Recent political shifts impacting health policy and access to care for millions dominated the news in 2025.
Actions by the federal government impacting health care dominated the news stories in 2025.
Image credit: Lila Patel - stock.adobe.com

This year was a tumultuous period for American health care policy, dominated by political shifts and a new administration. The most-read news stories published by The American Journal of Managed Care® (AJMC®) highlighted how government decisions impacted the lives of millions and how patients are facing more barriers to care.
These top 5 stories underscore how 2025 was a year of constant friction at the intersection of public health and political power.
Insurance claim denials, particularly for essential medications, have seen a significant increase in recent years, creating major barriers for patients trying to access care. This trend is driven by payers and pharmacy benefit managers utilizing cost-control mechanisms like prior authorizations and formulary exclusions, which often do not align with established clinical best practices. The result of these cost-control mechanisms is delayed treatment, worsening patient symptoms, and an increased administrative burden for providers.
“The idea behind the denials and the prior authorization is to lower costs in the short term, but sometimes treatment delays or lapses can potentially increase costs with preventable complications, emergency, and more frequent primary care office visits,” Christopher Gold, DO, an internal medicine physician at Mount Sinai, New York, said in an interview with AJMC.
President Donald Trump’s announcement at the end of 2024 that he was nominating Robert F. Kennedy Jr to run HHS was controversial, and Kennedy’s Senate confirmation hearings for HHS secretary were dominated by scrutiny of his long history of promoting vaccine skepticism and misinformation. He attempted to walk back his past statements by claiming he is "pro-safety" and supports vaccines. Senators from both parties questioned his refusal to acknowledge established scientific evidence, such as the lack of a link between vaccines and autism, and challenged him on his shifting and contradictory stances on reproductive rights.
Additionally, Kennedy displayed a lack of fundamental knowledge regarding crucial federal health programs, incorrectly stating that Medicaid is fully funded by the federal government and struggling to detail his plans for Medicare and Medicaid reform.
In February, Trump endorsed the House Republican budget, which proposed an $880 billion cut to programs overseen by the House Energy and Commerce Committee. The proposed reduction would force states to absorb the funding gap, primarily impacting the nearly 80 million Americans who rely on the program, including those in rural areas, low-income citizens, and 40% of US children.
A week later, the House narrowly passed the budget resolution endorsed by the president, including the deep cuts to Medicaid, sending it on to the Senate. The resolution proposed cutting approximately $880 billion from Medicaid and other health programs over the next decade, with the goal of funding significant tax cuts and raising the country’s debt limit. The measure passed despite internal GOP pushback over concerns of the cuts to Medicaid.
Ultimately, the House version of the budget resolution did not pass the Senate as it was, with the Senate passing an alternative, amended version that the House later adopted.
The most-read article of the year came shortly after Trump was sworn in for his second term as president. On Inauguration Day, the returning president signed an executive order that would reverse Biden-era initiatives aimed at reducing prescription drug costs for Medicare and Medicaid recipients, expanding the Affordable Care Act, and increasing protections for Medicaid enrollees. Some of the initiatives from former President Joseph R. Biden, such as Medicare drug negotiation under the Inflation Reduction Act, the annual out-of-pocket cap on Part D prescription drugs, and the $35 monthly cap on insulin, remained unaffected.
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