— -- In his first act as president, Donald Trump, sitting at the Resolute Desk, signed an executive order directing agencies to minimize “the economic burden” of the Affordable Care Act until it is repealed.
Out on the campaign trail, Trump frequently called for the repeal and replace of Obamacare, and the executive order signaled that doing away with President Obama’s sweeping health care law would be a priority from day one. While Trump has been unsuccessful in repealing the Affordable Care Act during his first year in office, the Department of Health and Human Services has managed to make significant changes.
In 2017, Health and Human Services under the Trump administration rolled back the Obamacare birth control mandate, allowing employers to exempt themselves if they have a moral or religious objection, ended cost-sharing reduction payments to insurance companies to help provide lower cost insurance for middle and low income consumers, cut advertising and outreach spending for the Affordable Care Act 90 percent, cut the sign-up period on the federal health care exchanges in half, and threw out the individual mandate—a tax penalty for those who don’t sign up for health insurance.
But all the HHS changes in health care policy were at times overshadowed by controversy swirling around Tom Price, Trump’s first pick for Secretary of Health and Human Services. A Politico report in September revealed that during his time as HHS Secretary, Price used private jets at taxpayers’ expense costing hundreds of thousands of dollars. The story embarrassed HHS --and the Trump administration.
“I don’t like the optics,” Trump said to reporters outside the White House when asked about Price’s private jet scandal. Price didn’t last much longer -- later that day, he resigned as HHS Secretary.
In the meantime, Eric Hargan stepped in as the Acting Secretary and Deputy Secretary of HHS. Alex Azar, Trump’s nominee for HHS Secretary is expected to be sworn in soon but he won’t be without controversy, either. After Azar served at HHS under the Bush administration, he worked as president of operations at the pharmaceutical giant Eli Lilly and Co. Trump often called for the curbing of the high cost of drugs, but critics say Azar’s ties to the drug industry could prevent any significant reforms.
In addition to overseeing the Affordable Care Act, HHS oversees important government programs related to health and health policy and operates the Food and Drug Administration, Centers for Medicaid and Medicare Services, and the National Institutes of Health. Seventy six percent of the Department’s 2017 budget went towards funding Medicare and Medicaid.
The Trump administration unveiled new rules for the two largest federal programs in 2017, allowing states to fast track approval for state Medicaid changes. Still, next year HHS could face one of its most controversial departures from the Obama administration: Seema Verma, the Administrator for Centers for Medicaid and Medicare Services signaled that states might be able to enforce work requirements for poor people on Mediciad.
ABC News will begin livestreaming coverage of the State of the Union Address on Tuesday night starting at 8:15 p.m. EST. Then at 9:00 p.m. EST you can watch the full State of the Union Address followed by the Democratic response on abcnews.com, Facebook, Twitter, and YouTube, and the ABC News app.