Guest blog: Trump’s executive orders could jeopardize immigrants’ health coverage

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By Mekdes Agezew, NCL Health Policy Spring Intern

As President Donald Trump begins his second term in office, he has signed a series of executive orders (EOs) aimed at reversing policies implemented by the Biden administration. In his first week alone, Trump revoked 78 of Biden’s executive orders and actions, impacting areas such as immigration, climate change, oil exploration, gender equality, federal diversity programs, and health care coverage.

<strong>Trump’s Immigration Policies and Their Impact on Health Care Access</strong>

One of President Trump’s executive orders expanded the power of Immigration and Customs Enforcement (ICE), to increase arrests and deportations of undocumented immigrants. As of February 3rd, DHS reports 5,693 deportations via X. and on February 6th the White House confirmed that 461 individuals arrested by ICE were released. Included in this is the removal of Colombian nationals via military planes on January 26, 2025. Colombian President Gustavo Petro initially resisted but ultimately conceded after threats of economic tariffs, and sent an aircraft of their own to pick up around 200 individuals being deported.

Although these deportation efforts primarily target undocumented immigrants, their effects extend to broader immigrant communities, including millions of U.S.-born children in mixed-status families. During Trump’s first term, restrictive immigration policies and increased enforcement created widespread fear, discouraging immigrant families from enrolling in healthcare programs such as Medicaid. The expanded “public charge” rule, later reversed, exacerbated these concerns by making immigrants fear that using public benefits could jeopardize their residency or citizenship applications. As of 2023, nearly three-quarters of immigrant adults, including nine in ten who are likely undocumented, reported uncertainty about using non-cash assistance due to fears of jeopardizing their immigration status.

During Trump’s first administration, which also increased immigration enforcement, KFF found that there was a decrease in health care use and participation in Medicaid and CHIP because of immigration-related fears. Now, with the Administration’s doubling down on a more forceful immigration agenda, fears are intensifying. His rollback of policies expanding Medicaid and ACA coverage, combined with rising enforcement actions, is expected to increase the number of uninsured immigrants and reduce participation in vital healthcare assistance programs.

<strong>Proposed Medicaid Funding Cuts and their Impact</strong>

Medicaid provides high-quality, affordable health care to Americans, including children, pregnant women, veterans, seniors, and low-income individuals. It covers essential services such as primary care, hospital stays, prescription drugs, and preventive care. While undocumented immigrants are ineligible for any federally funded coverage, lawfully present immigrants are often eligible, with a five-year waiting period. However, some states have expanded coverage by eliminating the waiting period.

Currently, the Trump administration is exploring ways to reduce federal spending and cut taxes, including cuts to Medicaid’s budget. On January 28, 2025, the White House issued a memo freezing federal loans and grants to review whether federally funded programs align with the Trump administration’s goals. This caused widespread confusion about Medicaid’s future, which was only exacerbated by reports from states that they were unable to access the systems used to draw down federal health dollars. Later, officials clarified that Medicaid—since it provides direct payments—was not included in the freeze. However, the program remains a target for Republican officials. House Republicans released a draft budget resolution on February 13 as part of their budget reconciliation strategy. With Medicaid being the largest program

overseen by the Energy and Commerce Committee; it is the primary plausible source for the minimum $880 billion cuts the Committee needs to find. Additionally, a bill was introduced within both chambers that would prohibit states from using Medicaid funding to provide healthcare benefits for illegal immigrants. If federal Medicaid funding is cut, states will be forced to either cover the costs themselves or scale back the program. States that choose to continue Medicaid may tighten eligibility requirements, reduce benefits, or limit enrollment, making healthcare access even more challenging for low-income and immigrant families. For instance, Idaho state Rep. Lori McCann states that if the state repeals its Medicaid expansion, more than 89,000 Idahoans could lose their coverage. Ultimately, this could increase the number of uninsured individuals and aggravate health disparities.

<strong>The Potential Impact of RFK Jr.’s Health Policies</strong>

On February 13, 2025, the Senate confirmed Robert F. Kennedy Jr. as Secretary of Human Health Services (HHS). As an anti-vaccine zealot, Sec. Kennedy. continues to voice his opposition to childhood vaccine mandates and question the safety of all vaccines. Secretary Kennedy also staunchly opposes pharmaceutical companies and their influence. As Secretary, RFK Jr can influence Medicaid’s vaccine coverage policies, potentially limiting access to childhood immunizations and other preventative vaccines for millions of low-income and immigrant families.

We are already seeing the consequences of declining vaccination rates. For example, Texas is experiencing an outbreak of measles amongst youth, totaling 58 cases at the time of writing, with 13 people hospitalized. Measles spreads easily and quickly in unvaccinated children and adults. This outbreak is the worst seen in the US in 30 years. The US is also facing the worst flu season in 15 years with nearly 400,000 hospitalizations and 16,000 deaths from the flu as of February 8. Further restrictions to vaccine access would pose serious public health risks,

particularly for children who rely on Medicaid for immunizations against diseases such as measles and polio.

The Impact of Halting Lower Drug Prices and Expanded Health Coverage Former President Biden prioritized lowering prescription drug costs and expanding health coverage under ACA and Medicaid, which NCL supports. In January 2021, Biden’s Executive Order 14009 strengthened these programs, extending enrollment periods and allowing more individuals and families to access health care. And in October 2022, Biden further issued Executive Order 14087 to reduce prescription drug prices, addressing the skyrocketing costs that burden low-income families. Over a quarter of adults have difficulty affording their prescription medications, and over half of adults worry about being able to afford them. When looking at race/ethnicity, 61% of Black adults and nearly 70% of Hispanic adults report worrying about their ability to afford their medications. By revoking these initiatives, the Trump Administration puts the health of low-income and vulnerable immigrant families and the communities they reside in, at greater risk.

While Mr. Trump has yet to announce a comprehensive health care plan, his actions suggest a shift away from affordability and accessibility, leaving whole communities across the US at risk, and it won’t be only immigrant communities, though they suffer more than most.

<strong>Conclusion</strong>

By rescinding executive orders that expanded Medicaid, ACA coverage, and lowered drug prices, Trump is engaging in a reckless experiment that runs the risk of spreading illness and disease; in doing so, he and his HHS Secretary put all Americans at risk. While the consequences of this experiment will be felt by all, immigrant families and communities are expected to be hit even harder.

Nancy Glick

Preventing foodborne illness is worth the investment

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By Nancy Glick, Director of Food and Nutrition Policy

“We’re not going back” is a rallying cry not usually associated with food safety policy. But if the Trump Administration heeds the call from the trade association for the processed meat industry to withdraw a needed proposed food safety rule, Americans will indeed go back to facing preventable foodborne illness outbreaks. 

The rule in question – to allow USDA’s Food Safety and Inspection Service (FSIS) to establish standards that will keep Salmonella contaminated chicken carcasses and poultry parts from entering the market – comes at a time when Salmonella infections are on the rise in the U.S.  According to data from the Centers for Disease Control and Prevention (CDC), Salmonella bacteria cause over 1 million human infections in the United States each year, putting more Americans at risk for serious illness, including fever, bloody diarrhea, and sometimes life-threatening complications. Moreover, CDC estimates that foodborne Salmonella causes 29 illnesses for each case that is detected – meaning significantly more people are getting sick than records show.  

The National Consumers League (NCL), as part of the Safe Food Coalition, praised FSIS for issuing the proposed rule in January 2025, as did many public health and medical societies. Why? One reason is because chicken is a major source of illness from Salmonella, causing an estimated 195,634 illnesses each year at a cost of $2.8 billion annually, according to Consumer Reports. In fact, CDC estimates that about one in every 25 packages of chicken at the grocery story are contaminated with Salmonella.  

The other reason is the good news. Today, advances in technology make it possible for inspectors to rapidly detect and mitigate Salmonella and other foodborne pathogens throughout the poultry supply chain. Thus, the FSIS rule is predicated on new technologies for early detection of foodborne bacteria.  

But, the Meat Institute, speaking for the $227.9 billion meat and poultry processing industry, has asked the Trump Administration to withdraw the rule as a way to reduce “burdensome” regulations. The group says the new FSIS rule, which was three years in the making, will “add cost to the production and supply of food, exacerbating food price inflation to the detriment of consumers.”  

However, NCL actually speaks for consumers, and we challenge this position. Polls show that Americans favor stronger food safety oversight. In a 2022 survey, 74 percent said it would be worth a 1 to 3 percent increase in the cost of food to pay for added safety measures.  

Moreover, Americans recognize that foodborne illness has widespread consequences, both in terms of people’s lives and costs to society. Starting with the human toll, CDC estimates that 48 million people get sick, 128,000 are hospitalized and 3,000 people die each year from foodborne diseases. In terms of the cost to the economy, a study by researchers from USDA’s Economic Research Service puts the cost to the economy at $75 billion (in 2023 dollars) annually, which includes medical care, lost productivity, and premature deaths, including those associated with secondary chronic illnesses.   

For all these reasons, Americans are not willing to give up food safety protections for the possibility of saving a few pennies when buying poultry products. Instead, consumers – along with public health officials and infectious disease specialists – are calling on the Trump Administration to finalize enforceable safety standards for poultry products as part of the new “Make America Healthy Again” initiative because the FSIS rule will result in safer food and fewer illnesses.  

The DEIA dilemma: What would Abraham Lincoln say

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By Sally Greenberg, NCL CEO

One of the dates seared into my memory from a young age is February 12 —President Abraham Lincoln’s birthday. We’ve had some truly heroic presidents, but it’s hard to compare any to the towering figure of Abraham Lincoln.

One of my favorite Lincoln quotes is this: “I am a firm believer in the people. If given the truth, they can be depended on to meet any national crisis. The great point is to bring them the real facts.”

As we enter the age of the second Donald Trump presidency, I’m reminded of Lincoln’s wisdom, wit, and kindness—qualities sorely lacking in the current occupant of the Oval Office. And unlike Lincoln, the truth too often eludes Mr. Trump.

This brings me to what the Trump administration is currently doing to try to erase diversity in America. They are waging war on DEIA (Diversity, Equity, Inclusion, and Accessibility), forcing federal agencies to wipe any reference of DEIA from their websites. In the process, they insult and demean millions of Americans and undermine the remarkable diversity that defines our beautiful democracy.

During his famous Gettysburg Address, Lincoln called upon Americans to “bind up the nation’s wounds.”  The Trump administration could have heeded that advice and worked to represent all people after the very polarizing election Instead, their attacks on diversity deepen our divides.

Misconceptions about DEIA abound. DEIA initiatives—like implementing accessibility measures for people with disabilities, addressing gender pay inequity, and diversifying recruitment outreach—exist to correct discriminatory organizational practices. As Erica Foldy, a professor at NYU’s Wagner Graduate School of Public Service, explains, DEIA efforts don’t discriminate; they put employers “on the path of creating more merit-based companies, more merit-based firms,” aiming to ensure that qualified people of all backgrounds have an “equal chance of being hired; you’re going to be paid the same as employees at comparable levels.”

Research from management consulting firm McKinsey & Company found that companies with more diversity financially and socially outperform those that are less diverse.

“The most successful companies understand that DEI isn’t just a ‘”nice-to-have,'” said Christie Smith, the former vice president for inclusion and diversity at Apple. “It’s a driver of innovation, talent attraction, and competitive advantage.”

I was among the many in my generation who marched on Washington for civil rights, women’s rights, reproductive rights, and LGBTQ+ rights. We wrote letters, met with members of Congress, and donated to causes that helped make America great—by making it more inclusive.

The fight didn’t start here. Long before I became head of this organization, the women who founded NCL were championing the rights of children, women, minorities, and immigrants. Florence Kelley, NCL’s first general secretary, was a founding member and signed the original charter forming the NAACP in 1909. She refused to stay in hotels that barred Black guests and was an outspoken advocate for federal anti-lynching laws—a law that wasn’t passed until 2022!  Her protégé, Frances Perkins, went on to serve as Secretary of Labor under FDR and, in one of her first acts, desegregated the cafeteria at the Department of Labor.

So championing DEIA – even if they didn’t call it that – has always been in NCL’s DNA. And so many Americans before us waged brave and bruising battles to secure these rights.  Rosa Parks refused to give up her seat to a white person on a segregated bus, and her protest sparked the Montgomery bus boycott, paving the way for the 1964 Civil Rights Act, signed by President Lyndon Johnson, which prohibited discrimination on the basis of race, religion, and national origin.

Japanese Americans, many of them U.S. citizens who were born in the U.S., were unjustly imprisoned after Japan attacked Pearl Harbor in 1941. They finally received reparations 47 years later through an act of Congress.

Jewish Americans formed the Anti-Defamation League in 1913 after Leo Frank, a Jew, was falsely accused of murder and lynched by a mob in Georgia.

Throughout the 20th century, gay and lesbian Americans were routinely harassed, arrested, fired from jobs, and discharged from the service until they’d had enough and fought back against yet another police raid. The Stonewall Riot in 1969 at a gay bar in New York City changed history – and many marches later and the formation of gay rights groups like the Human Rights Campaign secured myriad reforms and protections for the LGBTQ+ community.

President George H.W. Bush signed the Americans with Disabilities Act (ADA) in 1990, ensuring basic accessibility measures we take for granted today. So, when you see curb cuts and wheelchair-accessible restrooms, we can thank President Bush and the movement behind the ADA.

I began my career with the Anti-Defamation League in the 1980s, lobbying for hate crimes legislation when it was a novel concept.  At first it was a hard sell, but today, every state has hate crime laws. If you paint a swastika on a synagogue or burn a cross on a lawn, that’s not just vandalism—it’s a hate crime because we recognize that targeted violence against certain groups (all DEIA Americans) is an attack on our democracy.  And. I’m pretty sure we aren’t repealing those hate crime laws!

I am saddened that so many Americans have fought and gained hard-won rights and protections that are now under attack. Memo to Trump and his allies: America’s embrace of difference and diversity makes us a beacon to the rest of the world.

Finally, Lincoln once said, “The philosophy of the schoolroom in one generation will be the philosophy of government in the next.”  So, though the Trump administration may try to erase our land of difference and diversity, good luck with that.

The far-right thinks they have a right to control what we say, think, read, and do, but Americans don’t take kindly to being told what to do.

Most of us have grown up in a country that is far more diverse and embracing of differences than the generations before us. Diversity, alas, is our superpower and our future. You can try to erase it or ban it, but the genie is out of the bottle—and no executive order or website purge will put it back in. One way or the other, it is here to stay.

And hallelujah for that.

Congress should reject proposals to make school more expensive

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By Eden Iscil, Senior Public Policy Manager

A list of policy proposals currently under consideration by Republican majorities in Congress has become public. The 50-page document covers a range of programs and issue areas, looking for ways to pay for the new government’s “big, beautiful” swath of initiatives. Unfortunately, there are a bunch of policies thrown in that would make things worse for consumers. These three bad ideas related to education caught my eye. 

Taxing college scholarships. If you or your kid win a scholarship to help pay for college, the new Congress might want a piece of it. Under the proposal, they would take $5.4 billion each year from scholarship winners. This is especially harmful given a significant portion of scholarships are awarded to students who demonstrate financial need.

Making it harder for low-income children to eat breakfast or lunch at school. A plan to eliminate $900 million yearly in school breakfasts and lunches hinges on requiring children to “submit income verification documentation.” Time and time again, we have found that adding more bureaucracy to government programs reduces the number of people who enroll, even when they are eligible to benefit from the program. In this case, that means kids going hungry, which unsurprisingly is associated with worse academic performance. 

Forcing students to pay their loans while still in school. The answer to the $1.7 trillion student debt problem is not to force students to pay their loans “while actively studying.” Costs for college students are already sky-high; Congress doesn’t need to make them higher. 

Why are these ideas even on the table? Apparently, to give $522 billion to corporations by lowering the corporate tax rate. And, to cover the defunding of tax enforcement for the wealthy, a proposal the leaked memo estimates will allow high-earners and corporations to evade a total of $47 billion in taxes. 

Call your member of Congress and let them know they shouldn’t make students worse off just to pay for more corporate tax cuts.  

References (page number indicates page of Republicans’ memo where the proposal is located): 

Page 11, “Eliminate Exclusion of Scholarship and Fellowship Income” 

Page 34, “Require Income Verification for School Breakfast Program (SBP) and National School Lunch Program (NSLP)” 

Page 30, “End in-school interest subsidy” 

Pages 14 and 15, “Lower the Corporate Rate to 15 Percent” and “Repeal IRA’s IRS Enforcement Funding”