What Is (and What Is Not) on Trump and Kennedy’s Make America Healthy Again Public Health Agenda

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The same day Robert F. Kennedy, Jr. was sworn in as Secretary of Health and Human Services, the White House issued an Executive Order (EO) and a fact sheet to establish a “Make America Healthy Again” (MAHA) Commission. These pronouncements give us a sense of the public health priorities for the new Administration, with their focus on an “escalating health crisis” driven by a greater prevalence of chronic diseases such as cancer, cardiovascular disease, and diabetes affecting both children and adults. Notably, developmental conditions such as autism, and mental health issues generally, are mentioned as important components of this crisis.

As solutions to these very real health issues, the documents call for the federal government health agencies to “aggressively combat” chronic health threats with “fresh thinking” in areas such as nutrition, physical activity, healthy lifestyles, and medication practices, as well as environmental hazards and the quality and safety of foods and drugs. Rooting out “conflicts of interest” features prominently, with the need for “transparency” mentioned four times in the EO alone. All of this is very much in keeping with the problems and policies that Kennedy and other MAHA figures have highlighted in appearances and op-eds. Some of the more specific policy prescriptions previously championed by Kennedy include: reducing exposure to additives and other harmful substances in foods (though as HHS Secretary, he’s not in a position to directly address most aspects of food policy), banning fluoride in drinking water (which remains primarily a state and local, not federal, policy choice), and increasing research into and use of “preventative, alternative and holistic approaches” such as gym memberships, dietary supplements, and psychedelics. We might expect the Commission to highlight such policies when it releases its MAHA strategy, which the EO requires within 180 days.

However, it is also worth noting what these pronouncements do not mention. The words “vaccine” and “infectious” do not appear, even as the nation faces a burgeoning measles outbreak and the threat of avian flu. Substance use (including alcohol and opioids) is not featured, though U.S. deaths from these occur at a rate six times higher than in 1980. Gun violence, a leading cause of death for young people, is another notable absence. And, as for potential policy solutions, increasing people’s access to health coverage and care does not appear in the MAHA mission statement, nor is there any indication the Commission’s scope will encompass the broader social issues inextricably linked to chronic disease and poor health in general, such as poverty, lack of educational attainment and inadequate housing. In addition, possible future cuts to Medicaid currently being contemplated could reduce health coverage and curtail access to chronic disease care, mental health services, and other supports provided to low-income vulnerable populations.

Simultaneously, through DOGE, the White House could be undermining the federal public health infrastructure that would be responsible for implementing sweeping new health initiatives via cuts to the federal workforce and relevant institutional capacities such as the National Institutes of Health, the Food and Drug Administration, and the Centers for Disease Control and Prevention. It is unclear how the MAHA Commission will square its goal to “tackle the health crisis facing America” with such major challenges not addressed and a shrinking, less capable health infrastructure.