HFMA

Sept. 9: CMS implements policies to cut $50 billion in federal healthcare spending. CMS policies under Oz aim to cut $50B in federal spending | HFMA

Aug. 11: Federal regulators should hold off on further price transparency requirements and more enforcement, hospital advocates recently told CMS. Hospital groups push back on CMS price transparency push | HFMA

Aug. 6: Medicare’s FY26 final rule for hospital inpatient payments includes the latest federal effort to streamline and improve prior authorization. Finalized regulations look to phase out manual prior authorization

Aug. 4: Federal healthcare officials took a step last week toward permitting rebate models in the 340B Drug Pricing Program, launching a pilot to allow for the testing of such models. 340B rebate models arrive in the form of a new pilot program

Aug. 1: Hospitals collectively will receive a base payment increase of 2.6% in Medicare reimbursement for inpatient care provided in FY26, according to a newly published final rule. Medicare final rule sets FY26 hospital inpatient payments

July 31: Eight health systems have joined a Trump administration initiative to accelerate the implementation of integrated patient-facing technology in the healthcare ecosystem. CMS looks to modernize the U.S. digital health infrastructure

July 18: Medicare’s 2026 proposed rule for hospital outpatient care includes the Trump administration’s latest effort to augment price transparency requirements. CMS pushes new proposals on hospital price transparency

July 16: Although payment rates technically would increase under Medicare’s 2026 proposed rule for hospital outpatient care, various provisions would chip away at the finances of hospitals and health systems. Medicare hospital outpatient payment rule includes a surprising cut

July 15: Medicare’s 2026 proposed rule for physicians is a key early chance for the Trump administration to shape U.S. healthcare policy in alignment with HHS Secretary Robert F. Kennedy Jr.’s Make America Healthy Again approach. In physician payment rule, CMS emphasizes key priorities

July 2: The DOJ announced that it’s restarting the False Claims Act (FCA) working group, Healthcare fraud enforcement ramps up in the Trump administration

June 21: CMS formally implemented an Affordable Care Act marketplace rule that is expected to reduce plan enrollment in the name of program integrity, but the agency took steps to try to mitigate the long-term impact. CMS finalizes the program integrity rule for the ACA marketplaces

June 19: The costs of hospital inpatient care are a key driver in forecasts that the Medicare Hospital Insurance (HI) Trust Fund will run out of money within eight years. Part A hospital spending is accelerating Medicare insolvency

May 29: Recent CMS directives to hospitals include a process change regarding Medicare patient status reviews. CMS announces change to Medicare short-stay inpatient reviews

May 27: CMS is launching a series of reviews to crack down on federal Medicaid funds going to cover those unlawfully present in the country and is planning to recoup any affected federal funds. CMS to crack down on Medicaid funds for undocumented | HFMA

May 22: CMS directives for hospitals include a process change regarding Medicare patient status reviews. CMS announces change to Medicare short-stay inpatient reviews

May 22: Hospitals will have to be more specific in the pricing information they provide under CMS’s updated price transparency instructions. New guidance makes hospital price transparency obligations more exacting | HFMA

May 21: Rapid acceleration of digital healthcare applications and a sharpened focus on fraud, waste and abuse will be central to the looming transformation of the U.S. healthcare system, Mehmet Oz, MD, administrator of CMS, told a healthcare audience. Dr. Oz describes a reimagined healthcare technology ecosystem

April 11: CMS releases the Medicare FY26 proposed rule for inpatient hospital payments and long-term care hospitals. Medicare’s FY26 inpatient hospital proposed rule includes a restrained payment update

April 10: HHS and CMS detail plans for the agency in the context of Make America Healthy Again. CMS seeks feedback on applying MAHA guidelines in healthcare

April 8: CMS releases Medicare Advantage final payment rate notice. How 340B remedy payments affect Medicare Advantage payments

April 4: MA and Part D final rule issued. Final 2026 rule for MA, Part D leaves out proposed GLP-1 drug coverage | HFMA

March 12: CMS streamlines the portfolio of alternative payment models sponsored by the Center for Medicare & Medicaid Innovation. Trump administration charts a new course at CMMI

March 10: Proposed rule for the Affordable Care Act health insurance marketplaces issued. Affordable Care Act enrollment to decrease under proposed rule

Feb. 14: The administration announces funding cut for the ACA Navigator program. Administration tweaks the ACA marketplaces amid subsidy debate

Feb. 7: A National Institutes of Health (NIH) notice aims to implement a standard indirect rate of 15% across all NIH grants for indirect costs. Q&A: CFO details how one health system digests Trump policies | HFMA

Legislative Actions

Sept. 30: Democrats push for $1.4 trillion spending boost, risking federal shutdown. Federal Shutdown Risks as Democrats Push for Spending | HFMA

Sept. 17: The hospital tax exemption comes under scrutiny in Congress. The hospital tax exemption comes under scrutiny in Congress

Sept. 15: Some commissioners question MedPAC finding of no MA margin impact. MedPAC: Rising MA enrollment doesn’t impact hospital margins | HFMA

Sept. 15: Some commissioners question MedPAC finding of no MA margin impact. MedPAC: Rising MA enrollment doesn’t impact hospital margins | HFMA

Sept. 5: Senate, House release diverging HHS budget proposals for FY26. HHS budget proposals released for FY26

Sept. 2: Small hospitals take biggest hit if Congress implements Medicare bad debt pay cut. Medicare bad debt cuts may hit rural hospitals hard | HFMA

Sept. 2: IRA drives ‘substantial’ out-of-pocket cost increases. Medicare drug law raises Medicaid enrollees’ OOP costs | HFMA

Aug. 11: The Congressional Budget Office (CBO) released its most detailed projections yet about how the budget reconciliation bill stands to affect healthcare coverage. How and when the budget bill will reduce insurance enrollment

Aug. 4: Twelve percent of 340B hospitals could lose eligibility for the program due to Medicaid spending cuts in the recently enacted budget reconciliation law, according to a recent projection. 340B eligibility at risk for 314 hospitals amid Medicaid cuts | HFMA

July 31: The Senate Health, Labor Education and Pensions (HELP) Committee held a July 31 hearing to examine ways to make healthcare more affordable for consumers and other purchasers. Senate committee eyes healthcare reform to enhance affordability

July 28: Despite hospitals and health systems facing large federal funding cuts from the recently enacted reconciliation law, advocates and observers agree there will be ample opportunities to mitigate them. Hospitals seek to mitigate federal funding cuts | HFMA

July 22: Testimony during a congressional hearing this week highlighted the strain hospitals are experiencing from the administrative roadblocks posed by Medicare Advantage (MA). Perils and promise of Medicare Advantage highlighted at hearing

July 21: Congressional Republicans are planning a second budget reconciliation package this year that would include further cuts in federal healthcare spending. Arrington hints at new reconciliation bill with healthcare cuts | HFMA

July 21: health system executives are scrambling to prepare their organizations for numerous health policy changes recently enacted as part of the budget reconciliation law. Hospitals plan for OBBB rollout | HFMA

July 14: A series of regulatory changes and lack of action in other areas will financially impact hospitals and health systems long before cuts included in the recently enacted budget reconciliation law. Regulatory changes to impact hospital revenue in 2025 | HFMA

July 14: Recently enacted federal cuts to Medicaid are scheduled to begin in future years, but some states could act on them sooner. States could implement OBBB Medicaid cuts sooner | HFMA

July 12: The reverberations for Medicaid have drawn most of the recent headlines, but federal policy developments also portend a big contraction of the individual-insurance market in 2026 and beyond. Constriction looms for the individual insurance market

July 7: Declines in coverage and spending await the healthcare industry under the budget reconciliation bill signed into law by President Donald Trump on July 4, but the immediate consequences could be muted. How the reconciliation bill will shake out for hospitals

July 4: President Trump signs reconciliation bill into law, after the Senate passed it, 51-50, July 1 and the House cleared it, 218-214, July 3. Senate passes budget reconciliation bill with Medicaid cost-cutting

July 1: The House passed the reconciliation bill by a party-line 218-214 vote (with two Republicans voting “no”), teeing it up for President Donald Trump to sign into law July 4. Senate passes budget reconciliation bill with Medicaid cost-cutting

July 1: The Senate voted, 51-50 — with Vice President J.D. Vance breaking the tie — to pass a tax and spending reduction bill on July 1 that includes more than $1 trillion in 10-year Medicaid cuts. Senate passes bill with $1 trillion in Medicaid cuts | HFMA

June 26: HFMA has written Republican congressional leaders to suggest a three-year delay of Medicaid funding cuts while a national commission studies a comprehensive overhaul of all Medicaid financing. HFMA proposes national commission on Medicaid finance | HFMA

June 12: Reconciliation bill includes taxes changes that could affect NFP hospitals. New taxes could hit hospitals in the budget reconciliation bill

June 6: According to early discussions in the Senate, a final version of the budget reconciliation bill could reduce the amount of federal spending in Medicare Advantage. Subsequently, however, a key senator said any Medicare provisions are unlikely to make the bill. MA provisions could end up in the budget reconciliation bill

May 22: The House-passed budget reconciliation bill, which features high-profile Medicaid changes, also has many lower-profile healthcare provisions, including last-minute alterations. House Passes Bill with Wide-Ranging Healthcare Changes and Cuts | HFMA

May 22: sweeping federal policy bill that includes major changes to Medicaid is halfway toward becoming law after narrow passage by House Republicans. Budget reconciliation bill passes the House

May 16: In the days after a key House committee approved legislation that includes substantial cuts to Medicaid funding, the bill’s path forward remained full of obstacles. Budget reconciliation bill faces a rocky road

May 11: The House Energy and Commerce (E&C) Committee published its portion of a budget reconciliation bill that would slash 10-year projected federal spending. As expected, Medicaid would incur the brunt of the committee’s proposed rollbacks, with repercussions for enrollment. Budget reconciliation bill hits Medicaid provider payments

April 14: Twelve Republican House moderates wrote a letter to Speaker Mike Johnson on Medicaid cuts. Medicaid cuts: Republicans’ stance on Medicaid policy changes | HFMA

April 5: Senate passes budget reconciliation blueprint. Questions about Medicaid cuts unresolved in latest budget blueprint

April 3: Senate formally confirmed Oz as CMS administrator. Dr. Oz describes changes he would bring as CMS administrator

March 14: Congress passes FY25 Continuing Resolution, including healthcare provisions, to fund the federal government for the remainder of the fiscal year. Medicaid DSH payment cut again delayed in proposed funding bill

March 14: Dr. Mehmet Oz has Senate confirmation hearing for the post of CMS administrator. Dr. Oz describes changes he would bring to Medicare, Medicaid as CMS administrator | HFMA

March 10: House Democrats write CMS to oppose staff reductions. Trump Admin’s cuts to CMS staff: Democrats’ concern | HFMA

Feb. 25: House Oversight and Government Reform Committee highlights significant Medicaid spending cuts. Congressional discusses an approach to Medicaid spending cuts

Feb. 25: The House passes a budget resolution authorizing up to $880 billion in Medicaid cuts. Proponents weigh in as Medicaid cuts come under consideration.

Feb. 12: House Oversight Committee’s Delivering on Government Efficiency (DOGE) Subcommittee hearing on improper payments, with a Medicaid focus. DOGE panel focuses on Medicaid fraud and waste | HFMA

Mid-January: Congressional Republicans issue list of proposed healthcare cuts, including $1 trillion in 10-year Medicaid spending. GOP puts ideas for major healthcare spending cuts in writing | HFMA

Judicial Actions

Aug. 28: Court limits CMS’s authority to immediately apply the ACA marketplace program integrity final rule. Court limits application of the ACA marketplace integrity rule

June 27: With a 6-3 decision in Kennedy v. Braidwood, the Supreme Court overruled an appeals court’s finding that members of the U.S. Preventive Services Task Force were not constitutionally appointed. Supreme Court retains the ACA’s mandate about preventive care

May 15: Hospitals hoping to avoid having to use a rebate model in the 340B Drug Pricing Program received good news in court. Court rules against drug companies on 340B rebate model

April 29: Supreme Court decision on Medicare disproportionate share hospital (DSH) payments. Supreme Court: HHS can maintain disputed DSH formula approach

March 17: HHS motion filed in federal district court opposing the request of three drug companies for a summary judgment that would allow them to turn 340B into a rebate program instead of offering up-front discounts. Trump and Biden administrations unite on drug pricing issues

March 14: Appeals court ruling restricts options for hospitals seeking to use litigation to ensure prompt Medicaid payment. Timely Medicaid payment not enforceable in federal court

March 5: Injunction placed on Trump administration policy, which would cap reimbursement for indirect medical research costs at institutions such as teaching hospitals, until its legal fate is decided. Injunction on policy that that would affect funding for AMCs