2025 Year in Review: Political Shifts and Policy Battles

2025 marked a year of turmoil and change within the U.S. healthcare policy landscape. With the change in administration came new leaders and direction. The editors at Healthcare Innovation maintained a daily pulse on news coming from Washington, D.C.

From executive orders and agency shakeups to court rulings and budget brinkmanship, the year unfolded as a sustained stress test for public health infrastructure, safety-net programs, and regulatory stability.

January

President Trump opened his second term by rescinding a long list of executive orders issued by former President Biden, reversing policies tied to healthcare costs, COVID-19 outreach, Affordable Care Act (ACA) expansions, and protections against gender-based discrimination.

He also signed an executive order announcing his intention to withdraw the United States from the World Health Organization (WHO) and then, on Jan. 27, ordered officials at the federal Centers for Disease Control and Prevention (CDC) to immediately stop any communications with the WHO.

The administration froze routine communications posted by the Department of Health and Human Services (HHS) and removed inspectors general from most cabinet-level agencies. A sweeping federal spending freeze—temporarily blocked by a judge—sparked widespread alarm before the White House ultimately retracted the federal grants freeze.

February

In early February, Robert F. Kennedy Jr.’s HHS nomination advanced out of the Senate Finance Committee. On February 13, the U.S. Senate confirmed him as the new Secretary of HHS.

On February 10, the same day that a group of 22 state attorneys general filed suit in federal court to stop President Donald Trump from cutting off funding from the National Institutes of Health and Department of Health and Human Services for medical and health research, a federal district judge granted a temporary restraining order, blocking the White House’s plan.

In mid-February, 1,000 Indian Health Service workers were laid off; however, shortly after, the layoffs were rescinded.

On Friday, February 14, the Trump White House moved to slash employment levels at multiple federal healthcare agencies. The White House announced that it was slashing one-tenth of the CDC workforce. Mass layoffs also hit the NIH and the FDA. Additionally, two training programs were gutted at the CDC: one that embeds public health graduates in local health departments, the Public Health Associate Program (PHAP), and the Laboratory Leadership Service (LLS) program, which fosters the next generation of Ph.D. laboratory scientists. On February 19, crowds of current and former HHS staff protested staffing cuts outside the agency’s headquarters in Washington, D.C. Employee cuts at the U.S Department of Veterans Affairs (VA) brought the total number of layoffs to 2,400 in less than a month.

Later in the month, the Infectious Diseases Society of America condemned the White House’s weakening of vaccination promotion.

United States of Care (USofCare), together with 47 other health advocacy groups, filed an amicus brief on February 25 in Kennedy v. Braidwood (formerly Braidwood v. Becerra), urging the Supreme Court of the United States to protect access to free preventive services for nearly 151 million people ahead of oral arguments expected in April.

Also on February 25, President Donald Trump signed an executive order to advance price transparency on healthcare costs by directing federal agencies to implement a 2019 order signed during his first term.

On a party-line vote on Feb. 25, Republicans in the House of Representatives passed a continuing resolution to keep the federal government running, which involved massive potential cuts to the Medicaid program.

March

March brought high-profile resignations, including the abrupt departure of HHS’s Assistant Secretary for Public Affairs. The White House withdrew its CDC director nominee hours before a confirmation hearing, later naming Susan Monarez as acting—and then permanent—director. Peter Marks, M.D., Ph.D., the FDA’s top vaccine regulator, resigned while criticizing Robert F. Kennedy Jr.

On March 11, the House of Representatives voted 217-213 to pass a continuing resolution to fund the federal government through Sept. 30. The bill also extended certain key healthcare provisions that were set to expire at the end of March.

On March 27, HHS announced sweeping changes to the agency's staffing and organization through a restructuring that would result in the loss of 20,000 jobs.

April

Democratic members of Congress erupted on Tuesday, April 1, over the mass layoffs ordered by Robert F. Kennedy Jr. at HHS and its component agencies, asserting that the 10,000-plus layoffs announced and underway could cripple a range of public health and social service functions that HHS had fulfilled for decades.

Mehmet Oz was confirmed to become Administrator of the federal Centers for Medicare and Medicaid Services (CMS), shortly before CMS boosted Medicare Advantage payment benchmarks.

The CDC published its latest Autism and Developmental Disabilities Monitoring (ADDM) Network survey, on April 15. 

On April 16, a report came out that the HHS Budget would be significantly reduced.

In a blow to hospitals that care for indigent patients, the U.S. Supreme Court on April 29 sided with HHS over disproportionate-share hospital supplementary payments, commonly referred to as “DSH” payments, in a ruling that would impact several hundred hospitals nationwide.

May

The Republican members of the House Ways and Means Committee’s powerful Subcommittee on Health sent a letter to CMS Administrator Mehmet Oz and CMMI Director Abraham Sutton, calling for a refocus on CMMI’s priorities.

On May 1, the HHS and NIH announced the development of the next-generation, universal vaccine platform, Generation Gold Standard, using a beta-propiolactone (BPL)-inactivated, whole-virus platform.

In early May, 19 state attorneys general filed suit in federal court, alleging that the Trump administration is responsible for massive layoffs at HHS.

The White House, through its Office of Management and Budget, released its proposed 2026 budget, which included significant cuts to the HHS. Then, on May 11, the Republican leadership of the House Energy and Commerce Committee released its FY2026 plan on healthcare and energy, which includes significant cuts to the Medicaid program and new work requirements. On May 18, House Republicans advanced the budget bill, named the “One Big Beautiful Bill Act,” from the House Budget Committee to the House Rules Committee, which the House of Representatives passed on May 22. The bill involved a massive tax cut for the wealthiest Americans, partly offset by hundreds of billions of dollars in cuts to Medicaid.

In mid-May, a federal judge stopped the Trump administration from cutting $11 billion in public health grants to states.

During a podcast appearance on May 27, HHS Robert F. Kennedy Jr. said he might ban government scientists from NIH and other HHS agencies from publishing articles in recognized clinical journals both nationally and internationally, and might establish a government-sponsored journal for their publications.

June

HHS Secretary Robert F. Kennedy announced on June 9 the immediate dismissal of all 17 members of the CDC's Advisory Committee on Immunization Practices, igniting outrage among public health experts and national healthcare associations. Days later, HHS Secretary Robert F. Kennedy appointed eight new members, several of whom drew controversy and protests from healthcare experts and leaders.

June 16, a federal judge declared illegal the Trump administration’s cuts to hundreds of grants issued by the NIH.

Also on June 16, an intra-party fight erupted among Republicans on the Senate Finance Committee as they introduced the Senate version of the 2026 budget bill, with members divided over whether to enact harsher Medicaid provisions than the House version.

Also in June, the Supreme Court upheld Tennessee’s ban on gender-affirming care for transgender minors.

The U.S. Supreme Court, in a 6-3 ruling, allowed South Carolina to block Planned Parenthood's access to federal Medicaid funding for non-abortion services. 

In a 6-3 ruling on June 27, the Supreme Court upheld a key ACA provision on preventive care and rejected a plea from a group of religious conservatives who argued that enforcing the preventive care mandate discriminated against them on religious grounds.

July

In early July, the U.S. Senate passed the 2026 budget bill advocated by President Trump, largely along party lines. The Congressional Budget Office estimated that it would cut more than $1.02 trillion from Medicaid and CHIP and uninsure more than 11.8 million people.

A U.S. District Judge ruled that the spring layoffs of 10,000 HHS staffers were illegal and that 19 state attorneys general had established harm to the fired employees.

On July 7, a federal judge ruled in favor of Planned Parenthood, in a case related to Medicaid funding cuts.

Also on July 7, the VA announced that it’s on pace to reduce its total staff by nearly 30,000 employees by the end of fiscal year 2025.

Furthermore, Justice Department officials subpoenaed confidential patient records from hospitals and physicians engaged in gender-affirming healthcare for minors.

The HHS announced that it rescinded a policy that extended certain federal public benefits to immigrants lacking permanent legal status.

The Substance Abuse and Mental Health Services Administration (SAMHSA) stated that it will no longer silo LGBTQ+ youth services, also known as the “Press 3 option,” of the nation's Suicide and Crisis Lifeline, 988.

Two of RFK Jr.’s top aides left the agency in July. After only a few months on the job, RFK Jr.’s chief of staff, Heather Flick Melanson, and deputy chief of staff for policy, Hannah Anderson, left.

On July 29, Susan Monarez was confirmed by the Senate to lead the CDC permanently.

In late July, a federal judge ruled that Planned Parenthood must continue to be reimbursed for Medicaid funding.

August

On August 1, Secretary Robert F. Kennedy, Jr. announced additional repeals of federal policy that financially rewarded hospitals for reporting staff vaccination rates. 

HHS canceled contracts for the development of a range of vaccines targeting COVID-19 and the flu.

On August 8, a gunman opened fire across the CDC headquarters, leading to CDC employees and others professionally involved in public health work expressing concerns over the increase in extremist views that might impact their safety. Over 750 current and former HHS staffers urged Secretary Robert F. Kennedy, Jr. to “stop spreading inaccurate health information.”

A federal judge in Maine denied Medicaid funding to Maine Family Planning amid ongoing legal disputes over abortion provider funding.

Later in August, the CDC tapped a known vaccine skeptic, Retsef Levi, to lead its COVID-19 working group.

The HSS announced on August 26 that it demanded 46 states and territories remove all references to gender ideology from their federally funded Personal Responsibility Education Program (PREP) educational materials within 60 days.

HHS announced the departure of Susan Monarez as the director of CDC on August 27; however, it was later indicated she was ousted.

Later in the month, SAMHSA announced $19 million in supplemental funding to expand housing capacity for homeless individuals.

September

On September 4, Senators from both parties sharply questioned HHS Secretary Robert F. Kennedy Jr. on vaccine policy and the turmoil at the CDC, some calling on him to resign. States took opposite approaches to vaccine policy: Florida announced an end to all vaccine mandates, while Massachusetts announced a mandate requiring all insurers to cover vaccines.

Also on September 4, HHS announced it would implement measures to increase access to more affordable catastrophic health coverage through HHS’s new hardship exemption guidance. 

Early September, rumors spread that HHS Secretary Robert F. Kennedy Jr. was to announce findings that would associate acetaminophen with autism risk.

On September 9, HHS Secretary Robert F. Kennedy Jr. released a new report on issues around chronic illnesses in children.

The CDC appointed five new members to the ACIP (CDC Advisory Committee on Immunization Practices) on September 15, just days before a critical vaccine policy meeting.

Also on September 15, CMS announced details on how states can apply for funding from the $50 billion Rural Health Transformation Program (RHTP), established under the Working Families Tax Cuts Act.

President Trump advised in the Oval Office alongside Health Secretary Robert F Kennedy Jr., that women avoid taking acetaminophen, known as Tylenol, throughout their pregnancy.

The chances of a federal government shutdown increased dramatically on September 23, with healthcare policy priorities taking center stage.

October

After the federal government shut down on the first of October, healthcare leaders were left with questions about how healthcare might be affected. Telehealth services faced an immediate halt in funding.

On October 6, the CDC announced that it updated its adult and child immunization schedules to incorporate individual-based decision-making for COVID-19 vaccination and recommended that toddlers receive protection from varicella (chickenpox) as a standalone immunization rather than in combination with measles, mumps, and rubella vaccination.

Confusion reigned at HHS over the weekend of October 10-12, as a mass layoff of CDC staff was partially reversed.

On October 15, the governors of 15 states came together to announce the creation of a new entity, called the Governors Public Health Alliance.

Increasing calls from healthcare advocacy groups emphasized the urgent need for Congress to make the Enhanced Premium Tax Credits (EPTCs) permanent.

November

November 9, Senators approved a tentative deal to end the government shutdown. Days later, President Donald Trump signed a government funding bill, bringing an end to a record 43-day government shutdown. However, debates were ongoing over extending expiring ACA tax credits.

December

As 2025 comes to a close, questions and uncertainty remain in the healthcare policy landscape.

Early in December, U.S. vaccine advisers abolished a long-standing recommendation that all American newborns receive the hepatitis B shot.

The HSS approved on December 16 the addition of Duchenne Muscular Dystrophy (DMD) and Metachromatic Leukodystrophy (MLD) to the Recommended Uniform Screening Panel (RUSP).

On Wednesday, December 17, the House passed a conservative healthcare bill that would not address expiring ACA tax credits. The following day, House Democrats urged GOP leaders to hold an urgent vote to extend the credits, as lawmakers are set to leave for the holidays. Earlier in the month, the Senate voted to reject a bill that would have extended them. Previously, Republicans blocked an attempt by Democrats, with support from four Republicans, to preserve the ACA subsidy.

HHS canceled seven grants worth millions of dollars to the American Academy of Pediatrics (AAP), stating that certain policies conflicted with HHS’s priorities.

On December 18, the Trump administration announced new rules to prohibit federal funding for gender-affirming care for minors, targeting hospitals and doctors offering such treatments.

Congress left for the remainder of 2025 without reaching a healthcare deal, leaving the ACA subsidies to expire on December 31. 

2025 will be remembered not for incremental reform, but for institutional disruption. The long-term consequences—for patients, providers, and public trust—will define the healthcare debate well beyond Washington’s next election cycle.