Since assuming office for a second term, President Trump and officials in his administration have instituted numerous policy actions through the Department of Health and Human Services (HHS) that have profoundly affected public health across the United States. This resource catalogs these key actions chronologically, beginning with the first days of the administration and extending through subsequent developments, linked policy changes, and related outcomes. While this overview captures many of the most significant shifts in federal health policy, it is not an exhaustive list of every federal action with health implications, as various other policy changes outside of HHS also carry public health consequences.
The policy shifts began immediately after President Trump took office on January 20, 2025, when a series of executive orders precipitated the removal of numerous federal websites and health databases. In the wake of executive orders revoking prior administration policies and establishing new federal guidance related to gender ideology, diversity, equity, and inclusion (DEI), and merit-based opportunities, HHS began removing thousands of websites and public health databases. These included resources related to DEI, LGBTQ+ health, reproductive health, HIV/AIDS research, and health disparities, alongside limits on data collection in these areas. The removals sparked immediate legal challenges, including a lawsuit filed to reverse the deletions. Over the following months, the administration agreed to restore these health-focused websites and data to their January 29, 2025 versions.
Financial and administrative structures within federal health agencies also experienced swift upheaval. On February 7, 2025, the National Institutes of Health announced a new 15% standard indirect cost rate for health research grants, replacing historical rates that supported administration and facility costs at grantee institutions. The policy immediately drew legal challenges from state attorneys general, resulting in a temporary restraining order, a nationwide preliminary injunction, and ultimately a permanent injunction issued by a federal judge on April 4, keeping prior rates in place while the administration appealed the ruling. Concurrently, the White House and the Department of Government Efficiency initiated reductions in force affecting personnel across federal agencies, including significant staff cuts at HHS and the Centers for Disease Control and Prevention.
Following the Senate’s 52-48 party-line confirmation of Robert F. Kennedy, Jr. as HHS Secretary on February 13, 2025, the administration formally established the Make America Healthy Again (MAHA) policy agenda and the MAHA Commission via executive order. Charged with combating childhood chronic disease, obesity, diabetes, and mental health disorders, the commission set in motion broader public health strategy reviews. Around the same time, President Trump issued an executive order prohibiting federal funding to schools, K-12 institutions, and universities requiring COVID-19 vaccination for in-person attendance. Although college vaccine mandates initially persisted at fifteen institutions, all had dropped their requirements by mid-March 2025. Secretary Kennedy outlined his broader public health priorities during an HHS welcome ceremony on February 18, emphasizing investigations into the childhood vaccine schedule, administrative transparency, and environmental factors potentially linked to chronic illness.
Regulatory and grant-making procedures underwent a significant transformation on February 28, when Secretary Kennedy issued a new rule rescinding the longstanding "Richardson Waiver" from 1971. By aligning HHS rulemaking procedures strictly with the Administrative Procedure Act, matters relating to agency management, personnel, grants, benefits, and contracts were exempted from traditional public notice and comment requirements. While proponents argued the change streamlined implementation, lawmakers and public health groups raised concerns over reduced public visibility regarding critical funding and policy adjustments.
Public health research priorities shifted as spring progressed. In March 2025, HHS announced that the CDC would study factors contributing to the rise in autism diagnoses, a focus later accompanied by controversial administrative claims linking acetaminophen use during pregnancy to autism, alongside repeated assertions connecting vaccines to autism despite established scientific consensus. Meanwhile, the FDA released guidance for 2025-2026 influenza vaccine composition without consulting its external advisory committee, the Vaccines and Related Biological Products Advisory Committee, marking a distinct break from past practices and occurring amid curtailed official communications with the World Health Organization following U.S. withdrawal from the UN agency.
Simultaneously, the NIH initiated the termination of numerous grants supporting HIV prevention and treatment, including adolescent-focused initiatives and pre-exposure prophylaxis research. HHS also removed a 2024 Surgeon General advisory declaring gun violence a public health crisis from its website, coinciding with the closure of the White House Office of Gun Violence Prevention and staff reductions within the CDC’s Injury Center and Division of Violence Prevention. Financial pressures intensified when HHS and the CDC sought to pull back $11.4 billion in supplemental COVID-19 and public health funding previously allocated to state and local health departments. A coalition of 23 mostly Democratic-led states successfully sued the administration, resulting in a federal judge indefinitely blocking the funding clawback for participating states, restoring approximately 80% of the targeted funds for those jurisdictions by late August 2025.
In late March 2025, HHS unveiled a sweeping reorganization plan in accordance with executive orders on workforce optimization. The proposal sought to combine several existing agencies—including the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, and parts of the Office of the Assistant Secretary for Health—into a new Administration for a Healthy America, while moving the Administration for Strategic Preparedness and Response under the CDC. Though certain organizational changes and office closures proceeded, broader structural shifts requiring congressional approval stalled. Concurrently, mass federal layoffs moved forward following Supreme Court rulings overturning lower court blocks, resulting in estimated reductions of over 20,000 jobs across HHS.
Targeted funding freezes also impacted family planning and infant care. In March 2025, HHS withheld a portion of Title X family planning service grants from one in five grantees, affecting all nine Planned Parenthood recipients and dozens of clinics across 23 states. On April 1, federal participation in the "Safe to Sleep" infant mortality reduction campaign ended with the elimination of the National Institute of Child Health and Human Services communications office. Days later, the CDC was ordered to cut contract spending by $2.9 billion to meet efficiency targets.
Environmental and drug safety policies saw notable adjustments. Secretary Kennedy announced plans to re-examine federal water fluoridation policies, proposing that the CDC alter its recommendations while states like Utah and Florida enacted outright bans on community water fluoridation. The FDA directed Pfizer and Moderna to update warning labels on mRNA COVID-19 vaccines to highlight expanded risks of myocarditis and pericarditis, and subsequently announced collaborative federal measures with HHS to phase out petroleum-based synthetic food dyes through voluntary industry actions. To bolster domestic medical development, HHS launched a $500 million initiative for a universal vaccine platform, repurposing prior pandemic-related research funds.
Regulatory approaches to vaccines and research continued to evolve through mid-2025. In May, the White House released its fiscal year 2026 budget request proposing steep discretionary funding cuts for federal health agencies alongside funding requests for the proposed Administration for a Healthy America. An executive order issued in May placed stricter oversight and funding restrictions on federally supported gain-of-function research involving biological agents. Later that month, FDA leaders announced that future approvals of new COVID-19 booster formulations for individuals not considered at high risk would require evidence from randomized, controlled clinical trials.
Policy disputes surrounding immunization intensified significantly on May 27, 2025, when Secretary Kennedy announced via social media that COVID-19 vaccines for healthy children and pregnant women had been removed from the CDC recommended immunization schedule without prior review by the Advisory Committee on Immunization Practices. Medical organizations subsequently filed lawsuits challenging the procedural bypass, while professional societies issued independent clinical guidance conflicting with the updated federal stance. Shortly thereafter, Secretary Kennedy dismissed all seventeen sitting members of the ACIP, replacing them with new appointees, including several critics of existing vaccination policies.
The reconstitution of advisory panels was accompanied by structural and regulatory changes across drug and prevention programs. The FDA established the Commissioner’s National Priority Voucher program to expedite reviews for products serving national health interests, while approving landmark treatments such as lenacapavir, a twice-yearly injectable HIV prevention drug. However, HHS simultaneously altered program requirements for teen pregnancy prevention and sex education grants, withholding funds from states and organizations that declined to revise curricula to align with executive orders restricting gender inclusivity messaging. Concurrently, the CDC deactivated its H5N1 bird flu emergency response, transitioning to monthly reporting of human infection data despite rising animal detection rates in the fall.
Leadership stability within federal agencies faced ongoing turbulence. Following the July swearing-in of Susan Monarez as CDC Director, internal conflicts regarding vaccine policy approvals and personnel decisions led to her removal by the White House less than a month later, after which Deputy HHS Secretary Jim O’Neill assumed the role of acting director. Meanwhile, the administration canceled scheduled meetings of the U.S. Preventive Services Task Force, raising questions regarding future preventive health recommendations tied to Affordable Care Act coverage mandates, even as the Supreme Court upheld the constitutional framework of ACA preventive service requirements while confirming the executive authority to modify task force membership.
As the year progressed, HHS advanced further measures targeting specific medical technologies and interventions. The agency announced a coordinated wind-down of $500 million in BARDA funding dedicated to mRNA vaccine development, redirected focus toward alternative platforms, and formally reinstated the federal Task Force on Safer Childhood Vaccines. The FDA limited the approval scope of 2025-2026 COVID-19 vaccines to individuals aged 65 and older and high-risk adults. In September, the MAHA Commission released its comprehensive strategy document outlining over 120 initiatives aimed at curbing childhood chronic disease through dietary reforms, chemical reductions, and modified research priorities.
Further regulatory revisions arrived in the fall of 2025. ACIP voted to recommend individualized decision-making for COVID-19 vaccines across all age groups and advised separating the combination MMRV vaccine for young children. President Trump and Secretary Kennedy jointly announced federal initiatives to authorize and cover leucovorin as an autism treatment while issuing safety warnings regarding acetaminophen use during pregnancy, drawing widespread pushback from scientific and medical communities. Concurrently, the CDC altered public-facing website language regarding vaccines and autism to state that potential links could not be ruled out, drawing formal condemnation from major medical associations.
Late-year developments included mass layoffs of federal health personnel during a government shutdown, new enforcement actions restricting unapproved ingestible fluoride products for children, and the FDA’s decision to initiate the removal of black box warnings from menopausal hormone replacement therapy products. In December 2025, ACIP voted to end the universal birth dose recommendation for the hepatitis B vaccine for infants born to mothers testing negative for the virus, and CMS informed states they would no longer be required to report specific immunization metrics within Medicaid and CHIP core sets.
Entering 2026, HHS implemented major structural revisions to the federal childhood immunization schedule, reducing the number of routinely recommended vaccine-preventable diseases from seventeen to eleven, while shifting several immunizations to shared clinical decision-making. Although federal courts subsequently issued stays halting certain implementation steps pending ongoing litigation, administrative efforts to align domestic schedules with international peer practices persisted. The administration also advanced new antiviral prize programs, navigated continuing legal challenges regarding public health funding cuts to state health departments, and updated ACIP charter rules to broaden member expertise criteria. The rollout of modified federal reporting standards for infectious disease mortality statistics and newly established clinical research programs focused on reported adverse events following immunization continued to shape the national public health landscape through late 2026.
