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.