A lot has happened in the three months since President Trump began his second term in office, or has it?
There have been dramatic headlines, government layoffs, import tariffs, and a slew of executive orders. The endless news cycle suggests the United States is immeasurably different than it was at the end of 2024. However, less has changed than you might think.
Why? The makeup of Congress and the checks and balances afforded us by the Constitution.
The Current State of Government: Narrow Majorities
Tim Fraser, CNECT’s VP of Government Affairs
The Republican party holds the presidency, and the majorities in both the house and senate. This trifecta normally lays the perfect foundation for a party to progress its agenda. In 2025, this doesn’t tell the full story.
As it stands, the Republicans have a one-seat majority in the House, and a four-seat majority in the Senate, meaning near full party consensus is required for bills to pass. Factions within the Republican party, like the highly conservative Freedom Caucus, can make consensus difficult, and many iterations of policies are required to secure approval.
So far, what we’re seeing is getting things done is hard — and the government doesn’t like things that are hard to accomplish.
Checks and Balances: Stymied Policy Progress
Another factor slowing the Trump administration’s progress is a fundamental principle of the U.S. Constitution: checks and balances.
Starting with 26 on his first day in office, President Trump has now signed over 100 (and counting) executive orders. The purpose of executive orders is to bypass Congressional voting, therefore avoiding the challenges of narrow majorities.
However, an executive order does not change existing laws; only Congress can make changes. Executive orders are much more limited in their impact and must pass a judicial review, which grants courts the power to strike down orders they deem to be unlawful or unconstitutional.
And this is what is currently happening.
Policies in Place: The President’s Progress So Far
This is not to say President Trump hasn’t successfully implemented policies. Many of his executive orders have been enacted, to varying degrees of impact. Rather than list them all, I’ll highlight a few policies likely to directly affect you and your organization.
Tariffs
Originally thought to be a trade bargaining tool, tariffs have fast become this administration’s signature policy, and April 2 — or “Liberation Day” as the President called it — was its premiere.
The purpose of tariffs is either to encourage domestic trade and manufacturing by taxing imports or leverage reduced tariffs on American imports in exchange for removing them. We don’t yet know if these tariffs will bring long-term success, but their short-term impact has been characterized by:
- Increasing prices, with consumers bearing the brunt.
- Plunging stock markets around the world.
- Strained relationships and looming trade wars with partners and allies.
Right now, the biggest impact to organizations is suppliers raising prices. I’ve seen first-hand the lengths CNECT goes to protect its members from economic shifts. In fact, they were highlighted in March’s supply chain update email.
Looking ahead, the aftermath of April 2 has raised concerns of a recession in the U.S. The government affairs team and I will continue to monitor economic forecasts, and we’ll be sure to keep you up to date.
Government Workforce
Shrinking government and its responsibilities has proven to be another hallmark of President Trump’s second administration.
The Department of Government Efficiency (DOGE) has cut jobs, funding, and programs across several government departments.
DOGE has targeted the Department of Health and Human Services (HHS), cutting billions of dollars of approved funding and blocking investment across various programs and research projects. More concerning, 10,000 HHS jobs have been eliminated with another 10,000 accepting the “fork the road” optional resignations.
Additionally, DOGE’s “Dismantling” of the Department of Education will give the responsibility of managing education back to the states, which could affect the availability of certain skilled workers in your area over the coming years.
Legal challenges remain over many of these workforce and funding cuts. For our healthcare members, it’s important to identify which, if any, of the vulnerable programs your organization benefits from and start planning for a potential future without them.
It’s time for planning, not panic.
Future Government Agenda: What’s on the Horizon?
It’s proven difficult to nail down specifics when it comes to this administration’s policies. That said, I can confidently say they will continue to pursue three pillars of their agenda:
- Strength in defense.
- Immigration reform and border control.
- Tax cuts (and how to fund them).
Tariffs and reduced departmental budgets are both cost-saving measures necessary for President Trump to pursue his aggressive tax cuts, highlighted by reducing corporation tax and providing tax relief for some of the highest-earning Americans.
Debt Ceiling Deadline
The debt ceiling sets the legal limit on the amount of money the U.S. government can borrow. The most recent limit of $36.1 trillion was reinstated by Congress in January.
It is the responsibility of the government to agree to a funding bill that ensures spending stays below the debt ceiling. Currently, such a package is in the works but has not been agreed.
If no spending package is agreed upon, the U.S. will default on its debt somewhere between July and September. This hasn’t happened since 1971, and I don’t see it happening in 2025.
Budget Reconciliation Bill Progress
As mentioned above, the GOP is facing difficulties in progressing its agenda — the reconciliation bill is no exception.
Negotiations have been fierce within the House and the Senate and between the two chambers. Areas of disagreement include:
- Cuts to Medicaid and safety-net programs.
- The severity of tax breaks and budget cuts.
- The extent to which tax breaks will add to the deficit.
In recent weeks, the Republicans have made progress — but it’s still in the early stages and compromise on the level of offsets still need to be agreed upon. Reconciliation only requires a simple majority, so it’s far easier to negotiate and compromise within your party than it is when bipartisanship is required. There is a window of time for advocacy, with Speaker of the House Mike Johnson working toward a final product by August Recess.
Threats to Medicaid: Insight for Healthcare Organizations
I’ll start by saying this: we are not on the precipice of chaos right now, but we are close, and advocacy is needed.
The budgets for Medicaid and Medicare are indeed vulnerable, and forecasts suggest budget reconciliation is impossible without cuts to the program. But plenty stands in the way of dramatic cuts.
The government has yet to even agree on the severity of cuts, let alone start mapping out how they will be enacted. Cuts to Medicaid remains a bone of contention between the House and the Senate. Those differences may be resolved soon, especially if a budget reconciliation is to be passed, but even if decisions do happen this year, the effects will be delayed, because implementation takes time.
The mid-term elections also loom large for many senators and representatives. Who’s going to vote for them if they’ve just taken their health insurance away?
In summary: The federal Medicaid cuts will not occur this fiscal year, but scenario planning is necessary, and I encourage you to start now.
Ongoing Advocacy: How We’re Supporting You
You’re in good hands.
We’ve set up a dedicated rapid response team to work alongside government affairs in actively tracking executive orders, policy changes, judicial action, legislative proposals, and regulatory updates that may impact health care.
This includes monitoring tariff policies and supply chain stability to ensure our agility in responding to shifts affecting operational costs or access to medical supplies and pharmaceuticals.
I can personally attest to the strong relationships we maintain with policymakers, industry leaders, and advocacy organizations. They make it much easier for us to anticipate and react to changes in real time.
We’ll continue to send our members the monthly supply chain update email to share any information or insights you need to know.
Community Health and Advocacy
We remain committed to protecting and advancing the interests of our community health center members. My team is relentless in our advocacy for policies that continue to support CHCs, providers, and patients.
We’re steadfast in our focus on preserving critical programs like Medicaid, Medicare, the 330 grant, the 340B drug pricing program, and value-based care initiatives, while also addressing external factors like trade policies that will impact the cost and availability of essential health care supplies.
We’re fighting for you, and we’ll get through this challenging period together. Remember, it’s time for planning and advocacy, not panic.