The Trump Administration continues to push forward with Executive Orders targeting deregulation, healthcare reforms under the “Make America Healthy Again” initiative, and establishing English as the official U.S. language. However, numerous lawsuits challenge these actions, including disputes over agency firings and funding freezes.
President Trump has asked Congress to pass a budget featuring deep federal spending cuts to support significant tax reductions. He addressed Congress recently, highlighting his administration’s accomplishments and goals, which received mixed reactions across party lines.
Due to a narrow Republican majority and a limited legislative window before the 2026 midterms, the Administration is accelerating its agenda through executive action and urgent budget negotiations.
Several healthcare bills are under consideration, including legislation expanding rural care access (H.R. 44), banning prior authorizations (H.R. 639), extending premium tax credits (H.R. 247), and reforming Pharmacy Benefit Managers (PBMs). PBM reform has bipartisan interest, but it stalled after a broader funding bill was blocked following criticism by Trump and Elon Musk.
The Hemophilia Federation of America (HFA) supports efforts like the HELP Copays bill to ban Copay Accumulator Adjustment Programs (CAAPs). It is actively involved in legal advocacy and coalition work to protect patient access and affordability.
In addition, due to the Health and Human Services (HHS) Reduction in Force directive, the CDC’s Division of Blood Disorders and Public Health Genomics and the Blood Disorders Surveillance and Epidemiology Branch have been effectively shut down.
These divisions are vital in monitoring the U.S. bleeding disorders population, tracking blood-borne pathogens, and ensuring treatment product safety.
The recent cuts to CDC programs have profound implications for the bleeding disorders community. The reduction of the CDC’s Community Counts project will significantly limit national surveillance efforts that have deepened our understanding of joint disease and other comorbidities in people with bleeding disorders. Inhibitor testing, a vital service provided by CDC clinical labs in support of Hemophilia Treatment Centers (HTCs), is now at risk, an especially harmful loss for rural and underserved communities that rely heavily on these resources. Additionally, the weakening of CDC-led monitoring for blood-borne threats like HIV, Hepatitis, Zika, and Ebola poses a grave risk to the safety of the national blood supply, potentially exposing patients to avoidable health crises.
Furthermore, the Presidential Administration continues to rapidly push its agenda, particularly around federal budget changes aimed at cutting costs and boosting U.S. manufacturing. Continued tax
cuts drive budget proposals and
calls to reduce “waste, fraud, and abuse.” However, many of these cuts target crucial public health
and safety programs.
The Senate passed a resolution calling for $1 billion in cuts to the HELP Committee and increasing Finance Committee spending by
$1.5 trillion (which oversees Medicaid). The House, however, initially proposed $880 billion
in cuts to energy and commerce, which is also responsible for Medicaid oversight.
A final budget compromise passed the House on April 10, with most Republicans voting in favor.
Enhanced Premium Tax Credit (ePTC): A Lifeline Under Threat
The enhanced Premium Tax Credit, created to expand access to healthcare coverage under the ACA, has helped 3–4 million Americans, especially during and after COVID-19. Without renewal for 2026, coverage costs would rise drastically. Premiums could increase to 93%, with coverage losses for nearly 4 million people.
To make matters worse, the proposed Marketplace Integrity and Affordability Rule for 2025 could further limit access to healthcare by shrinking the Open Enrollment window and removing income-based premium caps. The rule would also impose stricter documentation requirements for income verification, making it harder for individuals to qualify for coverage. Most concerning, it would eliminate enrollment opportunities for low-income individuals earning less than 150% of the federal poverty level, potentially leaving many vulnerable Americans without affordable healthcare options.
Pharmaceutical Tariffs: A New Threat
While many tariffs have been delayed, the Administration is still pursuing pharmaceutical import tariffs, potentially disrupting drug supply chains and driving up prescription drug costs. The goal is to bring manufacturing back to the U.S., though its effectiveness remains widely debated.
CDC Cuts: Dismantling Essential Services
A massive Reduction in Force (RIF) eliminated nearly all staff from the CDC’s Division of Blood Disorders, Public Health Genomics, and related branches. These offices monitored the safety of blood products, tracked comorbidities, and offered life-saving lab services.
Key concerns include the loss of critical surveillance programs like Community Counts, which limits the ability to monitor disease progression and treatment effectiveness for individuals with bleeding disorders. Eliminating specialized inhibitor testing services disproportionately impacts rural and under-resourced communities that rely on these diagnostics. Additionally, the safety of the national blood supply is now at risk, raising fears reminiscent of the “bad blood” era when contaminated blood products caused widespread harm. Compounding these issues is the absence of a transition plan, resulting in the abrupt loss of decades of institutional knowledge and expertise, with only two staff members remaining to manage what were once essential public health functions.
RFK Jr., now HHS Secretary, admitted some cuts may need to be reversed, but there is no indication the CDC’s blood disorder programs are among them.
Take Action with HFA
During an urgent call with over 275 community members and national partners, we committed to organizing our advocacy response. Help us defend against these harmful cuts and push for the reinstatement of critical public health infrastructure.
Here’s how you can help:
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