Eliminating Waste, Fraud, and Abuse in Medicaid My Administration has been relentlessly committed to rooting out waste, fraud, and abuse in Government programs to preserve and protect them for those who rely most on them. The Medicaid program was designed to be a program to compassionately provide taxpayer dollars to healthcare providers who offer care to the most vulnerable Americans. To keep payments reasonable, billable costs for such care were historically capped at the same level that healthcare providers could receive from Medicare. The State and Federal Governments jointly shared this cost burden to ensure those of lesser means did not go untreated. Under the Biden Administration, States and healthcare providers were permitted to game the system. For example, States “taxed” healthcare providers, but sent the same money back to them in the form of a “Medicaid payment,” which automatically unlocked for healthcare providers an additional “burden-sharing” payment from the Federal Government. Through this gimmick, the State could avoid contributing money toward Medicaid services, meaning the State no longer had a reason to be prudent in the amount of reimbursement provided. Instead of paying Medicare rates, many States that utilize these arrangements now pay the same healthcare providers almost three times the Medicare amount, a practice encouraged by the Biden Administration. These State Directed Payments have rapidly accelerated, quadrupling in magnitude over the last 4 years and reaching $110 billion in 2024 alone. This trajectory threatens the Federal Treasury and Medicaid’s long-term stability, and the imbalance between Medicaid and Medicare patients threatens to jeopardize access to care for our seniors. I pledged to protect and improve these important Government healthcare programs for those that rely on them. Seniors on Medicare and Medicaid recipients both deserve access to quality care in a system free from the fraud, waste, and abuse, that enriches the unscrupulous and jeopardizes the programs themselves. We will take action to continue to love and cherish the Medicare and Medicaid programs to ensure they are preserved for those who need them most. The Secretary of Health and Human Services shall therefore take appropriate action to eliminate waste, fraud, and abuse in Medicaid, including by ensuring Medicaid payments rates are not higher than Medicare, to the extent permitted by applicable law. This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person. DONALD J. TRUMP

By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered:

Section 1.  Purpose.  The United States stands at the threshold of a bold new chapter in aerospace innovation.  For more than 50 years, outdated and overly restrictive regulations have grounded the promise of supersonic flight over land, stifling American ingenuity, weakening our global competitiveness, and ceding leadership to foreign adversaries.  Advances in aerospace engineering, materials science, and noise reduction now make supersonic flight not just possible, but safe, sustainable, and commercially viable.  This order begins a historic national effort to reestablish the United States as the undisputed leader in high-speed aviation.  By updating obsolete standards and embracing the technologies of today and tomorrow, we will empower our engineers, entrepreneurs, and visionaries to deliver the next generation of air travel, which will be faster, quieter, safer, and more efficient than ever before.

Sec. 2. Regulatory Reform for Supersonic Flight. (a)  The Administrator of the Federal Aviation Administration (FAA) shall take the necessary steps, including through rulemaking, to repeal the prohibition on overland supersonic flight in 14 CFR 91.817 within 180 days of the date of this order and establish an interim noise-based certification standard, making any modifications to 14 CFR 91.818 as necessary, as consistent with applicable law.  The Administrator of the FAA shall also take immediate steps to repeal 14 CFR 91.819 and 91.821, which will remove additional regulatory barriers that hinder the advancement of supersonic aviation technology in the United States.
(b)  Within 18 months of the date of this order, the Administrator of the FAA shall issue a Notice of Proposed Rulemaking (NPRM) to establish a standard for supersonic aircraft noise certification under 14 CFR Part 36 and amend 14 CFR 91.817.  The proposed rule shall define acceptable noise thresholds for takeoff, landing, and en-route supersonic operation based on operational testing and research, development, testing, and evaluation (RDT&E) data as identified in subsection 3(a) of this order, and considering community acceptability, economic reasonableness, and technological feasibility.  The proposed rule shall further specify a process for periodic review and update of the rule to reflect future advances in aircraft noise reduction technology.  Any final rule in connection with the NPRM shall be issued within 24 months of the date of this order.

Sec. 3.  Advancing Supersonic Research and Development.  (a)  The Director of the Office of Science and Technology Policy (OSTP) shall, in consultation with the heads of relevant executive departments and agencies (agencies), including the Secretary of Defense, the Secretary of Commerce, the Secretary of Transportation, and the Administrator of the National Aeronautics and Space Administration, coordinate supersonic research and development through the National Science and Technology Council, with the goal of:
(i) identifying RDT&E needs for regulatory development, commercial viability, and operational integration of supersonic aircraft into the National Airspace System;
(ii) coordinating federally funded RDT&E and industry-led testing of supersonic technologies at Federal test sites; and
(iii) collecting and sharing the results of such RDT&E in a manner suitable for informing domestic regulatory development and international science and technology engagement on civil supersonic matters.
(b)  The Director of OSTP shall provide the results of the coordinated efforts in subsection (a) of this section to the Administrator of the FAA to inform the development of future procedures, regulations, and policies, including those related to the certification of civil supersonic aircraft and noise and environmental standards called for in this section 3.

Sec. 4.  Promoting International Engagement on Civil Supersonic Flight Regulations.  (a)  The Secretary of Transportation, acting through the Administrator of the FAA, and in consultation with the Director of OSTP and the heads of other agencies as considered appropriate by the Director of OSTP, shall engage the International Civil Aviation Organization and key foreign partners to seek global alignment regarding supersonic regulatory approaches.
(b)  The Administrator of the FAA, under the supervision of the Secretary of Transportation and in coordination with the Secretary of State, shall seek to secure bilateral aviation safety agreements with foreign aviation authorities as necessary for the safe international operation of supersonic aircraft.

Sec. 5.  General Provisions.  (a)  Nothing in this order shall be construed to impair or otherwise affect:
(i)   the authority granted by law to an executive department or agency, or the head thereof; or
(ii)  the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.
(b)  This order shall be implemented consistent with applicable law and subject to the availability of appropriations.
(c)  This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.
(d) The costs for publication of this order shall be borne by the Federal Aviation Administration.

                               DONALD J. TRUMP

THE WHITE HOUSE,
    June 6, 2025.