Promoted research and innovation in healthcare to ensure that American patients have access to the best treatment in the world. • Signed first-ever executive order to affirm that it is the official policy of the United States Government to protect patients with pre-existing conditions. • Passed Right To Try to give terminally ill patients access to lifesaving cures. • Signed an executive order to fight kidney disease with more transplants and better treatment. • Signed into law a $1 billion increase in funding for critical Alzheimer’s research. • Accelerated medical breakthroughs in genetic treatments for Sickle Cell disease. • Finalized the interoperability rules that will give American patients access to their electronic health records on their phones. • Initiated an effort to provide $500 million over the next decade to improve pediatric cancer research. • Launched a campaign to end the HIV/AIDS epidemic in America in the next decade. • Started a program to provide the HIV prevention drug PrEP to uninsured patients for free. • Signed an executive order and awarded new development contracts to modernize the influenza vaccine. Protected our Nation’s seniors by safeguarding and strengthening Medicare. • Updated the way Medicare pays for innovative medical products to ensure beneficiaries have access to the latest innovation and treatment. • Reduced improper payments for Medicare an estimated $15 billion since 2016 protecting taxpayer dollars and leading to less fraud, waste, and abuse. • Took rapid action to combat antimicrobial resistance and secure access to life-saving new antibiotic drugs for American seniors, by removing several financial disincentives and setting policies to reduce inappropriate use. • Launched new online tools, including eMedicare, Blue Button 2.0, and Care Compare, to help seniors see what is covered, compare costs, streamline data, and compare tools available on Medicare.gov. • Provided new Medicare Advantage supplemental benefits, including modifications to help keep seniors safe in their homes, respite care for caregivers, non-opioid pain management alternatives like therapeutic massages, transportation, and more in-home support services and assistance. • Protected Medicare beneficiaries by removing Social Security numbers from all Medicare cards, a project completed ahead of schedule. • Unleashed unprecedented transparency in Medicare and Medicaid data to spur research and innovation.

Remaking the Federal Judiciary Appointed a historic number of Federal judges who will interpret the Constitution as written. • Nominated and confirmed over 230 Federal judges. • Confirmed 54 judges to the United States Courts of Appeals, making up nearly a third of the entire appellate bench. • Filled all Court of Appeals vacancies for the first time in four decades. • Flipped the Second, Third, and Eleventh Circuits from Democrat-appointed majorities to Republican-appointed majorities. And dramatically reshaped the long-liberal Ninth Circuit. Appointed three Supreme Court justices, expanding its conservative-appointed majority to 6-3. • Appointed Justice Neil Gorsuch to replace Justice Antonin Scalia. • Appointed Justice Brett Kavanaugh to replace Justice Anthony Kennedy. • Appointed Justice Amy Coney Barrett to replace Justice Ruth Bader Ginsburg.

Achieving a Secure Border Secured the Southern Border of the United States. • Built over 400 miles of the world’s most robust and advanced border wall. • Illegal crossings have plummeted over 87 percent where the wall has been constructed. • Deployed nearly 5,000 troops to the Southern border. In addition, Mexico deployed tens of thousands of their own soldiers and national guardsmen to secure their side of the US-Mexico border. • Ended the dangerous practice of Catch-and-Release, which means that instead of aliens getting released into the United States pending future hearings never to be seen again, they are detained pending removal, and then ultimately returned to their home countries. • Entered into three historic asylum cooperation agreements with Honduras, El Salvador, and Guatemala to stop asylum fraud and resettle illegal migrants in third-party nations pending their asylum applications. • Entered into a historic partnership with Mexico, referred to as the “Migrant Protection Protocols,” to safely return asylum-seekers to Mexico while awaiting hearings in the United States. Fully enforced the immigration laws of the United States. • Signed an executive order to strip discretionary Federal grant funding from deadly sanctuary cities. • Fully enforced and implemented statutorily authorized “expedited removal” of illegal aliens. • The Department of Justice prosecuted a record-breaking number of immigration-related crimes. • Used Section 243(d) of the Immigration and Nationality Act (INA) to reduce the number of aliens coming from countries whose governments refuse to accept their nationals who were ordered removed from the United States. Ended asylum fraud, shut down human smuggling traffickers, and solved the humanitarian crisis across the Western Hemisphere. • Suspended, via regulation, asylum for aliens who had skipped previous countries where they were eligible for asylum but opted to “forum shop” and continue to the United States. • Safeguarded migrant families, and protected migrant safety, by promulgating new regulations under the Flores Settlement Agreement. • Proposed regulations to end the practice of giving free work permits to illegal aliens lodging meritless asylum claims. • Issued “internal relocation” guidance. • Cross-trained United States Border Patrol agents to conduct credible fear screenings alongside USCIS (United States Citizenship and Immigration Services) adjudication personnel to reduce massive backlogs. • Streamlined and expedited the asylum hearing process through both the Prompt Asylum Claim Review (PACR) and the Humanitarian Asylum Review Process (HARP). • Launched the Family Fraud Initiative to identify hundreds of individuals who were fraudulently presenting themselves as family units at the border, oftentimes with trafficking children, in order to ensure child welfare. • Improved screening in countries with high overstay rates and reduced visa overstay rates in many of these countries. • Removed bureaucratic constraints on United States consular officers that reduced their ability to appropriately vet visa applicants. • Worked with Mexico and other regional partners to dismantle the human smuggling networks in our hemisphere that profit from human misery and fuel the border crisis by exploiting vulnerable populations. Secured our Nation’s immigration system against criminals and terrorists. • Instituted national security travel bans to keep out terrorists, jihadists, and violent extremists, and implemented a uniform security and information-sharing baseline all nations must meet in order for their nationals to be able to travel to, and emigrate to, the United States. • Suspended refugee resettlement from the world’s most dangerous and terror-afflicted regions. • Rebalanced refugee assistance to focus on overseas resettlement and burden-sharing. • 85 percent reduction in refugee resettlement. • Overhauled badly-broken refugee security screening process. • Required the Department of State to consult with states and localities as part of the Federal government’s refugee resettlement process. • Issued strict sanctions on countries that have failed to take back their own nationals. • Established the National Vetting Center, which is the most advanced and comprehensive visa screening system anywhere in the world. Protected American workers and taxpayers. • Issued a comprehensive “public charge” regulation to ensure newcomers to the United States are financially self-sufficient and not reliant on welfare. • Created an enforcement mechanism for sponsor repayment and deeming, to ensure that people who are presenting themselves as sponsors are actually responsible for sponsor obligations. • Issued regulations to combat the horrendous practice of “birth tourism.” • Issued a rule with the Department of Housing and Urban Development (HUD) to make illegal aliens ineligible for public housing. • Issued directives requiring Federal agencies to hire United States workers first and prioritizing the hiring of United States workers wherever possible. • Suspended the entry of low-wage workers that threaten American jobs. • Finalized new H-1B regulations to permanently end the displacement of United States workers and modify the administrative tools that are required for H-1B visa issuance. • Defended United States sovereignty by withdrawing from the United Nations’ Global Compact on Migration. • Suspended Employment Authorization Documents for aliens who arrive illegally between ports of entry and are ordered removed from the United States. • Restored integrity to the use of Temporary Protected Status (TPS) by strictly adhering to the statutory conditions required for TPS.

Restoring American Leadership Abroad Restored America’s leadership in the world and successfully negotiated to ensure our allies pay their fair share for our military protection. • Secured a $400 billion increase in defense spending from NATO (North Atlantic Treaty Organization) allies by 2024, and the number of members meeting their minimum obligations more than doubled. • Credited by Secretary General Jens Stoltenberg for strengthening NATO. • Worked to reform and streamline the United Nations (UN) and reduced spending by $1.3 billion. • Allies, including Japan and the Republic of Korea, committed to increase burden-sharing. • Protected our Second Amendment rights by announcing the United States will never ratify the UN Arms Trade Treaty. • Returned 56 hostages and detainees from more than 24 countries. • Worked to advance a free and open Indo-Pacific region, promoting new investments and expanding American partnerships. Advanced peace through strength. • Withdrew from the horrible, one-sided Iran Nuclear Deal and imposed crippling sanctions on the Iranian Regime. • Conducted vigorous enforcement on all sanctions to bring Iran’s oil exports to zero and deny the regime its principal source of revenue. • First president to meet with a leader of North Korea and the first sitting president to cross the demilitarized zone into North Korea. • Maintained a maximum pressure campaign and enforced tough sanctions on North Korea while negotiating de-nuclearization, the release of American hostages, and the return of the remains of American heroes. • Brokered economic normalization between Serbia and Kosovo, bolstering peace in the Balkans. • Signed the Honk Kong Autonomy Act and ended the United States’ preferential treatment with Hong Kong to hold China accountable for its infringement on the autonomy of Hong Kong. • Led allied efforts to defeat the Chinese Communist Party’s efforts to control the international telecommunications system. Renewed our cherished friendship and alliance with Israel and took historic action to promote peace in the Middle East. • Recognized Jerusalem as the true capital of Israel and quickly moved the American Embassy in Israel to Jerusalem. • Acknowledged Israel’s sovereignty over the Golan Heights and declared that Israeli settlements in the West Bank are not inconsistent with international law. • Removed the United States from the United Nations Human Rights Council due to the group’s blatant anti-Israel bias. • Brokered historic peace agreements between Israel and Arab-Muslim countries, including the United Arab Emirates, the Kingdom of Bahrain, and Sudan. • In addition, the United States negotiated a normalization agreement between Israel and Morocco, and recognized Moroccan Sovereignty over the entire Western Sahara, a position with long standing bipartisan support.

•	Signed the Fix NICS Act to keep guns out of the hands of dangerous criminals.
•	Signed the STOP School Violence Act and created a Commission on School Safety to examine ways to make our schools safer.
•	Launched the Foster Youth to Independence initiative to prevent and end homelessness among young adults under the age of 25 who are in, or have recently left, the foster care system.
•	Signed the Trafficking Victims Protection Reauthorization Act, which tightened criteria for whether countries are meeting standards for eliminating trafficking.
•	Established a task force to help combat the tragedy of missing or murdered Native American women and girls.
•	Prioritized fighting for the voiceless and ending the scourge of human trafficking across the Nation, through a whole of government back by legislation, executive action, and engagement with key industries.
•	Created the first-ever White House position focused solely on combating human trafficking.

Cherishing Life and Religious Liberty Steadfastly supported the sanctity of every human life and worked tirelessly to prevent government funding of abortion. • Reinstated and expanded the Mexico City Policy, ensuring that taxpayer money is not used to fund abortion globally. • Issued a rule preventing Title X taxpayer funding from subsiding the abortion industry. • Supported legislation to end late-term abortions. • Cut all funding to the United Nations population fund due to the fund’s support for coercive abortion and forced sterilization. • Signed legislation overturning the previous administration’s regulation that prohibited states from defunding abortion facilities as part of their family planning programs. • Fully enforced the requirement that taxpayer dollars do not support abortion coverage in Obamacare exchange plans. • Stopped the Federal funding of fetal tissue research. • Worked to protect healthcare entities and individuals’ conscience rights – ensuring that no medical professional is forced to participate in an abortion in violation of their beliefs. • Issued an executive order reinforcing requirement that all hospitals in the United States provide medical treatment or an emergency transfer for infants who are in need of emergency medical care—regardless of prematurity or disability. • Led a coalition of countries to sign the Geneva Consensus Declaration, declaring that there is no international right to abortion and committing to protecting women’s health. • First president in history to attend the March for Life. Stood up for religious liberty in the United States and around the world. • Protected the conscience rights of doctors, nurses, teachers, and groups like the Little Sisters of the Poor. • First president to convene a meeting at the United Nations to end religious persecution. • Established the White House Faith and Opportunity Initiative. • Stopped the Johnson Amendment from interfering with pastors’ right to speak their minds. • Reversed the previous administration’s policy that prevented the government from providing disaster relief to religious organizations. • Protected faith-based adoption and foster care providers, ensuring they can continue to serve their communities while following the teachings of their faith. • Reduced burdensome barriers to ensure Native Americans are free to keep spiritually and culturally significant eagle feathers found on their tribal lands. • Took action to ensure Federal employees can take paid time off work to observe religious holy days. • Signed legislation to assist religious and ethnic groups targeted by ISIS for mass murder and genocide in Syria and Iraq. • Directed American assistance toward persecuted communities, including through faith-based programs. • Launched the International Religious Freedom Alliance – the first-ever alliance devoted to confronting religious persecution around the world. • Appointed a Special Envoy to monitor and combat anti-Semitism. • Imposed restrictions on certain Chinese officials, internal security units, and companies for their complicity in the persecution of Uighur Muslims in Xinjiang. • Issued an executive order to protect and promote religious freedom around the world.

Safeguarding the Environment Took strong action to protect the environment and ensure clean air and clean water. • Took action to protect vulnerable Americans from being exposed to lead and copper in drinking water and finalized a rule protecting children from lead-based paint hazards. • Invested over $38 billion in clean water infrastructure. • In 2019, America achieved the largest decline in carbon emissions of any country on earth. Since withdrawing from the Paris Climate Accord, the United States has reduced carbon emissions more than any nation. • American levels of particulate matter – one of the main measures of air pollution – are approximately five times lower than the global average. • Between 2017 and 2019, the air became 7 percent cleaner – indicated by a steep drop in the combined emissions of criteria pollutants. • Led the world in greenhouse gas emissions reductions, having cut energy-related CO2 emissions by 12 percent from 2005 to 2018 while the rest of the world increased emissions by 24 percent. • In FY 2019 the Environmental Protection Agency (EPA) cleaned up more major pollution sites than any year in nearly two decades. • The EPA delivered $300 million in Brownfields grants directly to communities most in need including investment in 118 Opportunity Zones. • Placed a moratorium on offshore drilling off the coasts of Georgia, North Carolina, South Carolina, and Florida. • Restored public access to Federal land at Bears Ears National Monument and Grand Staircase-Escalante National Monument. • Recovered more endangered or threatened species than any other administration in its first term. Secured agreements and signed legislation to protect the environment and preserve our Nation’s abundant national resources. • The USMCA guarantees the strongest environmental protections of any trade agreement in history. • Signed the Save Our Seas Act to protect our environment from foreign nations that litter our oceans with debris and developed the first-ever Federal strategic plan to address marine litter. • Signed the Great American Outdoors Act, securing the single largest investment in America’s National Parks and public lands in history. • Signed the largest public lands legislation in a decade, designating 1.3 million new acres of wilderness. • Signed a historic executive order promoting much more active forest management to prevent catastrophic wildfires. • Opened and expanded access to over 4 million acres of public lands for hunting and fishing. • Joined the One Trillion Trees Initiative to plant, conserve, and restore trees in America and around the world. • Delivered infrastructure upgrades and investments for numerous projects, including over half a billion dollars to fix the Herbert Hoover Dike and expanding funding for Everglades restoration by 55 percent.

Expanding Educational Opportunity Fought tirelessly to give every American access to the best possible education. • The Tax Cuts and Jobs Act expanded School Choice, allowing parents to use up to $10,000 from a 529 education savings account to cover K-12 tuition costs at the public, private, or religious school of their choice. • Launched a new pro-American lesson plan for students called the 1776 Commission to promote patriotic education. • Prohibited the teaching of Critical Race Theory in the Federal government. • Established the National Garden of American Heroes, a vast outdoor park that will feature the statues of the greatest Americans to ever live. • Called on Congress to pass the Education Freedom Scholarships and Opportunity Act to expand education options for 1 million students of all economic backgrounds. • Signed legislation reauthorizing the D.C. Opportunity Scholarship program. • Issued updated guidance making clear that the First Amendment right to Free Exercise of Religion does not end at the door to a public school. Took action to promote technical education. • Signed into law the Strengthening Career and Technical Education for the 21st Century Act, which provides over 13 million students with high-quality vocational education and extends more than $1.3 billion each year to states for critical workforce development programs. • Signed the INSPIRE Act which encouraged NASA to have more women and girls participate in STEM and seek careers in aerospace. • Allocated no less than $200 million each year in grants to prioritize women and minorities in STEM and computer science education. Drastically reformed and modernized our educational system to restore local control and promote fairness. • Restored state and local control of education by faithfully implementing the Every Student Succeeds Act. • Signed an executive order that ensures public universities protect First Amendment rights or they will risk losing funding, addresses student debt by requiring colleges to share a portion of the financial risk, and increases transparency by requiring universities to disclose information about the value of potential educational programs. • Issued a rule strengthening Title IX protections for survivors of sexual misconduct in schools, and that – for the first time in history – codifies that sexual harassment is prohibited under Title IX. • Negotiated historic bipartisan agreement on new higher education rules to increase innovation and lower costs by reforming accreditation, state authorization, distance education, competency-based education, credit hour, religious liberty, and TEACH Grants. Prioritized support for Historically Black Colleges and Universities. • Moved the Federal Historically Black Colleges and Universities (HBCU) Initiative back to the White House. • Signed into law the FUTURE Act, making permanent $255 million in annual funding for HBCUs and increasing funding for the Federal Pell Grant program. • Signed legislation that included more than $100 million for scholarships, research, and centers of excellence at HBCU land-grant institutions. • Fully forgave $322 million in disaster loans to four HBCUs in 2018, so they could fully focus on educating their students. • Enabled faith-based HBCUs to enjoy equal access to Federal support.

Combatting the Opioid Crisis Brought unprecedented attention and support to combat the opioid crisis. • Declared the opioid crisis a nationwide public health emergency. • Secured a record $6 billion in new funding to combat the opioid epidemic. • Signed the SUPPORT for Patients and Communities Act, the largest-ever legislative effort to address a drug crisis in our Nation’s history. • Launched the Initiative to Stop Opioid Abuse and Reduce Drug Supply and Demand in order to confront the many causes fueling the drug crisis. • The Department of Health and Human Services (HHS) awarded a record $9 billion in grants to expand access to prevention, treatment, and recovery services to States and local communities. • Passed the CRIB Act, allowing Medicaid to help mothers and their babies who are born physically dependent on opioids by covering their care in residential pediatric recovery facilities. • Distributed $1 billion in grants for addiction prevention and treatment. • Announced a Safer Prescriber Plan that seeks to decrease the amount of opioids prescriptions filled in America by one third within three years. • Reduced the total amount of opioids prescriptions filled in America. • Expanded access to medication-assisted treatment and life-saving Naloxone. • Launched FindTreatment.gov, a tool to find help for substance abuse. • Drug overdose deaths fell nationwide in 2018 for the first time in nearly three decades.

•	Launched the Drug-Impaired Driving Initiative to work with local law enforcement and the driving public at large to increase awareness.
•	Launched a nationwide public ad campaign on youth opioid abuse that reached 58 percent of young adults in America.
•	Since 2016, there has been a nearly 40 percent increase in the number of Americans receiving medication-assisted treatment.
•	Approved 29 state Medicaid demonstrations to improve access to opioid use disorder treatment, including new flexibility to cover inpatient and residential treatment.
•	Approved nearly $200 million in grants to address the opioid crisis in severely affected communities and to reintegrate workers in recovery back into the workforce.

Took action to seize illegal drugs and punish those preying on innocent Americans. • In FY 2019, ICE HSI seized 12,466 pounds of opioids including 3,688 pounds of fentanyl, an increase of 35 percent from FY 2018. • Seized tens of thousands of kilograms of heroin and thousands of kilograms of fentanyl since 2017. • The Department of Justice (DOJ) prosecuted more fentanyl traffickers than ever before, dismantled 3,000 drug trafficking organizations, and seized enough fentanyl to kill 105,000 Americans. • DOJ charged more than 65 defendants collectively responsible for distributing over 45 million opioid pills. • Brought kingpin designations against traffickers operating in China, India, Mexico, and more who have played a role in the epidemic in America. • Indicted major Chinese drug traffickers for distributing fentanyl in the U.S for the first time ever, and convinced China to enact strict regulations to control the production and sale of fentanyl. • •