ExecutiveOrdersEO
EO 13890Executive OrderTrump 45 · R

Executive Order 13890

Protecting and Improving Medicare for Our Nation's Seniors

This executive order directs the Department of Health and Human Services to expand Medicare Advantage (MA) plan choices, reduce regulatory burdens on providers, accelerate coverage of innovative medical technologies, and inject market-based pricing into Medicare. It explicitly opposes the Medicare for All Act of 2019 and frames its policies as protecting seniors' existing choices while improving program sustainability through competition and value-based payment.

Federal Register Open PDF 84 FR 53573

Impact dates

  1. Waste/fraud/abuse regulatory changes take effect

  2. Proposed regulation expanding MA plan choices and other administrative actions

  3. Proposed network adequacy regulation for MA plans

  4. Proposed provider billing, reimbursement, and scope-of-practice reforms

  5. Proposed regulatory changes streamlining FDA-to-CMS coverage and innovation

  6. Proposed regulation providing seniors quality/cost data

  7. Proposed regulatory changes reducing provider burden and eliminating inefficient regulations

  8. Identification and removal of barriers to private Medicare contracts

  9. HHS report on modifying FFS payments to reflect MA/commercial prices

  10. HHS study and recommendations on market-based pricing in FFS Medicare

  11. HHS revision of rules preserving Social Security benefits for seniors declining Medicare Part A

Key directives

  • Propose regulation to expand MA plan choices within 1 year
  • Report on modifying FFS payments to reflect MA/commercial prices within 180 days
  • Propose network adequacy regulation for MA within 1 year
  • Propose provider billing and reimbursement reforms within 1 year
  • Streamline FDA-to-CMS coverage for innovative products within 1 year
  • Propose quality/cost data regulation for seniors within 1 year
  • Propose waste/fraud/abuse changes effective by January 1, 2021
  • Study market-based pricing in FFS Medicare within 180 days
  • Revise Social Security rules for seniors declining Medicare Part A within 180 days
  • Identify barriers to private Medicare contracts within 1 year

Who is ordered

Timeline

Immediate

  • EO establishes policy preference for market-based Medicare reforms over Medicare for All

Near term (90d)

  • HHS report on modifying FFS payments to reflect MA/commercial prices (180 days)
  • HHS study on market-based pricing in FFS Medicare (180 days)
  • HHS revision of rules preserving Social Security benefits for seniors declining Medicare Part A (180 days)

Long term

  • Regulations proposing expanded MA plan choices, network adequacy reforms, provider billing relief, innovation acceleration, quality/cost data transparency, waste/fraud/abuse changes effective January 1, 2021, and private contract barriers removal (all within 1 year)

Risks & tensions

  • Implementation depends on HHS regulatory capacity and may face legal challenges; many directives use 'to the extent permitted by law' language creating uncertainty about scope
  • Tension between expanding MA and protecting traditional FFS Medicare could disadvantage certain beneficiary populations
  • Market-based pricing in FFS Medicare may increase costs for some beneficiaries if commercial rates exceed current Medicare rates
  • Streamlining FDA-to-CMS coverage raises potential patient safety concerns if evidence standards are weakened
  • Opposition framing as protecting Medicare vs. expanding it creates political vulnerability for sustainability
Executive Order 13890: Protecting and Improving Medicare for Our Nation's Seniors · Executive Orders