Trump and RFK Jr.’s Policies Will Make America Sick

Take air pollution. The idea that Americans are being ​“poisoned” by seed oils, as Kennedy has asserted, is not based on science. But there is no debate that breathing particulate matter into one’s lungs is hazardous to lung and heart health: air pollution is linked with nearly 48,000 premature deaths a year in the United States. Yet in his first term, Trump rejected stricter limits on air pollution levels, weakened emissions standards for automobiles, and undermined restrictions limiting the pollution that power plants can dump into our water and skies. The Biden administration changed course on each count. Trump is now returning to office promising to shred every manner of regulation, explicitly including Biden’s power plant regulations, which by EPA estimates could lead to an additional 1,200 premature deaths and 1,900 cases of asthma per year. 

It is also unlikely that Trump will improve childhood nutrition, whatever the claims of Kennedy and his MAHA entourage. No one disagrees that poor nutrition drives childhood (and adult) obesity and metabolic disease, and that policy changes are urgently needed. First and foremost, we could tackle childhood poverty, an important driver of poor nutritional outcomes (for instance, nearly one in five children from low-income families are obese, a rate 70% higher that of children from higher income families). However, welfare state expansion is hardly on offer on the Republican menu, nor for that matter is the return of universal free school lunches — a short-lived pandemic-era achievement that could be extremely beneficial, particularly if coupled with strengthened nutritional requirements for school meals. But these were degraded by Trump the last time he had the chance: as the Washington Post reported, his administration proposed rules to ​“allow schools to cut the amount of vegetables and fruits required at lunch and breakfasts while giving them license to sell more pizza, burgers and fries to students.” 

It is equally doubtful that Trump will upgrade pharmaceutical regulation. RFK Jr. is correct that direct-to-consumer drug advertising should be scrapped, although the conventional wisdom is that the Supreme Court would block such a move as unconstitutional. It is also true that industry influence (and some degree of regulatory capture) has contributed to diluted efficacy standards for drug approval at the Food and Drug Administration (FDA). However, Kennedy’s ideas about efficacious therapies are unmoored from reality: he recently posted on X that he would end the FDA’s ​“aggressive suppression” of various dubious nostrums, like ivermectin, raw milk, ​“nutraceuticals,” chelating compounds, hydroxychloroquine, and ​“anything else that advances human health.” 

Meanwhile, Trump’s nominee for HHS deputy secretary — biotech investor and Peter Thiel-associate Jim O’Neill — at one point argued that the FDA should not even consider efficacy when initially approving drugs, an idea that would bring us back to the pre-Thalidomide regulatory era. Other nominees similarly fail to inspire confidence. Surgeon and television personality Mehmet Oz, Trump’s nominee to head the Centers for Medicare and Medicaid Services (CMS), was condemned by his own medical colleagues at Columbia University for peddling supplements and other snake oil products, while his nominee for FDA Commissioner — surgeon Marty Makary — has a slew of conflicts-of-interest with healthcare firms, including a telehealth corporation, a drug firm, an insurance provider, and an insurance broker, as Politico reported. Hardly a merry band ready and set to raise regulatory standards for drug approval based on the soundest science. 

Finally, there is the issue of healthcare affordability, coverage, and access. Medical care has been a key driver of rising life expectancy in recent decades, particularly through advances in the management of cardiovascular disease. Yet such advances can only help those who can afford and obtain care, a number that is likely to fall under Trump. During his first term, Trump and Republicans in Congress made an all-out push to repeal the Affordable Care Act, and almost succeeded in stripping healthcare from more than 20 million Americans while degrading protections for the chronically ill. Had the ACA repeal bill been signed into law, tens of thousands more Americans would likely have died preventable deaths each year. It is likely that Trump and Congressional Republicans will make another go at healthcare legislation this time around, even if it is not branded an ​“Obamacare repeal”: they are, for instance, eying big Medicaid cuts to fund their next round of tax cuts for the rich, a maneuver that could strip healthcare from millions — some of whom will die as a consequence. 

It is, however, not enough to critique the hypocrisies of MAHA. Undoubtedly, the slogan draws support from some of those with legitimate health concerns, particularly about undue corporate influence over our healthcare, medicines, food and water. Compared to those in other wealthy nations, we do indeed lead starkly shorter lives. In 2024, almost half of working-age Americans faced uninsurance or underinsurance. A populist, progressive vision of health — one that uses sound science to tackle corporate greed and achieve single-payer universal healthcare, better food for all, clean air and water, and more — is needed to confront the pseudoscientific health populism of the Right, as Sen. Bernie Sanders (I-Vt.) recently proposed in his own nine-point plan to ​“Make America Healthy Again.” Meanwhile, we must be clear-sighted about the role that MAHA will play in the next Trump administration and be prepared to fight back: it will be a smokescreen for a reactionary agenda that puts the prerogatives of corporations and the wealthy above the lives of ordinary people — policies that, quite simply, will make America sick.