Navigating the current healthcare legislative landscape

In the ever-evolving landscape of healthcare policy, staying informed about legislative changes is crucial for healthcare providers. Cencora is committed to keeping our customers informed about government and legislative actions that impact our collective ability to enable patient access to the life-changing care that they depend on. This article discusses need-to-know updates including recent executive orders from President Trump, latest on the Inflation Reduction Act and the Medicare Drug Pricing Negotiation Program, and more. 

Recent executive orders impacting healthcare

With the slew of executive orders (EOs) that have been signed recently, it’s important to understand both what an EO is and what it is not. An EO is a written directive, signed by the president, that orders the government to take specific actions. Through EOs, President Trump can order the federal government to take steps that are within the scope of the constitutional authority of the executive branch, and do not violate any federal law.¹ With that said, EOs are not legislation. They do not require approval from Congress, and Congress cannot simply overturn them. Only a sitting U.S. President may overturn an existing EO by issuing another EO to do so.²

According to the Federal Register, President Trump has signed 100+ EOs in his first 100 days as President.³ A few with impact to the healthcare industry are:

• Lowering Drug Prices by Once Again Putting Americans First, introduced on April 15, 2025, targets the goal of “lowering prescription drug prices to American patients.” While there are many sections of this EO each addressing a different method of achieving that goal, a few of them include “Improving upon the Inflation Reduction Act”, “Reducing the Prices of High-Cost Drugs for Seniors”, “Promoting Innovation, Value, and Enhanced Oversight in Medicaid Drug Payment”, “Improving Transparency into Pharmacy Benefit Manager Fee Disclosure”, and more.⁴
  
  
• Make America Healthy Again (MAHA) Commission, introduced on February 13, 2025, and led by Robert F. Kennedy, Jr., is an initiative that aims to identify various factors leading to chronic diseases in the U.S., specifically focusing on environmental and food factors, regulatory actions, etc., to develop a strategy to reverse the rising rates of U.S. chronic disease.⁵ 
  
  
• Empowering Patients with Clear Accurate, and Actionable Healthcare Pricing Information, introduced on February 25, 2025, is designed to enable patients with the information they need to make well-informed healthcare decisions by promoting “universal access to clear and accurate healthcare prices.”⁶
  
  
• Establishing and Implementing the Department of Government Efficiency (DOGE), introduced on January 20, 2025, aims to identify areas to make the government more efficient, effective, less burdensome, and less costly by reviewing programs, regulations, and dollars spent by the federal government to identify what needs reform.⁷
  
  
• Eliminating Waste and Saving Taxpayer Dollars by Consolidating Procurement, introduced on March 20, 2025, aims to reduce waste by consolidating federal procurement under the General Services Administration (GSA) and requires federal agencies to transfer their purchasing of common goods and services to the GSA's centralized system.⁸

In addition, President Trump has also rescinded approximately 100 previous EOs.⁹ Of those, two that are worth noting for healthcare providers are:

• Strengthening Medicaid and the Affordable Care Act (Executive Order 14009) encouraged states to expand Medicaid and improve access to Affordable Care Act (ACA) coverage while establishing special enrollment periods to increase health insurance accessibility. Additionally, it directs actions to reduce prescription drug costs through negotiation, importation, and promotion of generics, promotes health equity by addressing disparities in healthcare access and outcomes, and enhances consumer protections to enable affordable and quality health coverage.¹⁰
  
  
• Lowering Prescription Drug Costs for Americans (Executive Order 14087) directed the HHS Secretary to "consider whether to select for testing by the Centers for Medicare and Medicaid Services Innovation Center (CMMI) new health care payment and delivery models that would lower drug costs and promote access to innovative drug therapies for beneficiaries enrolled in the Medicare and Medicaid programs, including models that may lead to lower cost-sharing for commonly used drugs and support value-based payment that promotes high-quality care.”¹¹

Since the recission of Executive Order 14087, CMMI has terminated four Medicare payment models early following a comprehensive evaluation. Additionally, Centers for Medicare & Medicaid Services (CMS) will no longer pursue two prescription drug payment demonstrations: the Medicare $2 Drug List and Accelerating Clinical Evidence models.¹² Fortunately, the Enhancing Oncology Model (EOM) will continue to move forward as it was determined to be capable of meeting the Center's statutory mandate – either as is or with future modifications.

Medicare Drug Pricing Negotiation Program

In August 2022, the Inflation Reduction Act (IRA) was signed into law. For the first time, the law provides Medicare the ability to directly negotiate the prices of certain high expenditure, single source Medicare Part B and Part D drugs without generic or biosimilar competition through the Medicare Drug Price Negotiation Program (MDPNP).¹³ These negotiated prices, referred to as Maximum Fair Prices (MFPs), are based on negotiations and agreements reached between the Centers for Medicare & Medicaid Services (CMS) and participating drug manufacturers. With the first round of negotiated prices set to take effect on January 1, 202614, healthcare providers must stay informed about the developments surrounding this initiative.

CMS has recently published details regarding the first cycle of MFPs for select Part D drugs, alongside further announcements about the following rounds of negotiations:

1. Published explanations for the first round of 10 selected Maximum Fair Price (MFP) Part D drugs
2. Published list of the second round of 15 selected MFP Part D drugs
3. Published confirmation of manufacturer participation in the second cycle of negotiations
4. Released draft guidance for the third cycle of negotiations

To assist in navigating the IRA, Cencora has established an IRA Resource Center. This centralized hub consolidates valuable resources from CMS and additional insights, empowering providers to understand the potential implications of the program and to prepare accordingly.

Click here to visit resource center


As both the healthcare and legislative landscape continues to unfold, Cencora’s commitment to advocating for our customers remains steadfast. We will continue to provide proactive perspectives and strive to remain a reliable resource for our customers, monitoring and proactively shaping congressional and administrative activity, providing updates on implications, and sharing our expertise to shape public policy in support our customers and their patients.

References

1. https://www.aclu.org/news/privacy-technology/what-is-an-executive-order-and-how-does-it-work 
2. https://www.americanbar.org/groups/public_education/publications/teaching-legal-docs/what-is-an-executive-order-/ 
3. https://www.federalregister.gov/presidential-documents/executive-orders/donald-trump/2025 
4. https://www.whitehouse.gov/presidential-actions/2025/02/establishing-the-presidents-make-america-healthy-again-commission/ 
5. https://www.whitehouse.gov/presidential-actions/2025/04/lowering-drug-prices-by-once-again-putting-americans-first/ 
6. https://www.whitehouse.gov/presidential-actions/2025/02/making-america-healthy-again-by-empowering-patients-with-clear-accurate-and-actionable-healthcare-pricing-information/
7. https://www.whitehouse.gov/presidential-actions/2025/01/establishing-and-implementing-the-presidents-department-of-government-efficiency/
8. https://www.whitehouse.gov/presidential-actions/2025/03/eliminating-waste-and-saving-taxpayer-dollars-by-consolidating-procurement/
9. https://www.whitehouse.gov/fact-sheets/2025/03/fact-sheet-president-donald-j-trump-rescinds-additional-harmful-biden-executive-actions/ 
10. https://www.federalregister.gov/documents/2021/02/02/2021-02252/strengthening-medicaid-and-the-affordable-care-act
11. https://www.govinfo.gov/content/pkg/DCPD-202200925/html/DCPD-202200925.htm
12. https://www.cms.gov/newsroom/fact-sheets/cms-innovation-center-announces-model-portfolio-changes-better-protect-taxpayers-and-help-americans 
13. https://www.cms.gov/inflation-reduction-act-and-medicare/medicare-drug-price-negotiation 
14. https://www.cms.gov/files/document/fact-sheet-negotiation-process-flow.pdf

This article is based on a recent Q&A conversation between Lisa Harrison, SVP & President, Specialty Distribution and Solutions at Cencora, and Beth Mitchell, VP of U.S. Public Policy and Advocacy at Cencora. This conversation can be read here.