Donald Trump’s first steps on healthcare: Inaugural remarks, leaving the WHO, and more

As he took the oath of office Monday, President Donald Trump talked about healthcare in his inaugural address.

Before his first day in office ended, he signed an order to begin the process of taking the United States out of the World Health Organization. He also ordered a hiring freeze that could affect health agencies.

Trump talked about healthcare issues in a few brief portions of his first speech as president Monday. He said his administration is going to tackle chronic diseases and work to improve the health of kids.

“We will end the chronic disease epidemic and keep our children safe, healthy and disease free,” Trump said.

• Read more: What hospitals want from President Trump and the new Congress

Robert F. Kennedy Jr., Trump’s nominee to lead the U.S. Department of Health & Human Services, has repeatedly mentioned a desire to focus on chronic diseases. Kennedy’s nomination has elicited heavy criticism from healthcare leaders, who have cited his repeated criticism of vaccines and lack of experience leading a health organization.

The Senate must confirm Kennedy’s nomination. While some of Trump’s top Cabinet nominees have had hearings before senators, Kennedy hasn’t had a hearing yet.

Healthcare leaders have said they welcome more attention on chronic diseases. But some hope Trump also continues robust investments in infectious diseases.

Trump criticized America’s public health system for falling short in emergencies.

“We have a public health system that does not deliver in times of disaster, yet, more money is spent on it than any country anywhere in the world,” Trump said.

Trump also bemoaned federal emergency response in North Carolina, which suffered heavy damage from Hurricane Helene.

“Our country can no longer deliver basic services in times of emergency, as recently shown by the wonderful people of North Carolina, been treated so badly,” Trump said.

Congress approved a short-term spending package last month that directs $9 billion for recovery efforts in North Carolina; President Biden signed the legislation. The package included a total of $100 billion to aid states affected by natural disasters, said U.S. Sen. Thom Tillis, a Republican from North Carolina.

Trump also said in his administration, the federal government will only recognize the male and female genders.

“I will also end the government policy of trying to socially engineer race and gender into every aspect of public and private life,” Trump said. “We will forge a society that is color-blind and merit-based. It will henceforth be the official policy of the United States government that there are only two genders, male and female.”

LGBTQ leaders such as Liana Douillet Guzmán, CEO of FOLX Health, have worried that transgender individuals would face more hardships under the Trump administration and would find it harder to access care.

“President Trump and his team have decided to create a wedge around trans healthcare in particular, and they're doing it with a reliance on just complete and utter misinformation,” Douillet Guzmán told Chief Healthcare Executive® in an interview.

The president also said members of the military who were discharged for not complying with the COVID-19 vaccine requirements would be allowed to return to duty.

“I will reinstate any service members who were unjustly expelled from our military for objecting to the COVID vaccine mandate, with full back pay,” Trump said.

Trump said his administration will establish the much-discussed Department of Government Efficiency, which is aimed at reducing unnecessary federal spending. Trump didn’t specify which agencies could be targets for cuts.

Healthcare leaders have worried that the Trump administration may look at cutting spending on Medicaid, the federal-state program helping Americans with lower incomes pay for healthcare. Analysts such as Moody’s Ratings say significant cuts in Medicaid funding would hurt hospitals and health systems, particularly those who serve a higher percentage of patients with lower incomes.

Trump didn’t mention Medicare or Social Security in his inaugural speech, but he has said he has no plans to cut those programs, including in an interview with NBC News.

Leaving WHO

As some analysts expected, Trump issued an executive order that begins the process of removing the United States from the World Health Organization.

In the order, Trump referenced "the organization’s mishandling of the COVID-19 pandemic that arose out of Wuhan, China, and other global health crises."

The order also cites "unfairly onerous payments from the United States, far out of proportion with other countries’ assessed payments." The U.S. provides 18% of WHO's funding, Reuters reports.

Trump began the process of trying to get out of the WHO in 2020, but President Biden reversed that process and kept the U.S. in the organization.

Now, Trump has begun the process of withdrawing from WHO, and now he'll be able to do it. After signing the order, a reporter asked Trump, since he was president when the COVID-19 pandemic began, if he saw the importance of the WHO helping to coordinate a global response to outbreaks.

In response, Trump said, "I do, but not when you're being ripped off like we are by the World Health (Organization)."

Acting HHS secretary

Trump named Dorothy Fink, MD, as the acting U.S. Health & Human Services Secretary Monday. Fink has been serving as the deputy assistant secretary for women's health in the health department. Her office has led a wide-ranging collaborative effort with hospitals to improve maternal health.

Fink is board certified in endocrinology, internal medicine, and pediatrics. She practiced at he Hospital for Special Surgery and New York Presbyterian Hospital, Cornell University.

Hiring freeze

Trump also signed an executive order imposing a hiring freeze of civilian employees.

The freeze allows an exemption for the military and public safety, and Trump said the order won't "adversely impact" the delivery of Medicare, Social Security and veterans' benefits.

At first blush, though, the hiring freeze could affect federal health agencies, including the U.S. Department of Health and Human Services (excluding the Centers for Medicare & Medicaid Services), along with the National Institutes of Health and the Centers for Disease Control and Prevention.