What is an executive order?

Federal executive orders are written directives from the president of the United States to shape federal policy in specific ways. Executive orders are typically used to manage agencies and employees under the president’s control — for example, the US Department of Health and Human Services or the Food and Drug Administration — and may require them to take or refrain from taking specific actions. Executive orders enable presidents to respond to emergencies, set internal government policies and priorities, or issue instructions and guidance to staff. Executive orders have a long history and have been used, to varying degrees, by almost all US presidents.

For more on executive orders, see this report from the nonpartisan Congressional Research Service or the American Civil Liberties Union’s answers to FAQs in What Is an Executive Order and How Does It Work?.

For information on types of laws and how they relate to various government entities, please see ChangeLab Solutions’ short training video What Types of Laws Can Governmental Agencies Enact and Enforce?.

How can executive orders affect public health practice?

Executive orders cannot change statutes or the Constitution, or judicial interpretations of either. However, they can affect public health practice in various ways. Some executive orders are explicitly intended to guide the operations of federal public health agencies or promote public health goals. Because agencies interact with other government bodies, including state and local agency staff and officials, as well as with non-governmental organizations, executive orders can influence how non-federal actors work with their federal partners. Previous federal administrations have used executive orders to guide federal agencies’ COVID-19 response; establish interagency workgroups to improve service coordination for mental and behavioral health; and facilitate the gathering, sharing, and publishing of data to address public health threats.

Other executive orders apply broadly across federal agencies or do not have an explicit public health focus but may nevertheless have a profound effect on how governmental public health practitioners carry out their day-to-day duties and responsibilities. For example, for decades, executive orders have required federal agencies to assess the costs and benefits of proposed regulations that affect areas like environmental quality, food safety, and Medicare and Medicaid. Additionally, by directing the operations of federal agencies, executive orders can affect their capacity to perform their functions, including, in the case of public health agencies, protecting health.

What are the limits of executive orders?

The Supreme Court has explained that executive orders must be rooted in one of the president’s powers as outlined in the US Constitution or a law passed by Congress. Thus, the US Constitution and existing federal laws limit what executive orders can cover.

Executive orders are typically used to manage the internal operations of federal agencies and employees under the president’s control. Executive orders generally do not act like far-reaching, new federal laws, nor have executive orders generally been used to thwart judicial rulings or undermine constitutionally sound laws adopted by Congress. And aside from emergency contexts, executive orders generally do not directly govern the conduct and behavior of people and organizations outside of the executive branch. However, this area of the law is rapidly evolving due to ongoing litigation.

To learn more about how a balance of power is maintained between the three branches of government and the types of laws that each branch can create, refer to ChangeLab Solutions’ training Structure of Government.

How can executive orders be challenged or stopped?

The actions that federal agencies take in response to executive orders can affect their state, local, and non-governmental partners, as well as influence people’s lives. Those harmed by an executive order can challenge it by filing a lawsuit in federal court. Parties who can file such lawsuits include cities, states, legislators, and other government officials.

Courts can pause executive orders through temporary restraining orders (short-term pauses) or preliminary injunctions (longer-term pauses) while a court reviews their legality. If a federal court decides an executive order is unlawful, the court can strike it down or limit its application. Executive orders can also be reversed through new laws passed by Congress, or they can be amended, repealed, or replaced by a new president.

What are some recent executive orders that may affect public health practice?

Below are brief summaries of several relevant orders, with links to each. Many of these orders are currently being reviewed by courts. To track these and other related executive orders and see the status of any legal challenges to them, see Democracy 2025’s Response Center tracker. 

Note: Additional information about specific executive orders and their implications for public health is forthcoming from Act for Public Health and from other partners, linked in the Resources section at the end of this document.

• Executive Order 14168 states that it is the policy of the federal government to recognize only male and female as unchangeable sexes. The order directs federal agencies to update all agency policies, documents, and forms accordingly. It also prohibits the use of federal funds to promote “gender ideology” and directs federal agencies to enforce sex-based rights only as they relate to two biologically distinct sexes.
• Executive Order 14173 directs federal agencies to eliminate all DEIA (diversity, equity, inclusion, and accessibility) programs and policies, as well as to terminate DEIA-related contracts.
• Executive Order 14151 directs federal agencies to eliminate all offices, positions, and programs related to DEIA and environmental justice, as well as to terminate all equity-related contracts and grants.
• Executive Order 14187 directs federal agencies to work toward eliminating gender-affirming care for minors by prohibiting agencies from “fund[ing], sponsor[ing], promot[ing], assist[ing], or support[ing]” gender-affirming care.
• Executive Order 14148 rescinds prior executive orders related to pandemic response, public health–related environmental protections, DEI initiatives, and more.
• Executive Order “Establishing the President’s Make America Healthy Again Commission” establishes the Make America Healthy Again Commission, which is made up of officials from many federal agencies, including the National Institutes of Health and the Centers for Disease Control and Prevention, as well as agencies such as the Department of Education and the Department of Housing and Urban Development. The commission is tasked with developing a strategy to address a chronic disease crisis among children.

Constitutional provisions and doctrines apply to these executive orders and may limit their applicability or legality. These provisions include, for example,

• Equal protection rights guaranteed by the Fourteenth Amendment (and laws enforcing those rights — such as the Americans with Disabilities Act and the civil rights acts);
• Due process rights guaranteed by the Fifth Amendment;
• Free speech rights guaranteed by the First Amendment; and
• The separation of powers of the three branches of the federal government, as well as powers reserved for the states in the Tenth Amendment, such as states’ police powers to promote people’s health and safety.

Recent executive orders do not change these or any other laws. An executive order would need to be challenged in court to enforce any relevant laws and Constitutional provisions, as some have been.

How can I know whether a federal executive order affects my work?

Generally, if you have a working or funding relationship with a federal agency, your federal partners are crucial in determining how you may be affected, if at all. You can review documents relevant to your partnership — such as contracts, grants, or other types of agreements you have with federal entities — to ground conversations and gauge potential impacts. While executive orders are generally binding for affected agencies, the legality of many of the recent orders — including how they may affect actors outside of federal executive agencies — is unclear or untested. Many recent executive orders are currently under review by courts, and some have been paused while courts review them. The status of recent executive orders is subject to change resulting from court decisions, executive retractions, or congressional reversals.

Having a system in place to track and read executive orders can help you stay current on new developments. Generally, executive orders are shorter and easier to understand than statutes, regulations, or judicial opinions. Executive orders may plainly state their purpose, what the order applies to, when the order takes effect, whether it applies retroactively, and how to comply. That said, many of the recent federal executive orders are ambiguous or contradictory or include directives that are difficult to implement — all of which present challenges for compliance.

In addition to the orders themselves, it can be helpful to review any memos or new rules issued by agencies to implement these orders. These memos and rules often contain additional information and details about how the agency is interpreting the order and how it plans to implement or enforce the order.

How might I respond to a potentially relevant executive order?

While recent executive orders appear to target existing public health practices and are designed to prompt preemptive and expansive action to comply, acting in this way could potentially result in unnecessary overcompliance. It is advisable to consult with an attorney first, to consider options and assess risks. An attorney might be able to provide insight into

• Whether and how an executive order or other communications from executive branch agencies or officials affect your work;
• Whether proposed responses are likely to comply with the order or other sources of law (e.g., contracts or state and local law);
• The likelihood of federal enforcement; and
• The likelihood of a successful legal challenge to the order or actions taken by executive branch agencies or officials.

Other partners, such as state and local government agencies or public health organizations, might be able to share additional insight.

Given the unprecedented scope of these executive orders, answers will not always be clear. Decision making should be made strategically among partners, with the best available information related to the importance of the practices potentially restricted by the order; the health, fiscal, or administrative costs associated with proposed responses to comply with the order; your or your entity’s resources and risk tolerance; and the legality of the order.

What if I have additional questions?

An attorney can assist with interpretation and help you understand how specific executive orders might or might not apply to your work. If you do not have legal counsel, you might consider engaging a law firm, a nonprofit organization, or a local law school for representation (paid or pro bono).

You can also submit a request for technical assistance to Act for Public Health if you have additional questions.

Additional information about these executive orders and their implications for public health is forthcoming from Act for Public Health. We will update this page with new information as it becomes available.

Resources

Trackers (including tracking of legal challenges to executive orders)

• Democracy 2025: Response Center Tracker
• Just Security: Litigation Tracker: Legal Challenges to Trump Administration Actions
• Forbes: Here Are All the Major Lawsuits Against Trump and Musk
• Economic Policy Institute: Federal Policy Watch

Effects of recent executive orders

• Human Rights Campaign: Understanding Executive Orders and What They Mean for the LGBTQ+ Community
• National Council of Nonprofits: Executive Orders Affecting Charitable Nonprofits

Executive orders

• American Civil Liberties Union: What Is an Executive Order and How Does It Work?
• American Bar Association: What Is an Executive Order?
• Congressional Research Service: Executive Orders: An Introduction
• Congressional Research Service: Executive Orders and Presidential Transitions

Structure of government

• ChangeLab Solutions: What Types of Laws Can Governmental Agencies Enact and Enforce?
• ChangeLab Solutions: Structure of Government

2/21/2025