Continuing To Strengthen Americans' Access to Affordable, Quality Health Coverage

The order directs all federal agencies with responsibilities related to Americans' health coverage to review their existing policies and practices and identify opportunities to expand affordable coverage, improve benefit quality, lower costs, and help more Americans enroll. Agency heads must specifically examine six areas: making enrollment and plan selection easier; strengthening benefits and provider access; improving coverage comprehensiveness and protecting consumers from low-quality plans; expanding eligibility and reducing costs in ACA Marketplaces, Medicaid, and Medicare; improving connections between the healthcare system and other stakeholders to address health-related needs; and reducing household medical debt.

The order does not itself change any regulation, create a new benefit, or impose a concrete requirement on any private party. Any actual policy changes depend on future agency action taken pursuant to this review. Standard general-provisions clauses limit the order: it cannot override existing agency authority, cannot bind OMB's budget functions, and creates no enforceable legal rights.

Federal agencies with health coverage responsibilities — spanning Medicaid, Medicare, and ACA programs — whose leadership must conduct the directed review. Ultimately, the populations who could be affected by any resulting policy changes include uninsured and underinsured Americans, ACA Marketplace enrollees, Medicaid beneficiaries, and households carrying medical debt.

Any policy changes agencies develop through this review could affect premiums, eligibility thresholds, enrollment windows, and benefit scope for millions of Americans using ACA, Medicaid, and Medicare programs. The order also explicitly targets medical debt, a financial burden affecting households across income levels.

Agency heads are told to review existing actions across six specified topic areas, but the order sets no reporting deadline and names no oversight body to receive findings. There are no enforcement mechanisms within the order itself — any concrete change requires a separate rulemaking, guidance update, or policy action. The order's general-provisions clause explicitly states it creates no judicially enforceable rights, limiting outside accountability for whether or how agencies complete the review.