Trump Administration’s 18-Month Health Care Record: What Changed for Drug Prices, Insurance and Patients?

The Trump administration and Health and Human Services Secretary Robert F. Kennedy Jr. are highlighting 18 months of changes to U.S. health policy, with drug prices, insurance transparency, rural health care, food policy and government oversight among the major areas affected.

The U.S. Department of Health and Human Services marked the administration’s first 555 days with a broad review of its health-policy actions on August 21, 2026. The department says the effort has focused on prevention, lowering health costs, increasing transparency and changing how federal health programs operate.

The announcement covers a wide range of policies, from prescription drug pricing and hospital transparency to rural health funding, prior authorization and efforts to reduce fraud.

Some of the administration’s claims involve policies that are still being implemented or measured, while others have drawn questions from health-policy experts and lawmakers. KFF’s separate tracking of HHS actions shows how extensive the policy changes have been since the administration returned to office.

Prescription drug prices are a major focus

One of the administration’s most visible health-care initiatives is the effort to reduce prescription drug costs.

HHS says the TrumpRx program has generated more than $700 million in savings for Americans and that more than 800 prescription drugs are now available through the platform.

The administration has also pursued a Most Favored Nation pricing strategy, seeking to bring U.S. drug prices closer to prices paid in other developed countries.

The White House recently said prescription drug prices had recorded their largest annual decline in more than six decades and attributed the change to its policies. However, independent reporting has noted that the causes of the decline are more complicated, with existing policies such as Medicare drug-price negotiations also potentially contributing to lower prices.

There is also debate over how the administration calculates the more than $700 million in TrumpRx savings. Bloomberg reported that lawmakers have sought additional information about the figure and the agreements behind the program.

For consumers, the important distinction is that a lower advertised cash price does not necessarily mean it will be cheaper than using health insurance. Patients still need to compare the TrumpRx price with their insurance copay, deductible, pharmacy benefits and available generic alternatives.

Health insurers face pressure to change prior authorization

Prior authorization has become another major target of the administration’s health-care agenda.

The process requires patients or doctors to obtain approval from an insurer before certain treatments, procedures or medications are covered. Critics have long argued that complicated authorization requirements can delay care.

In 2025, Kennedy and CMS Administrator Mehmet Oz secured a voluntary commitment from major health insurers to make the process faster and more standardized. The participating insurers cover a large share of Americans, and the commitments included reducing unnecessary authorization requirements and moving toward electronic processes.

The issue continued into 2026. CMS has been working on interoperability and electronic prior-authorization requirements, while health-care organizations have pushed for standardized timeframes and better transparency around authorization decisions.

For people with health insurance, this could eventually mean fewer paperwork delays and faster decisions when seeking covered care. But the effect will depend on how the voluntary commitments and federal requirements are implemented.

Hospital prices are under greater scrutiny

The administration is also continuing its push for hospital price transparency.

Federal hospital price-transparency requirements already require hospitals to publish information about their standard charges and negotiated rates. For 2026, CMS changed the required allowed-amount data elements, including median, 10th-percentile and 90th-percentile amounts for certain negotiated charges.

HHS also said in its August review that more than 500 hospitals were still not complying with federal transparency requirements and could face penalties.

The issue matters to insured patients because the amount a hospital charges is not necessarily the amount a patient’s health plan will pay. Comparing negotiated rates and out-of-pocket costs can be particularly important for people with high deductibles or coinsurance.

$50 billion rural health program is moving forward

Rural health care is another major part of the administration’s health-policy agenda.

The Rural Health Transformation Program provides $50 billion over five years, with funding distributed from fiscal years 2026 through 2030. CMS documentation shows that the program is designed to support rural health systems, improve access to care and encourage new approaches to delivering services.

States began receiving their first-year awards in 2026. Reuters reported that individual state awards for the first year ranged from about $147 million to $281 million.

The funding could be significant for communities where hospitals and primary-care providers face financial and workforce pressures.

For people living in rural areas, the practical question will be whether the money translates into more available providers, stronger hospitals, expanded services and improved access to care.

HHS says it has identified billions in potential fraud

Fraud and improper spending in federal health programs have also become a major focus.

HHS says it has uncovered nearly $100 billion in fraud, saved more than $46.1 billion and recovered about $30.5 billion.

Those numbers are claims from the department’s own accounting of its enforcement efforts and should not be interpreted as proof that all of the identified amount represents confirmed criminal fraud.

The administration has also taken action involving Medicaid payments while reviewing suspected fraud and compliance problems in certain states.

The broader goal is to reduce improper payments while protecting access to Medicaid and other federal health programs.

Food and chronic disease prevention are central to the MAHA agenda

Not all of the administration’s health reforms involve insurance or medical care.

A large part of Kennedy’s agenda has focused on nutrition and chronic disease prevention through the Make America Healthy Again, or MAHA, initiative.

HHS says the administration has pushed new dietary guidelines, restrictions on petroleum-based synthetic food dyes and greater scrutiny of food ingredients. In August, HHS proposed requiring manufacturers to notify the FDA when they determine that an ingredient qualifies as Generally Recognized as Safe, or GRAS. HHS and USDA also submitted a proposed federal definition of ultra-processed foods.

The White House’s MAHA materials similarly identify food quality, childhood health and prevention as central priorities.

These policies are aimed at addressing chronic disease before expensive medical treatment becomes necessary, although their long-term effect on health outcomes will take time to measure.

The administration is also changing the federal approach to vaccines and research

HHS has made substantial changes to federal vaccine policy and biomedical research.

The department says the administration has reinstated a federal task force focused on childhood vaccine safety and has moved toward a different framework for childhood vaccine recommendations.

The administration has also announced restrictions on federally supported gain-of-function research and changes to COVID-era emergency authorities.

These policies have generated significant debate among public-health experts, physicians and policymakers, meaning the administration’s description of the reforms should be distinguished from independent assessments of their medical and public-health effects.

Rural and community health centers are expanding

Another part of the administration’s health-care agenda is expanding access to primary care.

HHS says HRSA-funded health centers served more than 32.7 million patients in 2025, the highest number in the program’s history.

In August 2026, HHS also announced $102 million in New Access Points funding, supporting 158 health centers and 415 new sites, according to the department.

The expansion is particularly relevant to people who live in communities with limited access to primary-care providers.

What the changes mean for people with health insurance

For consumers, the administration’s 18-month record is less about one single health-care change and more about several policies that could affect the cost and experience of receiving care.

The biggest areas to watch are prescription drug prices, prior authorization, hospital price transparency, rural health access and federal health-program oversight.

Drug-price initiatives could reduce some cash costs, but consumers should still compare those prices with insurance coverage and pharmacy benefits.

Prior-authorization reforms could reduce delays, but implementation across insurers and health plans will determine how much patients actually notice.

Hospital transparency rules could give consumers more information about the cost of care, particularly when they are comparing providers or planning elective services.

And the rural-health program could affect access to hospitals and primary care in communities that have historically faced fewer medical resources.

The bigger question is whether the reforms produce measurable results

The August 21 HHS announcement presents the administration’s first 555 days as a major transformation of American health policy.

There is no question that the administration has made a large number of policy changes across HHS, FDA, CMS, NIH and other federal health agencies. KFF’s ongoing tracker likewise documents a broad range of actions affecting public health and health policy.

But the more important test will be what happens next.

Prescription prices will need to be measured against actual consumer spending. Prior-authorization reforms will need to show whether patients receive faster decisions. Rural-health investments will need to demonstrate improved access and outcomes. And efforts to reduce fraud will need to distinguish confirmed improper payments from broader investigations and suspected misconduct.

For Americans, the success of the health-care agenda ultimately will not be measured by the number of policies announced. It will be measured by whether people can afford care, obtain treatment without unnecessary delays and understand what their health care will cost.

The Bottom Line

The Trump administration’s 18-month HHS review highlights major changes involving prescription drugs, insurance processes, hospital transparency, rural health and chronic-disease prevention. The policies are significant, but their long-term impact will depend on implementation and measurable results for patients.