The Source Blog

On August 13, 2025, President Donald Trump issued an executive order revoking Executive Order 14036 (Promoting Competition in the American Economy) issued by President Joe Biden on July 9, 2021.  Biden's executive order was remarkably lengthy and detailed, addressing many areas with significant implications for healthcare markets and competition.  Revoking the order represents a new direction in the Federal Government's competition priorities.

Biden’s Order on Promoting Competition

Biden's 2021 order was unusual in its scope and size, signaling an intention to reinvigorate antitrust enforcement across U.S. industries. The order noted that “[h]ospital consolidation has left many areas, particularly rural communities, with inadequate or more expensive healthcare options.” The order aimed to reverse corporate consolidation trends, while also placing a specific focus on areas such as non-compete clauses and anticompetitive conduct in the prescription drug market.  The order instructed federal agencies to be more aggressive in addressing consolidation in all areas.  Specifically, for healthcare, this meant heightened scrutiny of hospital mergers and addressing anticompetitive practices by payers and providers.

The Executive Order tasked the Secretary of Health and Human Services with supporting existing healthcare price transparency initiatives, ensuring that Americans can choose health insurance plans that meet their needs and compare plan offerings, lowering the prices of and improving access to prescription drugs and biologics, and addressing any efforts to impede generic drug and biosimilar competition.  The order also instructed the Chair of the FTC “to curtail the unfair use of non-compete clauses and other clauses or agreements that may unfairly limit worker mobility.”

The order adopted a "whole-of-government" approach, requiring coordination from over a dozen federal agencies.  It also established the "White House Competition Council” to coordinate the efforts of federal agencies in promoting competition across the U.S. economy.  The order directed more than a dozen federal agencies to take 72 different initiatives with the intention of promoting competition.  Overall, the order signaled a broad federal commitment to strengthening competition policy and addressing consolidation across the economy, with particular attention to healthcare.

Trump’s Revocation

The Executive Order issued by President Trump on August 13 that revoked Biden’s original order from 2021, was extremely brief and provided no rationale for the action. Biden’s 2021 order initiated a range of rulemaking by federal agencies to implement its directives, and even although Trump has subsequently revoked the order, the rules adopted under it remain binding administrative law.  As a result, it may take time for the Trump administration to unwind the effects of Biden's order

Reaction From Within the Federal Government

Although President Trump did not provide context for the revocation, other administration officials gave indications about what the move might mean.  The Department of Justice’s Antitrust Division immediately issued a statement supporting the move, declaring it to be “America First Antitrust” that “focuses on empowering the American people in the free markets, not enabling regulators and bureaucrats to prescribe outcomes”.  The statement said Trump’s order allows the DOJ “to continue its work to recalibrate and modernize the Federal approach to competition policy to suit the needs of our dynamic and innovative economy.”  The Division’s release highlights that they have already streamlined the Hart-Scott-Rodino Act (HSR) review process, including bringing back the granting of early termination in uncontroversial HSR reviews, and their use of “targeted and well-crafted” consent decrees to settle merger review concerns.  Consent decrees are agreements between the DOJ or FTC and the merging companies to deal with antitrust concerns by imposing conditions (often the sale of assets) to resolve competition issues in mergers and acquisitions.

FTC Chairman Andrew N. Ferguson issued a press release that condemned Biden’s 2021 order, claiming that it “encouraged top-down competition regulations, and established a flawed philosophical underpinning for the Biden-Harris Administration’s undue hostility toward mergers and acquisitions” contrasting it with Trump’s order “enforcing the antitrust laws passed by Congress, for the benefit of all American consumers and workers—lowering the cost of living, improving the quality of goods and services, fostering new innovations, and leading to ever-greater prosperity for our Nation."

Reactions From Others

Hannah Garden-Monheit, who served in a variety of roles under Biden including as Director for Competition Council Policy, stated, "This shows President Trump's claim he would 'Make America Competitive Again' was a sham.  Instead of enforcing the competition laws, he's throwing Main Street businesses and workers under the bus while doing favors for the rich and powerful”.  Others have commented that it “signals a broader shift away from coordinated, strong competition enforcement and toward a more politically managed approach.”

Conversely, the U.S. Chamber of Commerce responded to Trump’s action stating that “President Trump has rightfully chosen vigorous competition that entrusts American consumers to pick winners and losers in the marketplace, not more government bureaucracy.”

For the Future

The Biden administration, particularly with Lina Khan as chair of the Federal Trade Commission, took a very aggressive stance in challenging mergers, including those in the healthcare sector, and had taken strong positions on related competition issues, such as prescription drug prices and non-compete agreements.  During this time, the FTC filed suits to challenge healthcare mergers, including those between Lifespan and Care New England Health, HCA Healthcare and Steward Health Care, Illumina and Grail, Amgen and Horizon Therapeutics, and Novant Health and Community Health Systems.  The DOJ also challenged mergers, such as those involving UnitedHealth Group and Change Healthcare.  Additionally, the FTC also attempted to issue an ambitious rule banning many non-compete clauses in employee contracts.

Experts, including The Source, have spent months attempting to read the tea leaves to gauge the direction the Trump administration might take on antitrust enforcement and other issues related to competition.  While the revocation of Executive Order 14036, along with the subsequent statements from the DOJ and FTC, is the clearest sign yet that Trump intends a significant break from his predecessor's policies, the FTC under President Trump recently began a public inquiry about non-compete agreements to inform future policy.  Also, Trump officials have stated a willingness to continue using the 2023 Merger Guidelines at least for the present time.

For now, existing antitrust laws remain in place, meaning that mergers and acquisitions could still face scrutiny.  However, Trump's actions suggest that the federal enforcement environment will be friendlier to consolidation.  With the FTC and DOJ set to play a more minor role in challenging healthcare consolidation, the importance of state Attorneys General becomes significant.  The willingness of state legislatures to continue to pass laws addressing healthcare competition, and the ability of State AGs to enforce state and federal laws, may represent the best hope for limiting further consolidation in healthcare markets.

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