4 Things That Breast Cancer Experts Are Watching in the New Administration

Editor's note: We're closely tracking actions that could change breast cancer research and care. Watch this space for updates.

President Donald Trump was only just sworn in on January 20, 2025, and yet it feels like there have been several months’ worth of executive orders, funding bans, policy changes (and reversals to changes), and more. It can be hard to follow it all — much less make sense of what it might mean for you. 

“We’re in very uncharted territory with what we’re seeing during the first weeks of the new administration,” says Joanna Fawzy Doran, a cancer rights attorney and CEO of Triage Cancer.  The actions are “coming so fast and furious, it’s like drinking water out of a firehose.”  

Many of the changes directly affect the healthcare system, but many are also temporary, unclear, or tied up in court, leaving even researchers and cancer advocates unsure about how to proceed with their work. It remains to be seen which changes will have staying power, but many of the Trump administration’s orders and plans could limit access to health insurance and healthcare and slow the progress of cancer research — which has many breast cancer experts worried.

What will this mean for people living with breast cancer or people yet to be diagnosed? Whose treatment could be affected? Who may no longer be enrolled in clinical trials or even counted as a clinical trial participant? Ten experts in research, healthcare, law, and advocacy weighed in. 

DEIA has been built up to be a political issue, but it plays an important role in breast cancer research, care, and outcomes. Studies show that the number of people who get breast cancer — and how well their treatment works — varies across racial and ethnic groups. Because of this, the findings of a study that only looks at breast cancer in one group of people may not apply to a different group of people. We also know that having providers from diverse backgrounds benefits patients. “This is not a 'woke' mentality,” says Fumiko Chino, MD, a cancer researcher and assistant professor in breast radiation oncology at MD Anderson Cancer Center. “Evidence backs this up. For example, a diverse workforce can both improve outcomes and reduce costs.”

But DEIA, says Chino, has been “dumbed down to this idea that [it’s just about] trying to include more Black people or … more Hispanic people [in research].” It’s much broader than that, she explains. “The full realm of diversity, equity, and inclusion means that we're trying to make sure that we see all the barriers to receiving care. That includes people in rural areas, people who might be in a city center but have poor access to health care for other reasons, … young patients, people with kids in the home, the very old. There are many different ways that a one-size-fits-all treatment paradigm doesn't benefit the large group of people who [get] cancer because no cancer treatment should be one-size-fits-all. We really should be customizing our treatments to the individual.” 

The orders: Upon taking office, Trump issued executive orders 14151 “Ending Radical and Wasteful Government DEI Programs and Preferencing,” 14173 “Ending Illegal Discrimination and Restoring Merit-Based Opportunity,” and 14168: “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.”

Current status: Trump directed all federal agencies to end their DEI programs and practices and to stop giving funding to organizations that have DEI programs and practices. He also called for a crackdown on DEI in higher education. This area has a potentially very broad reach — from the research that gets funded, to clinical trial recruitment, to training and hiring of a healthcare workforce as diverse as the patients they serve, to ultimately having better science around how breast cancer functions in different people. These executive orders are currently in force. 

“There’s the potential for a really devastating shift in the things we’re going to be able to study, and for groups of patients that have already been chronically under-studied and under-represented in clinical trials,” says Kathy Miller, MD, professor of oncology and of medicine and associate director of clinical research at the IU Simon Cancer Center in Indianapolis, Indiana.

The National Institutes of Health (NIH) is the largest funder of cancer research in the world. When the NIH is functioning normally, it provides grants to cancer research teams — including those conducting clinical trials at hospitals, medical schools, and other institutions across the nation. Research funded by the NIH and other federal agencies has always been vital to advancing the understanding of breast cancer, developing better treatments, and improving care and outcomes. 

Before any study is funded, researchers submit proposals outlining their plans for the study and how it will advance science. The best of these proposals are then discussed in meetings called study sections, where groups of experts narrow them to the best of the best. For a breast cancer researcher, any delay in these steps slows down the process of answering important questions about the disease, new treatments, and more. For a person living with breast cancer looking for a clinical trial, delays in funding for new trials could mean that they can’t access treatments that could help them.  

“Cancer research has long enjoyed bipartisan support,” Lisa Lacasse, president of the American Cancer Society Cancer Action Network, said in a statement. “Robust and sustained research funding needs to be preserved and continued, so that everyone has a fair chance to detect, treat and survive cancer.”

The orders: A memo issued by the Office of Management and Budget (OMB) called for a temporary freeze on nearly all federal grants, including to community health centers. A notice banned most communications with the outside world from the NIH and other federal health agencies. Executive order 14151 “Ending Radical and Wasteful Government DEI Programs and Preferencing” will also affect research. In addition, a new policy change could dramatically reduce how much NIH puts towards a research team’s overhead costs (such as lab equipment, utilities, and paying for support staff).

Current status: The temporary grant freeze has been rescinded, although there are still reports that some promised funding is frozen. It doesn’t appear that any NIH-funded clinical trials that had started before Trump took office were paused or stopped. Many researchers who have grant proposals that are in the process of being considered or approved are worried, especially those whose proposals include concepts or language considered to be DEIA-related. And the cancellations of some NIH study section meetings in January and February are causing delays in grant approvals and research. Some parts of the communications ban remain in place, while others have been lifted. A federal judge ordered a temporary pause on the cuts to funding for overhead costs.

Millions of Americans — including many of those affected by breast cancer — are insured through Medicaid, Medicare, or plans purchased on their state’s Health Insurance Marketplace (also called ACA plans). Under President Joe Biden, the number of Americans enrolled in Medicaid and Marketplace plans grew significantly — in large part because the administration made it easier for Americans to sign up for coverage. It extended enrollment periods, subsidized plan costs, and funded organizations that help people enroll. Reducing barriers to health insurance is important because many people with breast cancer find it difficult to afford their care and their prescriptions. 

The orders: Trump revoked a number of Biden’s executive orders, including one that sought to protect and strengthen Medicaid and the ACA and another to lower prescription drug costs. The Trump administration is currently looking to cut other federal programs that help Americans access healthcare services. 

Current status: These rollbacks are currently in force and are likely to result in fewer people enrolling in Medicaid and ACA Marketplace plans. Because open enrollment season has just ended, though, the effects may not be fully felt until later this year. Also, Congress is considering making huge cuts to federal spending on Medicaid.

“Cutting back Medicaid and Marketplace coverage means that more people won’t be able to access cancer care without profound financial hardship,” says Miller. “It will be bad for cancer outcomes and will reduce the number of patients who are able to enroll in clinical trials.”

Transgender and non-binary people, who make up about 1% of the U.S. adult population (approximately 3 million adults), face many health risks, including breast cancer. Trans men, trans women, and non-binary people (and cisgender men) can all develop the disease. While there is limited data on breast cancer risk in transgender people, research shows that LGBTQ+ people face higher cancer rates and worse health outcomes in the U.S.

“A lot of our concerns are that work that is being done to try and help ensure that trans communities have equal access to resources, like cancer screenings, and treatment will be shuttered before it’s even initiated,” says Scout, MA, PhD, executive director of the National LGBT Cancer Network (Scout has only one name).

The order: Executive Order 14168: “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government” recognizes only two sexes, male and female, and prohibits the acknowledgement of gender or gender identity in federal agencies. 

Current status: This executive order is in force and has widespread consequences on transgender health research and programs, including any scientific research that studies gender minorities. The CDC has removed webpages and datasets that included information about transgender and gender-diverse people, including health disparities. Other science agencies, including the NIH, are reviewing programs that violate the order. 

“If the federal government pulls grants already studying the transgender population … then the studies stop and we have less information,” says Amy Beumer, Ph.D., a metastatic breast cancer advocate who serves on the executive committee of METAvivor, a nonprofit that funds metastatic breast cancer research. “If we don’t have this information, we don’t move the needle forward on studying disparities in breast cancer.” 

It’s still unclear how this executive order will affect breast cancer research, prevention, and treatment for transgender people. But Scout worries that if the trans community can’t access vital healthcare, like cancer screenings, or welcoming providers, we'll see higher cancer incidence in this population in coming years. 

“We can close our eyes and pretend this group doesn’t exist,” Scout says. “But we do exist.”

“We need to be speaking up and out,” says Beumer, who has been living with metastatic breast cancer since 2020. Still, she recognizes that some people living with breast cancer and their caregivers might not have the bandwidth — and that’s OK too. “There are so many things you’re dealing with in life to try to get healthy. You can’t do any of this if you’re not healthy,” Beumer says.

If you feel up to it, here are a few actions you can take:

“Using our voices can only help,” says Doran. “Tell your members of Congress and your state elected officials to push back on some of the things that you don’t agree with, that have very practical implications for you. There is value in communicating the real impact of their decisions [on constituents like you]. It really fuels their decision-making process.”  

To easily find your current elected officials (at the federal, state, and local levels) and their contact info, use Common Cause’s Find Your Representatives tool.

5calls.org also makes it easy to find the phone numbers for your members of Congress and provides scripts of what to say about particular issues. 

Triage Cancer offers a guide to cancer legislative advocacy that includes tips on communicating with your elected officials. In addition, you can watch their recent webinar about post-election advocacy at the federal and state levels.

The American Cancer Society’s Cancer Action Network, the National Coalition for Cancer Survivorship, and the National Breast Cancer Coalition also have many ongoing advocacy opportunities if you’re interested in improving the health care system for people affected by cancer. 

The most important thing to do is, of course, take care of yourself and stay connected to those you love as much as possible. This is always true, but in this case, self-care can also be a powerful tool for resistance. Many experts say that the intensity and pacing of these orders is overwhelming by design: They can quickly lead us to feel stressed, overwhelmed, and paralyzed, making it harder for us to respond. Even if you don’t have the energy to make calls or engage, staying as healthy and hopeful as possible can have profound ripple effects for those around you. Breastcancer.org has free virtual support groups where you can find community and share your feelings and experiences with others facing breast cancer.