The Trump administration has increased federal intervention in private industry, with the executive branch now holding equity stakes in more than 30 companies. These holdings are concentrated in the semiconductor, minerals, and quantum computing sectors. While some members of Congress and organizations like the U.S. Chamber of Commerce continue to advocate for traditional free-market principles, the administration has pursued a populist economic agenda that includes government-owned shares and tariffs.
This shift toward government ownership began in the summer of 2025, when the federal government acquired a 10 percent stake in Intel. The move was intended to support the American semiconductor industry against international competition. Since then, the administration has expanded its portfolio, leading some analysts at the American Enterprise Institute and the Cato Institute to observe that the Republican Party’s economic policy is moving toward more interventionist models traditionally associated with the Democratic Party.
In a separate move involving federal oversight, Vice President JD Vance and Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. are investigating hospitals for alleged insurance billing fraud. An HHS report released last week alleges that clinics misused diagnostic codes to obtain reimbursements for gender-affirming care for minors. The report identified approximately $50 million in claims for puberty blockers using "unspecified" endocrine disorder codes and $11 million for early puberty diagnoses in patients over age 13.
The healthcare billing investigation directly impacts Medicaid enrollees and medical providers. A new HHS rule finalized last week already prohibits federal Medicaid or CHIP funds from covering puberty blockers, hormone therapy, or surgery for individuals under age 18 (or 19 for CHIP). For the 200 clinics referred to the Justice Department, the outcome could range from legal settlements to a total loss of federal reimbursements. Medicaid beneficiaries in these programs would notice a immediate loss of coverage for these specific treatments due to the new regulation, while the medical industry faces a broader "reckoning" regarding billing practices and diagnostic coding.
The knock-on effects extend to the internal politics of the Republican movement, where traditional free-market proponents now find themselves at odds with the administration’s populist approach. While groups like Concerned Women for America support the crackdown on billing "upcoding," others express concern that these interventions set a precedent that future Democratic administrations could use to further expand government reach into the private sector. The next steps include potential Justice Department investigations into the 200 named clinics and ongoing debates within the GOP regarding the ethics of IVF coverage, as the Labor Department considers a rule to expand those benefits.